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Implementation of Findings from Clinical Trials to Inform Evidence into Practice Initiatives

Leads: Dr Kelly-Ann Schmidtke, Dr Amy Grove (Meths), Mr Aneel Bhangu (Long-term Conditions)

The team received funding from Research Design Service West Midlands to discuss early ideas for the project. The project will be working with public contributors linked to ARC WM’S Research Methods Theme to further shape and develop the project.

Dates: September 2020 - January 2022

Background:

Healthcare costs account for a major portion of government budgets and occupy a great deal of policy attention. In 2018/2019, the National Institute for Health Research (NIHR) awarded £317 million of funding to 334 research projects. Approximately one third of these projects were delivered through the Heath Technology Assessment (HTA) program. While demonstrating a return on this investment is challenging, ensuring that NIHR funded research can improve the health and wellbeing of patients is essential.

Policy and Practice Partners:

Candace Imison, the Associate Director of Evidence and Dissemination at the NIHR Centre for Engagement and Dissemination and Lynn Kerridge from NIHR dissemination centre.

Co-Funding Partners:

TBC – NIHR NETSCC, NIHR CED

Aims and Objectives:

We aim to examine the impact of research that has been funded through the NIHR’s HTA programme.

Methods:

To examine impact of research funded through the NIHR’s HTA programme, our research team is currently auditing whether the recommendations made in six HTA studies have been realised in NHS practice using the Hospital Episode Statistics Database, including the FOOD (2006), REACTIV (2006), NESSTAC (2010), REFLUX (2013), KAT (2014), and CLASS (2015) trials. Each quantitative audit will be followed-up with qualitative interviews, with key stakeholders. Interview participants will be purposefully recruited, starting with the HTA studies’ authors, then surgeons those authors recommend and finally other practitioners / administrators those surgeons recommend. The finding with be thematically analysed to highlight the most influential barriers and facilitators according to the Consolidated Framework for Implementation Research (CFIR). To immediately improve future implementation strategies, the research team will examine the links provided between each CFIR constructs and one or more of the 73 discrete implementation strategies best suited to influence it.

Main Results:

We anticipate that our audit will find that few (if any) HTA study recommendations have been realised. While the factors that influence each study may be practically different, large themes will likely materialise quickly. Some strategies to improve future implementation will emerge as more fruitful paths forward.

Conclusions:

In our conclusions, we will offer practical suggestions to help funders, service providers, and researchers employ the recommended implementation strategies. Where possible, we will work with researchers in our institutions to ensure they employ recommended strategies to realise impact from their own NIHR funded studies. The Department of Health has expressed interest in this study, as have international collaborators.

Implications for Implementation:

Clearer pathways for impact should be provided in grant applications to the NIHR and supported by the NIHR engagement and dissemination teams. Interventions that have made a significant change in practice have been identified. Where a change in practice has not occurred the barriers have been identified and ARC WM will work with the appropriate organisations, including the NIHR Centre for Engagement & Dissemination to improve uptake of findings.

Protocol:

A draft protocol is available here.