Developing an active implementation model for a chronic disease management program.

Area of Science:

• Healthcare implementation science
• Complex intervention design
• Primary care management

Background:

• Implementation of new healthcare programs, especially for chronic diseases like COPD, is often slow.
• Active, theory-driven implementation strategies show promise but require more evidence in complex primary care settings.
• The Central Denmark Region's COPD management program provided an opportunity to compare active vs. usual implementation models.

Purpose of the Study:

• To describe the development of an active implementation model for a COPD disease management program.
• To utilize the Medical Research Council's (MRC) model for complex interventions and the Chronic Care Model (CCM).
• To assess the feasibility of an active implementation model in a primary care setting.

Main Methods:

• Employed the MRC's five-stage model for developing complex interventions.
• Reviewed literature on general practice implementation and assessed empirical knowledge.
• Designed and tested the intervention (Phase I) and evaluated feasibility (Phase IV).

Main Results:

• The Chronic Care Model informed the design of efficient implementation elements.
• A multifaceted intervention was created, with a timeline structured by the MRC model (PaTPlot).
• Effective strategies included the Breakthrough Series, academic detailing, patient materials, and provider meetings.

Conclusions:

• The integrated approach using the MRC model and CCM proved feasible for a practice-based COPD program.
• Specific implementation strategies enhanced the model's practicality.
• The MRC model enhanced transparency and facilitated the implementation process.