505 Use of Implementation Science to Identify Implementation Determinants of Chronic Obstructive Pulmonary Disease Practice Guidelines

OBJECTIVES/GOALS: COPD is a progressive airways disease that results in death or disability. There poor uptake of clinical guidelines (CPG) to manage and studies bridge this implementation gap have shown inconsistent results. Using science principles we aim understand COPD-CPG determinants from providers’perspective. METHODS/STUDY POPULATION: The study being conducted ten VA Primary Care Clinics. Guided by the Consolidated Framework for Implementation Research (CFIR), conceptual framework developed guide systematic assessment multilevel contexts, are using semi-structured guides conduct key informant qualitative interviews (physicians, physician extenders nurses), support formative evaluation. CFIR domains relevant were determined multidisciplinary team. Informants identified through online outreach voluntary participation. Sampling adequacy will be assessed achievement code saturation. A template analysis used summarize barriers facilitators each component organized CFIR-domain. RESULTS/ANTICIPATED RESULTS: We anticipate list modifiable non-modifiable contextual, recipient (provider patient), CPG content (innovation) implementation. Many settings do not critical elements these CPG, such as standardized inhaler education/assessment pathway, patient education material, pulmonary rehabilitation referral pathway. Existing literature indicate reasons behind insufficient include low familiarity with guidelines, perception minimal value physicians, time constraints; present innovation specific our setting. DISCUSSION/SIGNIFICANCE: This comprehensive inform tool development strategies identification improve uptake. most common veteran lung disease. Improvement care has enormous potential benefit local veterans, well wider dissemination.