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Table 2 Final decision process using APEASE

From: Development of an intervention to facilitate implementation and uptake of diabetic retinopathy screening

Component Decision
included
✗ excluded
Who When Rationale for inclusion based on APEASE criteria
Briefing/training on the intervention • To overcome organisational barriers.
Audit and feedback Practice nurse At baseline and at six months • Component demonstrated effectiveness.
• Advise practices that nurse should conduct audit if practical but allow practices to decide locally.
Reimbursement • To overcome organisational barriers. Should be considered reimbursement rather than incentive as asking practices to do something extra not doing existing work better
Electronic prompt Administrator Every appointment • Component demonstrated effectiveness.
• Based on practicality, advise practices that administrator should add prompts but allow practices to decide locally.
• Alerts cannot be added selectively to the type of patient consultation (i.e. review vs. opportunistic) therefore occurring at every appointment based on practicality.
• Alert fatigue could be an issue if patient has many alerts on their file.
Information leaflet
 Enhanced/Endorsed GP or practice nurse By post, and opportunistically in appointment also • Component demonstrated effectiveness and is practical.
• GP/Nurse most effective as represent BCT (‘Information from a credible source’). Delivery modes practical within general practice.
 Narrative • Personal narrative not practical. To be most effective requires several different iterations (ages, gender, stage of disease). Generic narrative may not be acceptable to all.
• GP/Nurse most effective as represent BCT (‘Information from a credible source’).
Reminder message
 Face to face GP or practice nurse Part of every consultation; prompted by electronic alert on patient file • Component demonstrated effectiveness and is practical.
• GP/Nurse most effective as represent BCT (‘Information from a credible source’). Delivery modes practical within general practice.
 Phone call Practice nurse • Component demonstrated effectiveness and is practical. Delivery mode is sustainable within general practice as fits within existing practices, and equitable as possible to reach most patients using this approach.
• Nurse most practical and effective as represents BCT (‘Information from a credible source’). First considered administrative staff making the phone calls; however, if there is a script and probing it becomes an education opportunity and makes more sense for practice nurse to deliver this component.
 Follow-up letter GP • Component demonstrated effectiveness and is practical. Delivery mode is sustainable within general practice as fits within existing practices, and equitable as possible to reach most patients using this approach.
 Text message • Confidentiality (safety) concerns, that is, the wrong individual could access and read text messages). Not all patients may own or use mobile phones, as such, the mode may not be equitable. Not all practices use this mode and will have established acceptable consent processes, therefore not practical.