Swaithes, Laura Rachel ORCID: https://orcid.org/0000-0002-6739-1996 (2020) From research to primary care: a knowledge mobilisation study in osteoarthritis. Doctoral thesis, Keele University.

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Abstract

Background
Osteoarthritis (OA) is the most common long-term condition in primary care and is one of the most frequent causes of pain, loss of function and disability. Research evidence alone does not always lead to changes in practice that benefit patients, and OA is often not treated as per evidenced-based guidelines. The aims of this thesis were: (i) to identify lessons learnt from a research study and implementation project regarding OA best care, in order to provide insight into the knowledge mobilisation (KM) process in primary care (ii) to develop a toolkit to optimise KM for OA in primary care.
Methods
A systematic review and thematic synthesis were conducted to explore the factors affecting the implementation of evidence-based guidelines for OA in primary care. Analysis of data from three focus groups (n=21), and qualitative interviews (n=13), were conducted with key stakeholders to understand KM in primary care. A triangulation protocol of the empirical findings was used to generate draft recommendation statements which were subsequently refined in a consensus exercise with stakeholders (n=27), at a national knowledge mobilisation event. This informed the development of a toolkit to optimise KM for OA in primary care.
Results
KM of research evidence for OA in primary care is complex and multifaceted and influenced by a range of patient and clinician motivators. KM is optimised with consideration of specific primary care contextual factors. Adopting a whole practice approach was beneficial in circumnavigating potential implementation challenges and co-producing implementation plans relevant to the local context. The nature and impact of facilitation in optimising KM by mediating both internal and external contextual factors was shown. Clinical-academic collaboration and engaging in ‘knowledge networks’ optimised the uptake of evidence for OA. The knowledge mobiliser role was central to driving knowledge into practice in a contextualised way and was adopted by people with different characteristics (in terms of status, power and role). The perceived importance of patient and public involvement and engagement (PPIE) in KM was highlighted, yet uncertainty exists regarding the impact and role of PPIE in KM.
Triangulation of the three data sets produced a typology of six key empirical domains and a draft set of recommendation statements. The statements were refined following a consensus exercise with stakeholders (n=27) and the final toolkit developed.
Conclusions
This empirical study of KM demonstrated the importance of the knowledge mobiliser, underpinned by a strong academic collaboration (and infrastructure for KM) to overcome contextual barriers to KM in primary care. Further work is needed to better understand the role of PPIE in KM and evaluate the utility and transferability of the implementation toolkit.

Item Type: Thesis (Doctoral)
Subjects: H Social Sciences > HV Social pathology. Social and public welfare
Divisions: Faculty of Medicine and Health Sciences > School of Primary, Community and Social Care
Contributors: Paskins, Z (Thesis advisor)
Finney, A (Thesis advisor)
Dziedzic, KS (Thesis advisor)
Depositing User: Lisa Bailey
Date Deposited: 15 May 2020 09:20
Last Modified: 15 May 2020 09:20
URI: https://eprints.keele.ac.uk/id/eprint/7986

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