Table 5 Refinement of clinician support package following the learning in the pilot trial
Problems identified in pilot | Action taken before main trial |
|---|---|
• Cumbersome questionnaire wording and variable use of terms | • Design and validation of specific clinical version, with constructs stated for GPs |
• Sub-optimal treatment recommendations | • Rationalisation and refinement |
• Excessive length of clinician support sessions and requests to re-focus some parts | • Reduced to one 2 h session with less background information |
• Trainers reluctant to specify best fit of intervention within consultation | • Application of experience gained to be more directive, including production of video of simulated consultation for training |
• Some GPs missed clinician support sessions | • Training logs and prompt sheets introduced for each practice |
• Delays in detecting problems and taking remedial action with practices | • Early monitoring and re-visit to practice. • Monthly feedback and personal contact by same trainer |
• Poor engagement and performance by control practices | • Control and intervention practices to have training visit from GP and clinical researcher from study team • More focused clinician support sessions for control practices |