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Table 2 Research questions and evaluation

From: Integrated solutions for sustainable fall prevention in primary care, the iSOLVE project: a type 2 hybrid effectiveness-implementation design

Study outcomes Research questions Measurement
Effectiveness Will iSOLVE be effective in reducing falls in patients of participating practices compared to control practices? Falls over 12 months—recorded daily on monthly calendars
Will iSOLVE increase general practitioners’ engagement in fall prevention management and referral practices compared to the control GPs? Pre-post survey of GPs in trial—management of fall prevention and any changes in practice (Q11: frequency of risk factor assessment, medication review, advice); referral patterns (Q12: frequency of referral and to whom); knowledge of fall prevention services.
Will iSOLVE be effective in reducing burden of drug risk and polypharmacy in use of drugs associated with falls in patients of participating practices compared to control practices? Drug Burden Index; Falls Risk Increasing Drugs (FRID); Changes in polypharmacy and in use of drugs associated with falls (e.g., psychotropics).
Will iSOLVE be cost effective from a healthcare funder perspective, and expressed as an incremental cost per fall avoided? Falls and Health care utilization—monthly calendars intervention costs—staff, training, capital costs, consumables.
Will patients in the intervention group report significantly higher interaction with their GP about fall prevention and engagement in fall prevention activities compared to the control group? Pre-post patient survey.
Implementation How are the iSOLVE strategies adopted (or not) by general practitioners (GPs), by Allied health professional’s (AHP)), and by the primary care network?
How does this change practice in fall prevention?
How does this influence the nature of pathways for identifying older people at risk and managing fall risk within primary care?
In-depth interviews with a sample of the participating trial GPs, AHPs participating in the workshops and with key coordinating stakeholders, such as Primary Care Network staff
What are the factors that facilitate embedding of the intervention in usual care? In-depth interviews as above
Meeting minutes, observations, and field notes.
AHP planning strategies document from the workshops.
What factors will influence sustainability of training and knowledge translation for GPs, AHPs and community pharmacist? In-depth interviews of GPs and AHPs as above
Pre- and post surveys of AHPs who participate in the workshops
AHP planning strategies document from the workshops
What is the GPs professional network in relation to fall prevention and who is influential within their network? Relational network (who and influence) questions in survey for trial GPs. Network influence question in AHPs survey and in the ecological survey of GPs in geographical area of SNPHN
How effective is iSOLVE dissemination across the SNPHN network? Geographical survey of GPs in SNPHN