Study protocol of a mixed-methods evaluation of a cluster randomized trial to improve the safety of NSAID and antiplatelet prescribing

data-driven quality improvement in primary care

Aileen Grant*, Tobias Dreischulte, Shaun Treweek, Bruce Guthrie

*Corresponding author for this work

Research output: Contribution to journalArticle

11 Citations (Scopus)
3 Downloads (Pure)

Abstract

Background: Trials of complex interventions are criticized for being 'black box', so the UK Medical Research Council recommends carrying out a process evaluation to explain the trial findings. We believe it is good practice to pre-specify and publish process evaluation protocols to set standards and minimize bias. Unlike protocols for trials, little guidance or standards exist for the reporting of process evaluations. This paper presents the mixed-method process evaluation protocol of a cluster randomized trial, drawing on a framework designed by the authors.

Methods/design: This mixed-method evaluation is based on four research questions and maps data collection to a logic model of how the data-driven quality improvement in primary care (DQIP) intervention is expected to work. Data collection will be predominately by qualitative case studies in eight to ten of the trial practices, focus groups with patients affected by the intervention and quantitative analysis of routine practice data, trial outcome and questionnaire data and data from the DQIP intervention.

Discussion: We believe that pre-specifying the intentions of a process evaluation can help to minimize bias arising from potentially misleading post-hoc analysis. We recognize it is also important to retain flexibility to examine the unexpected and the unintended. From that perspective, a mixed-methods evaluation allows the combination of exploratory and flexible qualitative work, and more pre-specified quantitative analysis, with each method contributing to the design, implementation and interpretation of the other.

As well as strengthening the study the authors hope to stimulate discussion among their academic colleagues about publishing protocols for evaluations of randomized trials of complex interventions.

Original languageEnglish
Article number154
Number of pages6
JournalTrials
Volume13
DOIs
Publication statusPublished - 28 Aug 2012

Keywords

  • complex interventions
  • process evaluation
  • complex intervention
  • randomized controlled trial
  • mixed methods
  • protocol

Cite this

Study protocol of a mixed-methods evaluation of a cluster randomized trial to improve the safety of NSAID and antiplatelet prescribing : data-driven quality improvement in primary care. / Grant, Aileen; Dreischulte, Tobias; Treweek, Shaun; Guthrie, Bruce.

In: Trials, Vol. 13, 154, 28.08.2012.

Research output: Contribution to journalArticle

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