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Use and adaptation of a research derived evidence based tool by general practitioners: a qualitative study of the ‘Frailty Index’ (RDF19/HLS/SWECW/SANDERS)

  • Full or part time
  • Application Deadline
    Friday, January 25, 2019
  • Funded PhD Project (European/UK Students Only)
    Funded PhD Project (European/UK Students Only)

Project Description

Rationale:

Research evidence uptake by professionals working in healthcare is variable. Research has shown that top-down strategies are largely unsuccessful because clinicians want to adapt research evidence for their own local priorities (Grimshaw et al. 2012). Actionable tools offer one potential solution in transforming research evidence into a more usable form of knowledge at the optimal point of use. These tools have been described as third generation outputs, designed to drive the translation of evidence to action. Some tools, however, are designed in a way that make local adaptation difficult, possibly as clinicians prefer to use their own judgement.

One actionable tool widely used in UK primary care is the electronic frailty index (eFI), endorsed by NHS England. General practices in the UK are mandated to screen all patients over the age of 65 for high risk of frailty. The eFI has been adopted by many GP practices providing a common approach to case finding, assessment, care planning and case management. A key requirement is that GPs use the tool to support their decisions alongside ‘clinical judgement’. A research gap exists in how GPs manage the tool in this way.

Question:

1. How is the eFI used by GPs to screen, diagnose and manage patients with frailty?
2. How the requirement to use the tool for diagnosis/risk assessment/case management is managed alongside GPs’ clinical judgement?
3. What are the views of research teams responsible for designing the eFI about its intended and actual use by GPs?

Method:

1. Ethnography of eFI use by GPs and other healthcare professionals at 2 general practices, sampled from local contacts and clinical networks
2. Qualitative interviews with GPs/nurses 15
3. Qualitative interviews with patients diagnosed as ‘frail’ with the eFI (sampled from GP practice list) 10
4. Qualitative interviews with eFI design/evaluation/research team 10

Eligibility and How to Apply:

Please note eligibility requirement:
• Academic excellence of the proposed student i.e. 2:1 (or equivalent GPA from non-UK universities [preference for 1st class honours]); or a Masters (preference for Merit or above); or APEL evidence of substantial practitioner achievement.
• Appropriate IELTS score, if required.
• Applicants cannot apply for this funding if currently engaged in Doctoral study at Northumbria or elsewhere.

For further details of how to apply, entry requirements and the application form, see
https://www.northumbria.ac.uk/research/postgraduate-research-degrees/how-to-apply/

Please note: Applications that do not include a research proposal of approximately 1,000 words (not a copy of the advert), or that do not include the advert reference (e.g. RDF18/…) will not be considered.

Deadline for applications: Friday 25 January 2019

Start Date: 1 October 2019

Northumbria University is an equal opportunities provider and in welcoming applications for studentships from all sectors of the community we strongly encourage applications from women and under-represented groups.

Faculty: Health and Life Sciences
Department: Social Work, Education and Community Wellbeing
Principal Supervisor: Tom Sanders

Funding Notes

The studentship is available to Home/EU students where a full stipend, paid for three years at RCUK rates (for 2018/19, this is £14,777 pa) and full fees.

References

Grove A, Sanders T, Salway S, Goyder E & Hampshaw S (2018) A qualitative exploration of evidence-based decision-making in public health practice and policy: the perceived usefulness of a diabetes economic model for decision-makers. Evidence & Policy.

Sanders T, Wynne-Jones G, Ong BN, Artus M & Foster N (2017) Acceptability of a vocational advice service for patients consulting in primary care with musculoskeletal pain: A qualitative exploration of the experiences of general practitioners, vocational advisers and patients. Scandinavian Journal of Public Health (Sage).

Sanders T, Grove A, Salway S, Hampshaw S & Goyder E (2017) Incorporation of a health economic modelling tool into public health commissioning: Evidence use in a politicised context. Social Science & Medicine, 186, 122-129.

Ong BN, Morden A, Brooks L, Porcheret M, Edwards JJ, Sanders T, Jinks C & Dziedzic K (2014) Changing policy and practice: Making sense of national guidelines for osteoarthritis. Social Science & Medicine, 106, 101-109.

Ong BN, Rogers A, Kennedy A, Bower P, Sanders T, Morden A, Cheraghi-Sohi S, Richardson JC & Stevenson F (2014) Behaviour change and social blinkers? The role of sociology in trials of self-management behaviour in chronic conditions. Sociology of Health & Illness, 36(2), 226-238.

Sanders T, Nio Ong B, Sowden G & Foster N (2014) Implementing change in physiotherapy: professions, contexts and interventions. Journal of Health Organization and Management, 28(1), 96-114.

Welsh VK, Sanders T, Richardson JC, Wynne-Jones G, Jinks C & Mallen CD (2014) Extending the authority for sickness certification beyond the medical profession: the importance of ‘boundary work’. BMC Family Practice, 15(1).

Sanders T, Foster NE & Ong BN (2011) Perceptions of general practitioners towards the use of a new system for treating back pain: a qualitative interview study. BMC Medicine, 9(1).

Sanders T, Harrison S & Checkland K (2010) Personalizing protocol-driven care: the case of specialist heart failure nurses. Journal of Advanced Nursing, no-no.

Sanders T, Harrison S & Checkland K (2008) Evidence-based medicine and patient choice: The case of heart failure care. Journal of Health Services Research and Policy, 13(2), 103-108.

Sanders T & Harrison S (2008) Professional legitimacy claims in the multidisciplinary workplace: the case of heart failure care. Sociology of Health & Illness, 30(2), 289-308.

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