Using Implementation Science to Optimize the Uptake of Evidence-Based Medicine into Dermatology Practice

Ashrafzadeh, Sepideh; Metlay, Joshua P.; Choudhry, Niteesh K.; Emmons, Karen M.; Asgari, Maryam M.

doi:10.1016/j.jid.2019.10.011

Cited by 12 publications

(11 citation statements)

References 35 publications

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“…Respondents clearly welcomed the concept of reflecting on how evidence had affected their clinical practice. The time course of the translation into clinical practice of the four clinical trials (published in 2013, 2015 and two in 2017) is much faster than the average of 17 years previously suggested, 12 but this could be because the trials were published in high impact journals, the study drugs were already available in most countries, and those surveyed may have been early evidence adopters. The open‐access nature of our four trial publications may have also contributed to the reach of the studies.…”

Section: Discussionmentioning

confidence: 86%

“…Citations in guidelines are an easy way of tracking impact, but counts do not indicate how the study has been cited, and provides no evidence of direct patient benefit. The science of impact assessment and implementation science 12,23 in dermatology is very much in its infancy. We hope this report will stimulate others to invest more in translating research findings into practice, and to track the impact of research to ensure that patients ultimately benefit from it.…”

Section: Discussionmentioning

confidence: 99%

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Scoping the international impact from four independent national dermatology trials

et al. 2020

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Background. Research impact describes whether and how research results in wider benefits to society beyond academic publication. Little is known about translation of clinical trial research into dermatological practice. Aim. We scoped international impact from four independently funded clinical trials published by our group over the past 10 years. Methods. This was a scoping survey of 35 international colleagues from 22 countries followed by a narrative summary of emergent themes. Results. All recipients kindly responded to the survey. At least 20 emergent themes were identified, which broadly included: (i) interest and enthusiasm in the concept of trying to document clinical trial impact; (ii) direct impacts such as adoption of the drug as tested and recommended from the trial results, including more confidence using the drug in slightly different ways for the same condition; (iii) the finding that trial impact was dependent on factors such as drug availability and country-specific disease patterns; and (iv) the educational value of good trial design for journal club discussions and improving future clinical trial designs in dermatology. Our survey suggests that uptake into clinical practice was surprisingly rapid and widespread. Conclusion.Clinical trial research is of little use unless findings are translated into clinical practice for patient benefit. Our international scoping survey suggests that independent clinical trials that address important questions identified by the dermatology community have substantial, diverse and far-reaching impacts on dermatological practice.

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Section: Discussionmentioning

confidence: 86%

Section: Discussionmentioning

confidence: 99%

Scoping the international impact from four independent national dermatology trials

et al. 2020

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“…Although much of the published work on teledermatology during the COVID-19 pandemic focused on satisfaction among patients and care providers, less is known about its actual implementation during the early months of the pandemic [ 4 , 5 ]. The field of implementation science has been recognized for its potential to improve the integration of evidence-based practices into routine dermatologic care [ 6 ].…”

Section: Introductionmentioning

confidence: 99%

Using Implementation Science to Understand Teledermatology Implementation Early in the COVID-19 Pandemic: Cross-sectional Study

Briggs¹,

Lipoff²,

Collier³

2022

JMIR Dermatol

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Background Implementation science has been recognized for its potential to improve the integration of evidence-based practices into routine dermatologic care. The COVID-19 pandemic has resulted in rapid teledermatology implementation worldwide. Although several studies have highlighted patient and care provider satisfaction with teledermatology during the COVID-19 pandemic, less is known about the implementation process. Objective Our goal was to use validated tools from implementation science to develop a deeper understanding of the implementation of teledermatology during the COVID-19 pandemic. Our primary aims were to describe (1) the acceptability and feasibility of the implementation of teledermatology and (2) organizational readiness for the implementation of teledermatology during the COVID-19 pandemic. We also sought to offer an example of how implementation science can be used in dermatologic research. Methods An anonymous, web-based survey was distributed to Association of Professors of Dermatology members. It focused on (1) the acceptability, feasibility, and appropriateness of teledermatology and (2) organizational readiness for implementing teledermatology. It incorporated subscales from the Organizational Readiness to Change Assessment—a validated measure of organizational characteristics that predict implementation success. Results Of the 518 dermatologists emailed, 35 (7%) responded, and all implemented or scaled up teledermatology during the pandemic. Of the 11 care providers with the highest level of organizational readiness, 11 (100%) said that they plan to continue using teledermatology after the pandemic. Most respondents agreed or strongly agreed that they had sufficient training (24/35, 69%), financial resources (20/35, 57%), and facilities (20/35, 57%). However, of the 35 respondents, only 15 (43%) agreed or strongly agreed that they had adequate staffing support. Most respondents considered the most acceptable teledermatology modality to be synchronous audio and video visits with supplemental stored digital photos (23/35, 66%) and considered the least acceptable modality to be telephone visits without stored digital photos (6/35, 17%). Overall, most respondents thought that the implementation of synchronous audio and video with stored digital photos (31/35, 89%) and telephone visits with stored digital photos (31/35, 89%) were the most feasible. When asked about types of visits that were acceptable for synchronous video/audio visits (with stored digital photos), 18 of the 31 respondents (58%) said “new patients,” 27 (87%) said “existing patients,” 19 (61%) said “medication monitoring,” 3 (10%) said “total body skin exams,” and 22 (71%) said “lesions of concern.” Conclusions This study serves as an introduction to how implementation science research methods can be used to understand the implementation of novel technologies in dermatology. Our work builds upon prior studies by further characterizing the acceptability and feasibility of different teledermatology modalities. Our study may suggest initial insights on how dermatology practices and health care systems can support dermatologists in successfully incorporating teledermatology after the pandemic.

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“…Calls for antibiotic stewardship in dermatology have focused on more provider education, often assuming that more knowledge and evidence are sufficient to change antibiotic prescription practices. 4 The effectiveness of existing quality improvement initiatives that enable selfassessment of antibiotic prescription practices, such as the focused practice improvement module on limiting oral antibiotic use to 3-6 months for treatment of acne from the American Board of Dermatology, has not been assessed. The lack of evidence-based dissemination and implementation strategies contributes to the knowledge-to-action gap for ASP in acne.…”

mentioning

confidence: 99%

“…Implementation science examines strategies to integrate evidence-based interventions into clinical settings and has yet to be widely adopted in dermatology. 4,5 We propose designing future implementation interventions of ASPs using existing implementation science frameworks, such as the Theoretical Domains Framework or the Consolidated Framework for Implementation Research. 4 For example, the Theoretical Domains Framework provides a comprehensive approach to identify key determinants to behavior and to guide theory-informed intervention design.…”

mentioning

confidence: 99%

Developing and implementing approaches to limit antimicrobial resistance

Chu

Yeung

2022

Journal of the American Academy of Dermatology

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Using Implementation Science to Optimize the Uptake of Evidence-Based Medicine into Dermatology Practice

Cited by 12 publications

References 35 publications

Scoping the international impact from four independent national dermatology trials

Scoping the international impact from four independent national dermatology trials

Using Implementation Science to Understand Teledermatology Implementation Early in the COVID-19 Pandemic: Cross-sectional Study

Developing and implementing approaches to limit antimicrobial resistance

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