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Designing an implementation strategy to improve interprofessional shared decision making in sciatica: study protocol of the DISC study

BACKGROUND: Sciatica is a common condition worldwide that is characterized by radiating leg pain and regularly caused by a herniated disc with nerve root compression. Sciatica patients with persisting leg pain after six to eight weeks were found to have similar clinical outcomes and associated costs...

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Autores principales: Hofstede, Stefanie N, Marang-van de Mheen, Perla J, Assendelft, Willem JJ, Vleggeert-Lankamp, Carmen LA, Stiggelbout, Anne M, Vroomen, Patrick CAJ, van den Hout, Wilbert B, Vliet Vlieland, Thea PM, van Bodegom-Vos, Leti
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2012
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3465186/
https://www.ncbi.nlm.nih.gov/pubmed/22704251
http://dx.doi.org/10.1186/1748-5908-7-55
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author Hofstede, Stefanie N
Marang-van de Mheen, Perla J
Assendelft, Willem JJ
Vleggeert-Lankamp, Carmen LA
Stiggelbout, Anne M
Vroomen, Patrick CAJ
van den Hout, Wilbert B
Vliet Vlieland, Thea PM
van Bodegom-Vos, Leti
author_facet Hofstede, Stefanie N
Marang-van de Mheen, Perla J
Assendelft, Willem JJ
Vleggeert-Lankamp, Carmen LA
Stiggelbout, Anne M
Vroomen, Patrick CAJ
van den Hout, Wilbert B
Vliet Vlieland, Thea PM
van Bodegom-Vos, Leti
author_sort Hofstede, Stefanie N
collection PubMed
description BACKGROUND: Sciatica is a common condition worldwide that is characterized by radiating leg pain and regularly caused by a herniated disc with nerve root compression. Sciatica patients with persisting leg pain after six to eight weeks were found to have similar clinical outcomes and associated costs after prolonged conservative treatment or surgery at one year follow-up. Guidelines recommend that the team of professionals involved in sciatica care and patients jointly decide about treatment options, so-called interprofessional shared decision making (SDM). However, there are strong indications that SDM for sciatica patients is not integrated in daily practice. We designed a study aiming to explore the barriers and facilitators associated with the everyday embedding of SDM for sciatica patients. All related relevant professionals and patients are involved to develop a tailored strategy to implement SDM for sciatica patients. METHODS: The study consists of two phases: identification of barriers and facilitators and development of an implementation strategy. First, barriers and facilitators are explored using semi-structured interviews among eight professionals of each (para)medical discipline involved in sciatica care (general practitioners, physical therapists, neurologists, neurosurgeons, and orthopedic surgeons). In addition, three focus groups will be conducted among patients. Second, the identified barriers and facilitators will be ranked using a questionnaire among a representative Dutch sample of 200 GPs, 200 physical therapists, 200 neurologists, all 124 neurosurgeons, 200 orthopedic surgeons, and 100 patients. A tailored team-based implementation strategy will be developed based on the results of the first phase using the principles of intervention mapping and an expert panel. DISCUSSION: Little is known about effective strategies to increase the uptake of SDM. Most implementation strategies only target a single discipline, whereas multiple disciplines are involved in SDM among sciatica patients. The results of this study can be used as an example for implementing SDM in other patient groups receiving multidisciplinary complex care (e.g., elderly) and can be generalized to other countries with similar context, thereby contributing to a worldwide increase of SDM in preference sensitive choices.
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spelling pubmed-34651862012-10-06 Designing an implementation strategy to improve interprofessional shared decision making in sciatica: study protocol of the DISC study Hofstede, Stefanie N Marang-van de Mheen, Perla J Assendelft, Willem JJ Vleggeert-Lankamp, Carmen LA Stiggelbout, Anne M Vroomen, Patrick CAJ van den Hout, Wilbert B Vliet Vlieland, Thea PM van Bodegom-Vos, Leti Implement Sci Study Protocol BACKGROUND: Sciatica is a common condition worldwide that is characterized by radiating leg pain and regularly caused by a herniated disc with nerve root compression. Sciatica patients with persisting leg pain after six to eight weeks were found to have similar clinical outcomes and associated costs after prolonged conservative treatment or surgery at one year follow-up. Guidelines recommend that the team of professionals involved in sciatica care and patients jointly decide about treatment options, so-called interprofessional shared decision making (SDM). However, there are strong indications that SDM for sciatica patients is not integrated in daily practice. We designed a study aiming to explore the barriers and facilitators associated with the everyday embedding of SDM for sciatica patients. All related relevant professionals and patients are involved to develop a tailored strategy to implement SDM for sciatica patients. METHODS: The study consists of two phases: identification of barriers and facilitators and development of an implementation strategy. First, barriers and facilitators are explored using semi-structured interviews among eight professionals of each (para)medical discipline involved in sciatica care (general practitioners, physical therapists, neurologists, neurosurgeons, and orthopedic surgeons). In addition, three focus groups will be conducted among patients. Second, the identified barriers and facilitators will be ranked using a questionnaire among a representative Dutch sample of 200 GPs, 200 physical therapists, 200 neurologists, all 124 neurosurgeons, 200 orthopedic surgeons, and 100 patients. A tailored team-based implementation strategy will be developed based on the results of the first phase using the principles of intervention mapping and an expert panel. DISCUSSION: Little is known about effective strategies to increase the uptake of SDM. Most implementation strategies only target a single discipline, whereas multiple disciplines are involved in SDM among sciatica patients. The results of this study can be used as an example for implementing SDM in other patient groups receiving multidisciplinary complex care (e.g., elderly) and can be generalized to other countries with similar context, thereby contributing to a worldwide increase of SDM in preference sensitive choices. BioMed Central 2012-06-15 /pmc/articles/PMC3465186/ /pubmed/22704251 http://dx.doi.org/10.1186/1748-5908-7-55 Text en Copyright ©2012 Hofstede et al.; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Study Protocol
Hofstede, Stefanie N
Marang-van de Mheen, Perla J
Assendelft, Willem JJ
Vleggeert-Lankamp, Carmen LA
Stiggelbout, Anne M
Vroomen, Patrick CAJ
van den Hout, Wilbert B
Vliet Vlieland, Thea PM
van Bodegom-Vos, Leti
Designing an implementation strategy to improve interprofessional shared decision making in sciatica: study protocol of the DISC study
title Designing an implementation strategy to improve interprofessional shared decision making in sciatica: study protocol of the DISC study
title_full Designing an implementation strategy to improve interprofessional shared decision making in sciatica: study protocol of the DISC study
title_fullStr Designing an implementation strategy to improve interprofessional shared decision making in sciatica: study protocol of the DISC study
title_full_unstemmed Designing an implementation strategy to improve interprofessional shared decision making in sciatica: study protocol of the DISC study
title_short Designing an implementation strategy to improve interprofessional shared decision making in sciatica: study protocol of the DISC study
title_sort designing an implementation strategy to improve interprofessional shared decision making in sciatica: study protocol of the disc study
topic Study Protocol
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3465186/
https://www.ncbi.nlm.nih.gov/pubmed/22704251
http://dx.doi.org/10.1186/1748-5908-7-55
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