Table 1 Evaluation of feasibility

 Patients

Veterans Affairs multidimensional survey [59] capturing five dimensions related to polypharmacy and deprescribing: “medication concerns,” “provider knowledge,” “interest in stopping medicines,” “unimportance of medicines” and “patient involvement in decision-making.” [106]

Supplemented with interview questions on experience with the process, symptoms (improvements/new), relationship with PCP, empowerment, and care coordination dimensions identified in previous qualitative research as pertinent [41, 106,107,108].

These will be administered at 12 months

 Providers

Semi-structured interviews with selected providers based on the Theoretical Framework of Acceptability [109] (Table 2)

Focus group and survey based on Organizational Readiness to Change Assessment (ORCA) and Data-Driven Quality Improvement in Primary Care (DQIP)

Demand

Coordinator’s log: enrolment and retention of practices and providers

Implementation

Coordinator’s log: ability to apply the SPIDER elements as planned

Project memoranda: implementation facilitators and barriers; best practices

Adaptation

Coordinator’s log: fidelity to SPIDER process, and extent of change required to accommodate SPIDER to the context

Integration

Extent of effective collaboration across sectors (semi-structured interviews with selected practices)

Practicality

Ability to integrate the process into existing practice (semi-structured interview with selected practices)

Efficacy

Potential for approach to achieve desired outcomes: EMR-based PIPs, survey, patient health-related quality of life [110], emergency room visits and hospitalization where available from administrative data

Evaluation

Ability to consistently extract PIPs across PBRNs and derive the outcome measures

Ability to link study participant to health administrative data and extract emergency room data and hospitalization (Ontario)

Completeness of surveys (and individual components) by PCPs and patients and participants’ comments on these (e.g., content, clarity, length)

Participation of PCP and patients in interviews