Autopsy of a failed trial part 1: A qualitative investigation of clinician's views on and experiences of the implementation of the DAISIES trial in UK-based intensive eating disorder services

被引：3

作者：

Phillips, Matthew ^{[1
]}

Ince, Basak ^{[1
]}

Webb, Hannah ^{[1
]}

Dalton, Bethan ^{[1
]}

McCombie, Catherine ^{[2
]}

Irish, Madeleine ^{[1
]}

Mercado, Daniela ^{[1
]}

Peachey, Gemma ^{[3
]}

Zenasni, Zohra ^{[4
]}

Himmerich, Hubertus ^{[1
,3
]}

Robinson, Paul ^{[5
]}

Arcelus, Jon ^{[6
]}

Byford, Sarah ^{[2
]}

Treasure, Janet ^{[1
,3
]}

Landau, Sabine ^{[4
]}

Lawrence, Vanessa ^{[2
]}

Schmidt, Ulrike ^{[1
,3
]}

机构：

[1] Kings Coll London, Inst Psychiat Psychol & Neurosci, Dept Psychol Med, Sect Eating Disorders, London, England

[2] Kings Coll London, Inst Psychiat Psychol & Neurosci, Dept Hlth Serv & Populat Res, London, England

[3] South London & Maudsley NHS Fdn Trust, Maudsley Hosp, London, England

[4] Kings Coll London, Inst Psychiat Psychol & Neurosci, Dept Biostat & Hlth Informat, London, England

[5] UCL, Div Med, London, England

[6] Univ Nottingham, Inst Mental Hlth, Jubilee Campus, Nottingham, England

来源：

EUROPEAN EATING DISORDERS REVIEW | 2023年 / 31卷 / 04期

基金：

英国经济与社会研究理事会;

关键词：

anorexia nervosa; barriers to recruitment; implementation research; intensive treatment; qualitative research; ANOREXIA-NERVOSA; RECRUITMENT;

D O I：

10.1002/erv.2975

中图分类号：

B849 [应用心理学];

学科分类号：

040203 ;

摘要：

Objective: The DAISIES trial, comparing inpatient and stepped-care day patient treatment for adults with severe anorexia nervosa was prematurely terminated in March 2022 due to poor recruitment. This qualitative study seeks to understand the difficulties faced during the trial by investigating stakeholders' views on and experiences of its implementation. Method: Semi-structured interview and focus group transcripts, and trial management and oversight group meeting minutes from May 2020-June 2022 were analysed using thematic analysis. Participants were 47 clinicians and co-investigators involved with the DAISIES trial. The Non-Adoption, Abandonment, Scale-up, Spread, and Sustainability (NASSS) framework was applied to the interpretive themes to classify barriers and facilitators to implementation. Results: Five themes were identified: incompatible participation interests; changing standard practice; concerns around clinical management; systemic capacity and capability issues; and Covid-19 disrupting implementation. Applying the NASSS framework indicated the greatest implementation challenges to arise with the adopters (e.g. patients, clinicians), the organisational systems (e.g. service capacity), and the wider socio-political context (e.g. Covid-19 closing services). Conclusions: Our findings emphasise the top-down impact of systemic-level research implementation challenges. The impact of the Covid-19 pandemic accentuated pre-existing organisational barriers to trial implementation within intensive eating disorder services, further limiting the capacity for research.

引用

页码：489 / 504

页数：16