ID-5184 Wonca Abstracts supplement A-K 13-10-23 - Flipbook - Page 159
WONCA 2023 Supplement 1: WONCA 2023 abstracts (A–K)
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Implementing work-related Mental-health guidelines in
general PRacticE (IMPRovE): Primary findings of a parallel
cluster randomised controlled trial
Dr Vera Costa1, Professor Danielle Mazza1, Karen Nolidin1, Samantha Chakraborty1, Alex Collie1,
Justin Kenardy2, Bianca Brijnath3, Duncan Mortimer1, Joanne Enticott1, Prof Michael Kidd4,
Lyndal Trevena5, Sharon Reid5
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Monash University, 2University of Queensland, 3National Ageing Research Institute,
Australian National University, 5The University of Sydney
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Background
General practitioners (GPs) encounter challenges in managing patients with work-related mental health
conditions. The Implementing work-related Mental-health guidelines in general PRacticE (IMPRovE)
trial assessed the effectiveness of a multifaceted intervention in implementing the Clinical guideline
for the diagnosis and management of work-related mental-health conditions in general practice (the
Guideline).
Methods
Using a pragmatic hybrid III parallel cluster randomised controlled trial, GP clinics committed to
recruiting employed adults with work-related mental health conditions were allocated to either the
control or intervention group. Intervention clinics received academic detailing, enrolment into a virtual
community-of-practice and resources related to the Guideline. Control clinics were waitlisted until trial
completion. The sum of GPs’ responses to simulated patient scenarios at baseline and nine months
post-baseline provided a measure of their adherence to the Guideline.
Findings
GP recruitment occurred from December 2020 to February 2022. A total of 38 intervention clinics
(52 GPs) and 36 control clinics (46 GPs) contributed to the primary outcome data. After adjusting
for the stratification variables and clustering, GPs in the intervention arm had significantly higher
adherence scores than those in the control arm, by 0.98 points on a 0–9 scale (95% confidence
interval: 0.38, 1.58) with a Cohen’s d of 0.67, indicating a moderate to large effect.
Interpretation
GP adherence to the Guideline improved in those receiving our multifaceted intervention, indicating
that one or more components of the intervention was sufficient to change GP behaviour. For guidelines
to be useful, it is imperative that more attention is given towards strategies that aid implementation.
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