Effect of core versus enhanced implementation strategies on adherence to a clinical pathway for managing anxiety and depression in cancer patients in routine care: a cluster randomised controlled trial

Table 7 Differences between arms in adherence (continuous outcome)

Variable	Mean adherence (95% CI)	Mean difference to referent^b	95% Confidence interval	p value
Step 1^a
Core	91.5 (88.5–94.6)	Referent
Enhanced	90.6 (87.7–93.4)	− 1.00	− 5.14–3.15	0.64
Step 2
Core	48.1 (44.1–52.2)	Referent
Enhanced	50.9 (45.8–56.0)	2.78	− 3.74–9.29	0.40
Step 3
Core	51.4 (46.9–55.8)	Referent
Enhanced	59.0 (52.9–65.0)	7.61	0.084–15.14	0.048
Step 4
Core	46.8 (41.2–52.4)	Referent
Enhanced	56.3 (48.2–64.4)	9.46	− 0.38–19.29	0.06
Interaction between step allocation and implementation arm				0.025

^aStep 1 = minimal anxiety/depression, Step 2 = mild anxiety/depression, Step 3 = moderate anxiety/depression, Step 4 = severe anxiety/depression, Step 5 = very severe anxiety/depression but no patients scored in this Step
^bMeans have been adjusted for persons (due to repeated screens) and site (due to cluster randomisation)

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