An embedded mixed-methods study highlighted a lack of discussions on retention in clinical trial consultations

Acknowledgments The authors would like to acknowledge the trial participants, Surgeons and Research Nurses for agreeing to be audio-recorded as part of the main trial. Thanks also to Professor Craig Ramsay and Mr Irfan Ahmed the Chief Investigators of the trial. Thanks also to Karen Innes the Trial Manager and Becky Bruce the Data Coordinator for their support of the study. Ethics approval and consent to participate: This study was approved through the parent trial from NHS North of Scotland Research Ethics Committee (16/NS/0053). Informed consent was obtained from all participants. Declarations of interest: None. Role of funding source: KG held a Medical Research Council UK Methodology Fellowship during the delivery of this project (MR/L01193X/1). The Health Services Research Unit, Institute of Applied Health Sciences (University of Aberdeen), is core-funded by the Chief Scientist Office of the Scottish Government Health and Social Care Directorates. The funders had no involvement in study design, collection, analysis and interpretation of data, reporting or the decision to publish.Peer reviewedPostprin

Channelling the force of audit and feedback : averting the dark side

Funding EMD is funded through a personal fellowship from the Healthcare Improvement Studies Institute, supported by the Health Foundation’s grant to the University of Cambridge. JMG holds a Canada Research Chair in Health Knowledge Transfer and Uptake. NMI holds a Canada Research Chair in Implementation of Evidence-based PracticePeer reviewedPostprin

Alcohol use during pregnancy: an application of the theory of planned behavior.

The objective of this research was to apply the theory of planned behavior (TPB; Ajzen, 1988, 1991) to alcohol use during pregnancy. Of the pregnant women (N=130) who participated in the study, over one third reported consuming alcohol (34.8%), and the greatest proportion were drinking 2 to 4 times per month (16.4%). Binary logistic regression was conducted, and the full TPB model was able to distinguish between drinkers and abstainers, explaining 57.1% to 77.1% of the variance in drinking behavior. The TPB provides insight into reasons behind the behavior and can be usefully applied, both as a screening tool to identify pregnant women drinking during pregnancy and as an avenue for intervention work

Challenges and opportunities for conducting pre-hospital trauma trials : a behavioural investigation

Acknowledgements We would like to thank the participants for dedicating their time to be interviewed. We extend our thanks to Claire Cochran for facilitating recruitment. Funding LL was supported by a Wellcome Trust Institutional Strategic Support Fund award (reference RG13793-49). The Health Services Research Unit, Institute of Applied Health Sciences (University of Aberdeen), is core-funded by the Chief Scientist Office of the Scottish Government Health and Social Care Directorates. The funders had no involvement in the study design, collection, analysis, and interpretation of data, reporting, or the decision to publish.Peer reviewedPublisher PD

Active ingredients are reported more often for pharmacologic than non-pharmacologic interventions: an illustrative review of reporting practices in titles and abstracts

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Pharmacist and Data-driven Quality Improvement in Primary Care (P-DQIP):A qualitative study of anticipated implementation factors informed by the Theoretical Domains Framework

Objectives: The quality and safety of drug therapy in primary care are global concerns. The Pharmacist and Data driven Quality Improvement in Primary care (P-DQIP) intervention aims to improve prescribing safety via an informatics tool which facilitates proactive management of drug therapy risks (DTRs) by health-board employed pharmacists with established roles in general practices. Study objectives were (1) to identify and prioritise factors that could influence P-DQIP implementation from the perspective of practice pharmacists, and (2) to identify potentially effective, acceptable and feasible strategies to support P-DQIP implementation. Design: Semi-structured face-to-face interviews using a Theoretical Domains Framework (TDF) informed topic guide. The framework method was used for data analysis. Identified implementation factors were prioritised for intervention based on research team consensus. Candidate intervention functions, behaviour change techniques (BCTs) and policies targeting these were identified from the Behaviour Change Wheel. The final intervention content and modes of delivery were agreed with local senior pharmacists. Setting: General practices from three Health and Social Care Partnerships (HSCPs) in NHS Tayside. Participants: 14 NHS employed practice pharmacists. Results: Identified implementation factors were linked to thirteen theoretical domains (all except intentions) and six (skill, memory/attention/decision-making, behavioural regulation, reinforcement, environmental context/resources, social influences) were prioritised. Three intervention functions (training, enablement, and environmental restructuring) were relevant and were served by two policy categories (guidelines, communication/marketing) and eight BCTs (Instructions on how to perform a behaviour, problem solving, action planning, prompt/cues, goal setting, self-monitoring, feedback, restructuring the social environment). Intervention components encompass an informatics tool, written educational material, a workshop for pharmacists, promotional activities, and small financial incentives. Conclusions: This study explored pharmacists’ perceptions of implementation factors which could influence management of DTRs in general practices to inform implementation of P-DQIP, which will initially be implemented in one Scottish health board with parallel evaluation of effectiveness and implementation

Qualitative study exploring the key determinants of information gathering to inform the management of over-the-counter (OTC) consultations in community pharmacies

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Clinical stakeholders' opinions on the use of selective decontamination of the digestive tract in critically ill patients in intensive care units : an international Delphi study

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Non-prescription medicine misuse, abuse and dependence : a cross-sectional survey of the UK general population

BACKGROUND: Non-prescription medicines (NPMs) can be misused, abused or lead to dependence, but the prevalence of these problems within the UK general population was unknown. The aim of this study was to estimate the prevalence of self-reported misuse, abuse and dependence to NPMs.METHODS: A cross-sectional postal survey was sent to 1000 individuals aged ≥18 randomly drawn from the UK Edited Electoral Register.RESULTS: A response rate of 43.4% was achieved. The lifetime prevalence of NPM misuse was 19.3%. Lifetime prevalence of abuse was 4.1%. Younger age, having a long-standing illness requiring regular NPM use and ever having used illicit drugs or legal highs were predictive of misuse/abuse of NPMs. In terms of dependence, lifetime prevalence was 2% with 0.8% currently dependent and 1.3% dependent in the past. Dependence was reported with analgesics (with and without codeine), sleep aids and nicotine products.CONCLUSION: Given the increasing emphasis on self-care and empowering the public to manage their health with NPMs, the findings highlight the need for improved pharmacovigilance of these medicines to maximize benefits with minimal risk. Healthcare providers need to be aware of the potential for misuse, abuse and dependence, particularly in patients with long-term illness