Martindale, Anne-Marie, Elvey, Rebecca, Howard, Susan J, McCorkindale, Sheila, Sinha, Smeeta and Blakeman, Tom
(2017)
Understanding the implementation of 'sick day guidance' to prevent acute kidney injury across a primary care setting in England: a qualitative evaluation.
BMJ OPEN, 7 (11).
e017241-.
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Understanding the implementation of sick day guidance to prevent acute kidney injury across a primary care setting in Englan.pdf - Published version Download (1MB) | Preview |
Abstract
<h4>Objectives</h4>The study sought to examine the implementation of sick day guidance cards designed to prevent acute kidney injury (AKI), in primary care settings.<h4>Design</h4>Qualitative semistructured interviews were conducted and comparative analysis informed by normalisation process theory was undertaken to understand sense-making, implementation and appraisal of the cards and associated guidance.<h4>Setting</h4>A single primary care health setting in the North of England.<h4>Participants</h4>29 participants took part in the qualitative evaluation: seven general practitioners, five practice nurses, five community pharmacists, four practice pharmacists, two administrators, one healthcare assistant and five patients.<h4>Intervention</h4>The sick day guidance intervention was rolled out (2015-2016) in general practices (n=48) and community pharmacies (n=60). The materials consisted of a 'medicine sick day guidance' card, provided to patients who were taking the listed drugs. The card provided advice about medicines management during episodes of acute illness. An information leaflet was provided to healthcare practitioners and administrators suggesting how to use and give the cards.<h4>Results</h4>Implementation of sick day guidance cards to prevent AKI entailed a new set of working practises across primary care. A tension existed between ensuring reach in administration of the cards to at risk populations while being confident to ensure patient understanding of their purpose and use. Communicating the concept of temporary cessation of medicines was a particular challenge and limited their administration to patient populations at higher risk of AKI, particularly those with less capacity to self-manage.<h4>Conclusions</h4>Sick day guidance cards that focus solely on medicines management may be of limited patient benefit without adequate resourcing or if delivered as a standalone intervention. Development and evaluation of primary care interventions is urgently warranted to tackle the harm associated with AKI.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | Humans, Anti-Inflammatory Agents, Non-Steroidal, Angiotensin-Converting Enzyme Inhibitors, Attitude of Health Personnel, Qualitative Research, Pharmacies, Primary Health Care, England, Interviews as Topic, Patient Education as Topic, Angiotensin Receptor Antagonists, General Practice, Acute Kidney Injury |
| Divisions: | Faculty of Health and Life Sciences Faculty of Health and Life Sciences > Institute of Infection, Veterinary and Ecological Sciences |
| Depositing User: | Symplectic Admin |
| Date Deposited: | 17 Jun 2021 12:50 |
| Last Modified: | 13 Feb 2024 09:22 |
| DOI: | 10.1136/bmjopen-2017-017241 |
| Open Access URL: | http://dx.doi.org/10.1136/bmjopen-2017-017241 |
| Related URLs: | |
| URI: | https://livrepository.liverpool.ac.uk/id/eprint/3126725 |
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