Can complex health interventions be evaluated using routine clinical and administrative data? – a realist evaluation approach

Abstract

Applying the CMO approach can aid in a typical evaluation setting encountered by primary care managers: one in which the intervention is complex, the primary data source is routinely collected clinical and administrative data from a single centre, and in which randomization of patients into two research arms is too resource consuming to arrange.

Cost-effectiveness analysis for a tele-based health coaching program for chronic disease in primary care

“…This may be due to methodological challenges; self-management interventions are often complex interventions, and the standard experimental setting, a randomized controlled trial (RCT), is difficult to put into practice in real life [ 11 , 12 ]. Furthermore, routinely collected administrative and clinical data typically lack the important measurements needed in the assessment of self-management interventions [ 13 ].…”

Evaluating impact of clinical guidelines using a realist evaluation framework

“…Realist evaluation typically begins by eliciting and formalizing a programme theory [13–15]: ‘ a theory that lies between the minor but necessary working hypothesis, and the all‐inclusive systematic efforts to develop a unified theory that will explain the observed uniformities of social behaviour, social organisation and social change ’ [16]. A programme theory can either be formulated by an existing theory and experience, or through on‐site research to identify implicit models used to make sense of the intervention [12,13].…”

A Rapid Realist Review of Quality Care Process Metrics Implementation in Nursing and Midwifery Practice

“…Where interventions are supported at a national level [38] by an implementation framework [40] and organizations are externally facing, then there is a more standardized approach to implementation [33], leading to successful adoption of the intervention. Clinical sites that show readiness for QCP-M implementation have strong internal networks and communication systems that facilitate a practice culture compatible with the introduction of quality interventions and a learning climate supportive of nurses and midwives who are implementing the QCP-M, resulting in an increased chance of the intervention becoming embedded in practice [34,36,[38][39][40][41][42][43][44][45][46][47][48][49][50][51][52][53][54][55][56][57].…”