Scaling up a polypharmacy Action Learning Sets tool: interim findings and methodological insights

Brooks, Cindy, Argyropoulos, Anastasios, Matheson, Catherine, Guerrero-Luduena, Richard, Kryl, David, George, Ruth, Rowse, Vicki and Howard, Clare (2019) Scaling up a polypharmacy Action Learning Sets tool: interim findings and methodological insights. Implementation Science, 14 (Suuplement 2). (doi:10.1186/s13012-019-0911-5).

Abstract

Background

In line with national policy, to address the issues associated with inappropriate polypharmacy, the Centre for Implementation Science are evaluating the implementation of a Wessex Academic Health Science Network led Action Learning Sets (ALS) tool, to improve healthcare practitioners’ confidence, perceptions and experiences of stopping inappropriate medicines safely.

Methods

Up to 125 healthcare practitioners attending ALS across three localities in the South of England are being invited to participate in the study. A mixed method approach involving pre-post ALS questionnaires, evaluation forms and observational methods, will be used to evaluate the study.

To date, interim findings have been analysed from one locality (n=33), and methodological insights recorded which relate to the prospective scale up and evaluation of the ALS across two further localities. Quantitative paired pre-post ALS questionnaire responses were analysed using the Wilcoxon signed-rank test, whilst qualitative data were analysed using thematic analysis and ethnographic methods. Overall impact of the ALS will be evaluated using Kirkpatrick’s evaluation model.

Results

Interim findings show the ALS has contributed to improving perceptions, confidence and experiences in addressing polypharmacy and more specifically perceptions of; stopping inappropriate medicines, use of knowledge, information and tools, shared decision making with patients/clinicians and the role of institutional factors. Methodological insights relating to the scale-up of the ALS across two further localities include the impact of locality upon participation, as well as the process of engagement of participants in the evaluation.

Conclusion

Interim findings and methodological insights in scaling up the study may be of relevance to national policy to understand how to address polypharmacy issues in different localities.

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Contributors

Author: Cindy Brooks

Author: Richard Guerrero-Luduena

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