Defining ‘usual care' in trials of complex interventions
نویسندگان
چکیده
Background Defining ‘usual care’ in studies of health services is challenging as it comprises a large variety of locally variable services. Building Blocks is trialling the Family Nurse Partnership Programme (FNP) in England. FNP is a complex intervention provided to first-time teenage mothers in the community setting. It was developed and previously trialled in the USA where support services are very different. To fully interpret trial results, particularly when making international comparisons, insight into the control condition is essential.
منابع مشابه
Bench-to-bedside review: The evaluation of complex interventions in critical care
Complex interventions, such as the introduction of medical emergency teams or an early goal-directed therapy protocol, are developed from a number of components that may act both independently and inter-dependently. There is an emerging body of literature advocating the use of integrated complex interventions to optimise the treatment of critically ill patients. As with any other treatment, com...
متن کاملتاثیر آموزش به روش بازخوردمحور بر خودمراقبتی بیماران مبتلا به نارسایی قلبی
Background and purpose: Heart failure is one of the most common chronic diseases with high mortality rate. Self-care training is effective in reducing the number of hospitalizations and improves the quality of life in these patients. However, the influence of such training was not found to be viable in previous interventions. This study was conducted to determine the effect of training based on...
متن کاملUsual and unusual care: existing practice control groups in randomized controlled trials of behavioral interventions.
OBJECTIVE To evaluate the use of existing practice control groups in randomized controlled trials of behavioral interventions and the role of extrinsic health care services in the design and conduct of behavioral trials. METHOD Selective qualitative review. RESULTS Extrinsic health care services, also known as nonstudy care, have important but under-recognized effects on the design and cond...
متن کاملDefining usual care: do we need to think beyond clinical equipoise? A synthesis and secondary analysis of multiple qualitative data sets
Pragmatic mental health trials often have a ‘usual care’ arm. To date, no one has explored in detail what this arm actually entails. This presents difficulties for those recruiting individuals to trials and prevents researchers fully appreciating the reasons underlying any differences found between the clinical outcomes of different trial arms. We synthesized data collected during four qualitat...
متن کاملIt Is Not That Simple nor Compelling!; Comment on “Translating Evidence Into Healthcare Policy and Practice: Single Versus Multi-faceted Implementation Strategies – Is There a Simple Answer to a Complex Question?”
Healthcare decisions are often made under pressure, with varying levels of information in a changing clinical context. With limited resources and a focus on improving patient outcomes, healthcare managers and health professionals strive to implement both clinical and cost-effective care. However, the gap between research evidence and health policy/clinical practice persists despite our best eff...
متن کاملذخیره در منابع من
با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید
عنوان ژورنال:
دوره 14 شماره
صفحات -
تاریخ انتشار 2013