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Table 1 Study description of empirical studies (N = 13)

From: A scoping review of de-implementation frameworks and models

Author, year Setting Sample characteristics Topic/content area De-implementation intervention Primary action Secondary action Evidence for de-imp. Cost Stakeholder Method Study design Measures used Primary outcomes
Cuttler et al., 2005 [39] Clinical (academic, specialty) Physicians (n = 222) Pediatric specialty medicine Physician decision to terminate growth hormone therapy in pediatric patients Reduce, remove NA Mixed Y Y Mixed methods Cross-sectional Interview; survey Physician recommendation for case Scenarios
Goodwin, 2013 [40] Healthcare (broad) Healthcare manager, staff, and clinicians (n = 13) Reducing low-value care and costs in healthcare Program budgeting and Marginal analysis Reduce NA NR Y Y Mixed methods Case study Interviews; archival data Satisfaction and compliance with pbma process; cost
Grimshaw et al., 2020 [41] Healthcare (broad) Hospitals (n = 137) Preoperative tests; imaging for lower back pain Identify low-value care; identify local priorities; identify barriers and potential interventions; evaluate choosing wisely implementation; spread effective choosing wisely programs Reduce NA Ineffective Y Y Mixed methods Case study Hospital administrative data % reduction in low-value care
Gupta et al., 2019 [42] Hospital Patient records (n = 4,781) Neutropenic diet for immunocompromised patients Multi-step implementation strategy bundle targeting clinician and system-level change (e.g., training, EHR updates) Remove NA Ineffective Y Y Mixed methods Case study Content analysis of neutropenic diet prescribing; EHR review Absolute reduction in prescribing
Harris et al., 2017a [29] Health service network Healthcare experts, steering committee members, workshop attendees (n = 28) Disinvestment of clinically or cost ineffective health services (broadly) Development of deimplementation framework Remove NA NR Y Y Mixed methods Case study Literature review; interview; survey; workshop Development of deimplementation framework
Harris et al., 2017b [43] Health service network Healthcare experts (n = 15), healthcare staff (n = 65), senior administrators (n = 18) Disinvestment of clinically or cost ineffective health services (broadly) Development of deimplementation framework Remove NA NR Y Y Mixed methods Case study Literature review; interview; survey; workshop Describe methods for disinvestment
Harris et al., 2017c [44] Health service network Healthcare experts (n = 15), healthcare staff (n = 65), senior administrators (n = 18) Disinvestment of clinically or cost ineffective health services (broadly) Development of deimplementation framework Remove NA NR Y Y Mixed methods Case study Literature review; interview; survey; workshop Development of deimplementation framework
Harris et al., 2018 [45] Health service network NA Disinvestment of clinically or cost ineffective health services (broadly) Development of deimplementation framework Remove NA NR Y Y Mixed methods Case study Literature review; interview; survey; workshop Development of deimplementation framework
McKay et al., 2017 [46] Non-profit community based organization Organization staff (n = 5); clients (n = 396) HIV prevention Counseling intervention to identify and reduce risk behaviors. De-adoption involved transition of resource to replacement intervention. Remove Replace Ineffective Y N Mixed methods Archival secondary data analysis, interview Data abstraction of agency archival and client records, interviews (with program staff) Intervention deadoption process and consequences
Padek et al., 2018 [47] State health departments Program staff and leaders (n not available in protocol) Cancer prevention and control programs in public health departments NR Reduce NA Ineffective Y Y Mixed methods Study protocol (quantitative crosssectional, qualitative case study, abm simulation) Survey, case studies (interview), abm Mis-implementation of cancer prevention and control programs
Skolarus et al., 2018 [48] Clinical (VA) Patients and physicians (n not available in protocol) Prostate cancer (androgen deprivation therapy) Organization policy and behavior change (assess preferences and barriers; discrete choice experiment; formulary restriction; strategy targeting patient/provider decision making) Reduce Restrict Ineffective, contradicted N Y Mixed methods Study protocol (crosssectional) Interviews, surveys Acceptability, feasibility, scalability
Tangpong et al., 2015 [49] Organization/firm (multiple industries) Organizations (n = 96) Business/management Organizational behavior, layoffs, divestments, geographic exits Reduce Remove, restrict NR Y N Quantitative Longitudinal Survey Likelihood of turnaround success, changes in form operating conditions, internal firm performance, external capital market support
Voorn et al., 2018 [50] Hospital Hospitals (n = 21) Patient blood management in transfusion medicine (surgery) Information provision, goal specification, clinician feedback, benchmark with comparison to best practice hospitals (behavior change) Reduce NA Ineffective Y Y Quantitative Cluster randomized control trial Survey Use of low- value care (esa + blood salvage)
  1. Note: ABM agent-based modeling, N no, NA not applicable, NR not reported, Y yes. For the purposes of this review, “empirical” is defined as collection and analysis of primary data