Mini-symposium 3 - Successfully (mis)translating organisational interventions from research to practice: experience from three large trials of complex interventions to improve primary care prescribing safety

Aim and intended outcome The aim is to increase understanding among participants of strategies to successfully translate research-evaluated complex interventions into routine organisation and practice, including understanding of strategies which increase the likelihood of translation and discussion of the range of outcomes which count as ‘success'.Format Ninety-minute mini-symposium comprising three groups of presentations shifting from initially relatively didactic (what the literature tells us about successful translation) through more narrative (the translational story as it has played out in the prescribing safety context) to interactive (drawing on the experience of the audience for mutual learning).Content The formal presentations will draw on our experience of working with the NHS to translate the findings of three large trials of complex interventions to improve prescribing safety into routine practice. The PINCER, DQIP and EFIPPS trials between them involved more than 350 UK general practices, and evaluated both pharmacist and GP-led interventions of varying intensity. Although two of them are not yet published (all are complete), the trials have already had significant impact, but the road to wider implementation is neither smooth nor linear, and the implemented interventions are not necessarily those evaluated in the trials.Part 1: What does the literature tell us about strategies to promote successful translation? A brief review of barriers and facilitators of translation into policy and practice, and strategies to maximise translationBruce GuthriePart 2: Brief summary of the three prescribing interventions trialled and their effectiveness

• Tony Avery - PINCER (education and feedback, pharmacist-led review, 70 practices)
• Bruce Guthrie - EFIPPS (education and feedback, 262 practices)
• Tobias Dreischulte - DQIP (education and feedback, financial incentives, GP-led review, 33 practices)

Part 3: An honest account of translational strategies and what has actually got implemented so far including how NHS implementation differs from the interventions trialled

• Tony Avery - PINCER (cited in NICE medicines optimisation guidance, downloadable searches available to all English practices, QOF QIPP indicator incentivising use)
• Bruce Guthrie - EFIPPS and DQIP (searches available to all Scottish practices, measures built into National Therapeutic Indicators, multiple Health Boards have included in prescribing improvement work, implementation toolkit being developed by Scottish Patient Safety Programme)

Part 4: Interactive componentAt the start of the symposium we will invite people to prepare to talk for ~1 minute about their best or worst experience of translation, and what two key lessons they learned from this experience. We will start the session with 5-10 such narratives, followed by discussion to identify common themes in success and failure, and strategies to consider at different stages of the research process.Intended audience Researchers at any career stage, commissioners and clinicians.

Credits

• Bruce Guthrie