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Healthcare practitioners' experiences of an intervention to detect and treat patients with liver disease (the LOCATE intervention): a qualitative process evaluation

Healthcare practitioners' experiences of an intervention to detect and treat patients with liver disease (the LOCATE intervention): a qualitative process evaluation
Healthcare practitioners' experiences of an intervention to detect and treat patients with liver disease (the LOCATE intervention): a qualitative process evaluation

OBJECTIVES: The local care and treatment of liver disease (LOCATE) intervention embedded specialist liver nurses in general practitioner (GP) practices to improve the identification of progressive liver disease, enabling earlier intervention. This current process evaluation examines GP practice staffs' perceptions of the LOCATE intervention, in order to understand any potential barriers to successful implementation in clinical practice.

STUDY DESIGN AND SETTING: A qualitative process evaluation nested within the LOCATE feasibility trial, using semistructured interviews with practice staff from five GP surgeries in the UK.

PARTICIPANTS: A purposive sample of 29 interviews with practice staff (GPs, nurses, practice managers).

DATA COLLECTION: Interview transcripts were subjected to thematic analysis.

FINDINGS: The intervention was found to be acceptable to practice staff and a number of barriers and facilitators to the success of the intervention were identified. However, interviews suggested that the intervention did not provide sufficient guidance for clinicians to be able to help patients make the behavioural changes needed to reduce risk factors associated with liver disease. The intervention did appear to improve clinician awareness and knowledge about liver disease, enabling GPs to feel more confident interpreting and managing liver function blood tests in order to identify the early signs of liver disease.

CONCLUSIONS: This study enabled identification of potential barriers to implementation of specialist nurses in primary care to identify progressive liver disease and enable earlier intervention. The next steps are to improve the intervention to make it more feasible to implement in practice and more likely to help patients to make the behavioural changes required to prevent a major liver event.

TRIAL REGISTRATION NUMBER: 13/SC/0012; Post-results.

ETHICS: This study was reviewed and approved by NRES Committee South Central-Hampshire A, Bristol Research Ethics Committee Centre, level 3, block B, Whitefriars, Lewins Mead Bristol BS1 2NT.

Adult, Aged, Attitude of Health Personnel, Early Diagnosis, Elasticity Imaging Techniques, Female, General Practice, General Practitioners, Health Personnel, Hepatitis, Autoimmune, Hepatitis, Viral, Human, Humans, Liver/diagnostic imaging, Liver Cirrhosis/diagnosis, Liver Diseases/diagnosis, Liver Diseases, Alcoholic, Male, Middle Aged, Non-alcoholic Fatty Liver Disease, Nurse Clinicians, Nurses, Practice Management, Medical, Process Assessment, Health Care, Qualitative Research, Risk Reduction Behavior, United Kingdom
2044-6055
e028591
Reinson, Tina
929fcf68-3a7d-42e4-9efd-e9d188b2b9c8
Bradbury, Katherine
87fce0b9-d9c5-42b4-b041-bffeb4430863
Moore, Michael
1be81dad-7120-45f0-bbed-f3b0cc0cfe99
Sheron, Nick
cbf852e3-cfaa-43b2-ab99-a954d96069f1
Reinson, Tina
929fcf68-3a7d-42e4-9efd-e9d188b2b9c8
Bradbury, Katherine
87fce0b9-d9c5-42b4-b041-bffeb4430863
Moore, Michael
1be81dad-7120-45f0-bbed-f3b0cc0cfe99
Sheron, Nick
cbf852e3-cfaa-43b2-ab99-a954d96069f1

Reinson, Tina, Bradbury, Katherine, Moore, Michael and Sheron, Nick (2019) Healthcare practitioners' experiences of an intervention to detect and treat patients with liver disease (the LOCATE intervention): a qualitative process evaluation. BMJ Open, 9 (5), e028591, [e028591]. (doi:10.1136/bmjopen-2018-028591).

Record type: Article

Abstract

OBJECTIVES: The local care and treatment of liver disease (LOCATE) intervention embedded specialist liver nurses in general practitioner (GP) practices to improve the identification of progressive liver disease, enabling earlier intervention. This current process evaluation examines GP practice staffs' perceptions of the LOCATE intervention, in order to understand any potential barriers to successful implementation in clinical practice.

STUDY DESIGN AND SETTING: A qualitative process evaluation nested within the LOCATE feasibility trial, using semistructured interviews with practice staff from five GP surgeries in the UK.

PARTICIPANTS: A purposive sample of 29 interviews with practice staff (GPs, nurses, practice managers).

DATA COLLECTION: Interview transcripts were subjected to thematic analysis.

FINDINGS: The intervention was found to be acceptable to practice staff and a number of barriers and facilitators to the success of the intervention were identified. However, interviews suggested that the intervention did not provide sufficient guidance for clinicians to be able to help patients make the behavioural changes needed to reduce risk factors associated with liver disease. The intervention did appear to improve clinician awareness and knowledge about liver disease, enabling GPs to feel more confident interpreting and managing liver function blood tests in order to identify the early signs of liver disease.

CONCLUSIONS: This study enabled identification of potential barriers to implementation of specialist nurses in primary care to identify progressive liver disease and enable earlier intervention. The next steps are to improve the intervention to make it more feasible to implement in practice and more likely to help patients to make the behavioural changes required to prevent a major liver event.

TRIAL REGISTRATION NUMBER: 13/SC/0012; Post-results.

ETHICS: This study was reviewed and approved by NRES Committee South Central-Hampshire A, Bristol Research Ethics Committee Centre, level 3, block B, Whitefriars, Lewins Mead Bristol BS1 2NT.

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More information

Accepted/In Press date: 16 April 2019
Published date: 22 May 2019
Additional Information: © Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.
Keywords: Adult, Aged, Attitude of Health Personnel, Early Diagnosis, Elasticity Imaging Techniques, Female, General Practice, General Practitioners, Health Personnel, Hepatitis, Autoimmune, Hepatitis, Viral, Human, Humans, Liver/diagnostic imaging, Liver Cirrhosis/diagnosis, Liver Diseases/diagnosis, Liver Diseases, Alcoholic, Male, Middle Aged, Non-alcoholic Fatty Liver Disease, Nurse Clinicians, Nurses, Practice Management, Medical, Process Assessment, Health Care, Qualitative Research, Risk Reduction Behavior, United Kingdom

Identifiers

Local EPrints ID: 432030
URI: http://eprints.soton.ac.uk/id/eprint/432030
ISSN: 2044-6055
PURE UUID: b9d1a6ef-1583-4b0d-88c3-c0ea57dbaf22
ORCID for Tina Reinson: ORCID iD orcid.org/0000-0002-2436-1906
ORCID for Katherine Bradbury: ORCID iD orcid.org/0000-0001-5513-7571
ORCID for Michael Moore: ORCID iD orcid.org/0000-0002-5127-4509
ORCID for Nick Sheron: ORCID iD orcid.org/0000-0001-5232-8292

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Date deposited: 27 Jun 2019 16:30
Last modified: 06 Jun 2024 02:09

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Contributors

Author: Tina Reinson ORCID iD
Author: Michael Moore ORCID iD
Author: Nick Sheron ORCID iD

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