Factors that influence the feasibility and implementation of a complex intervention to improve the treatment of peripheral arterial disease in primary and secondary care: a qualitative exploration of patient and provider perspectives

Objectives Our aim was to examine the feasibility and implementation of a complex intervention to improve the care of patients with peripheral arterial disease (the LEGS intervention) from the perspective of patients, general practitioners and secondary care clinicians.Design A qualitative study inv...

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Main Authors: Athanasios Saratzis, Vanessa Lawrence, Ruth Benson, Emma Watson, Prakash Saha, Clair Le Boutillier, Bernadeta Bridgwood
Format: Article
Language:English
Published: BMJ Publishing Group 2023-01-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/13/1/e066883.full
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author Athanasios Saratzis
Vanessa Lawrence
Ruth Benson
Emma Watson
Prakash Saha
Clair Le Boutillier
Bernadeta Bridgwood
author_facet Athanasios Saratzis
Vanessa Lawrence
Ruth Benson
Emma Watson
Prakash Saha
Clair Le Boutillier
Bernadeta Bridgwood
author_sort Athanasios Saratzis
collection DOAJ
description Objectives Our aim was to examine the feasibility and implementation of a complex intervention to improve the care of patients with peripheral arterial disease (the LEGS intervention) from the perspective of patients, general practitioners and secondary care clinicians.Design A qualitative study involving semistructured individual interviews with patients and providers to gain an understanding of the feasibility of the LEGS intervention as well the barriers and facilitators to implementation in secondary and primary care.Setting Primary and secondary care settings across two National Health Service Trusts.Participants Twenty-five semistructured telephone interviews were conducted with (1) patients who had received the intervention (n=11), (2) secondary care clinicians responsible for delivering the intervention (n=8) and (3) general practitioners (n=6).Analysis Data were initially analysed using inductive descriptive thematic analysis. The consolidated framework for implementation research was then used as a matrix to explore patterns in the data and to map connections between the three participant groups. Lastly, interpretive analysis allowed for refining, and a final coding frame was developed.Results Four overarching themes were identified: (1) the potential to make a difference, (2) a solution to address the gap in no man’s land, (3), prioritising and making it happen and (4) personalised information and supportive conversations for taking on the advice. The impetus for prioritising and delivering the intervention was further driven by its flexibility and adaptability to be tailored to the individual and to the environment.Conclusions The LEGS intervention can be tailored for use at early and late stages of peripheral arterial disease, provides an opportunity to meet patient needs and can be used to promote shared working across the primary–secondary care interface.
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spelling doaj.art-5ff25992c77743f395e4bbe6e0a9efdc2023-01-24T00:30:09ZengBMJ Publishing GroupBMJ Open2044-60552023-01-0113110.1136/bmjopen-2022-066883Factors that influence the feasibility and implementation of a complex intervention to improve the treatment of peripheral arterial disease in primary and secondary care: a qualitative exploration of patient and provider perspectivesAthanasios Saratzis0Vanessa Lawrence1Ruth Benson2Emma Watson3Prakash Saha4Clair Le Boutillier5Bernadeta Bridgwood6The Leicester Vascular Institute, University of Leicester, Leicester, UK2 Health Service & Population Research Department, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, UKUniversity of Birmingham, Birmingham, UKNHS Highland, UKsenior house officer in surgeryDepartment of Health Services & Population Research, King’s College London, London, UKNIHR Cardiovascular Sciences, University of Leicester, Leicester, UKObjectives Our aim was to examine the feasibility and implementation of a complex intervention to improve the care of patients with peripheral arterial disease (the LEGS intervention) from the perspective of patients, general practitioners and secondary care clinicians.Design A qualitative study involving semistructured individual interviews with patients and providers to gain an understanding of the feasibility of the LEGS intervention as well the barriers and facilitators to implementation in secondary and primary care.Setting Primary and secondary care settings across two National Health Service Trusts.Participants Twenty-five semistructured telephone interviews were conducted with (1) patients who had received the intervention (n=11), (2) secondary care clinicians responsible for delivering the intervention (n=8) and (3) general practitioners (n=6).Analysis Data were initially analysed using inductive descriptive thematic analysis. The consolidated framework for implementation research was then used as a matrix to explore patterns in the data and to map connections between the three participant groups. Lastly, interpretive analysis allowed for refining, and a final coding frame was developed.Results Four overarching themes were identified: (1) the potential to make a difference, (2) a solution to address the gap in no man’s land, (3), prioritising and making it happen and (4) personalised information and supportive conversations for taking on the advice. The impetus for prioritising and delivering the intervention was further driven by its flexibility and adaptability to be tailored to the individual and to the environment.Conclusions The LEGS intervention can be tailored for use at early and late stages of peripheral arterial disease, provides an opportunity to meet patient needs and can be used to promote shared working across the primary–secondary care interface.https://bmjopen.bmj.com/content/13/1/e066883.full
spellingShingle Athanasios Saratzis
Vanessa Lawrence
Ruth Benson
Emma Watson
Prakash Saha
Clair Le Boutillier
Bernadeta Bridgwood
Factors that influence the feasibility and implementation of a complex intervention to improve the treatment of peripheral arterial disease in primary and secondary care: a qualitative exploration of patient and provider perspectives
BMJ Open
title Factors that influence the feasibility and implementation of a complex intervention to improve the treatment of peripheral arterial disease in primary and secondary care: a qualitative exploration of patient and provider perspectives
title_full Factors that influence the feasibility and implementation of a complex intervention to improve the treatment of peripheral arterial disease in primary and secondary care: a qualitative exploration of patient and provider perspectives
title_fullStr Factors that influence the feasibility and implementation of a complex intervention to improve the treatment of peripheral arterial disease in primary and secondary care: a qualitative exploration of patient and provider perspectives
title_full_unstemmed Factors that influence the feasibility and implementation of a complex intervention to improve the treatment of peripheral arterial disease in primary and secondary care: a qualitative exploration of patient and provider perspectives
title_short Factors that influence the feasibility and implementation of a complex intervention to improve the treatment of peripheral arterial disease in primary and secondary care: a qualitative exploration of patient and provider perspectives
title_sort factors that influence the feasibility and implementation of a complex intervention to improve the treatment of peripheral arterial disease in primary and secondary care a qualitative exploration of patient and provider perspectives
url https://bmjopen.bmj.com/content/13/1/e066883.full
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