Informing Implementation of a National Integrated Clinical Pathway for Low Back Pain in Ireland: A Pre-Implementation...

Area of Science:

• Health Services Research
• Implementation Science
• Primary Care Medicine

Background:

• Ireland's Health Service Executive is implementing a national integrated low back pain (LBP) pathway across primary and secondary care.
• Clinical pathways aim to enhance patient outcomes and resource management but face implementation challenges.
• Successful pathway implementation requires context-specific planning informed by implementation science frameworks.

Purpose of the Study:

• To investigate General Practitioner (GP) perspectives on the new LBP pathway.
• To identify barriers and facilitators to pathway implementation using GP insights.
• To inform the development of targeted strategies for optimal pathway adoption.

Main Methods:

• Qualitative study employing semi-structured interviews with a purposive sample of GPs.
• Framework Analysis guided data analysis, including open coding and mapping to the Consolidated Framework for Implementation Science.
• Evaluation of implementation outcomes such as acceptability, appropriateness, and feasibility.

Main Results:

• Identified key determinants influencing the implementation of the LBP pathway within primary care settings.
• Explored GP perceptions regarding the practical application and integration of the new pathway.
• Provided a foundation for developing evidence-based implementation strategies.

Conclusions:

• System-wide healthcare improvements are complex and require careful planning.
• This pre-implementation study design, involving key stakeholders, aims to optimize the rollout of Ireland's integrated LBP pathway.
• Understanding primary care perspectives is crucial for successful national healthcare pathway implementation.