Palliative Care and Advance Care Planning Intervention Fidelity Monitoring: Methods and Lessons Learned From PCORI-Funded Large-Scale, Pragmatic Clinical Trials.

IF 4.3 3区 材料科学 Q1 ENGINEERING, ELECTRICAL & ELECTRONIC
ACS Applied Electronic Materials Pub Date : 2024-10-01 Epub Date: 2024-09-06 DOI:10.1097/MLR.0000000000002037
Manisha Verma, Corita R Grudzen, Seiko Izumi, Neil Wenger, Areej El-Jawahri, Deborah Ejem, Rebecca A Aslakson
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引用次数: 0

Abstract

Over the past decade, the Patient-Centered Outcomes Research Institute (PCORI) funded multiple large-scale, comparative effectiveness clinical trials evaluating palliative care and advance care planning interventions. These are complex multicomponent interventions that need robust but flexible fidelity monitoring. Fidelity is necessary to maintain both internal and external validity within palliative care intervention research and to ultimately evaluate the real-world impact of high-quality interventions. Different trials not only took varying approaches to fidelity monitoring but also uncovered both unique and common challenges and facilitators. This article summarizes 8 of these trials and highlights approaches, adaptations, barriers, and facilitators for intervention fidelity monitoring. Identifying and delivering core elements while simultaneously allowing adaptations of noncore elements is a vital part of fidelity monitoring. Dissemination of such experiences can inform both future palliative care research as well as ongoing implementation of palliative care and advance care planning interventions across diverse clinical practices. Adoption of rigorous intervention fidelity methods is critical to advancing the science and reproducibility of palliative care interventions.

姑息关怀和预先护理计划干预的忠实性监测:从 PCORI 资助的大规模务实临床试验中汲取的方法和经验。
在过去的十年中,以患者为中心的结果研究所(PCORI)资助了多项大规模的比较有效性临床试验,对姑息关怀和预先护理规划干预措施进行评估。这些都是复杂的多成分干预措施,需要强有力但灵活的保真度监测。为了在姑息关怀干预研究中保持内部和外部有效性,并最终评估高质量干预措施在现实世界中的影响,保真度是必不可少的。不同的试验不仅采取了不同的忠实性监控方法,而且还发现了独特和共同的挑战和促进因素。本文总结了其中的 8 项试验,并重点介绍了干预忠实性监控的方法、调整、障碍和促进因素。确定和提供核心要素,同时允许对非核心要素进行调整,是忠实性监控的重要组成部分。这些经验的传播可以为未来的姑息关怀研究以及在不同临床实践中持续实施姑息关怀和预先医疗规划干预提供信息。采用严格的干预忠实性方法对于推进姑息关怀干预的科学性和可重复性至关重要。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
7.20
自引率
4.30%
发文量
567
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