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Theories, models and frameworks for de-implementation of low-value care: A scoping review of the literature
Linköping university, Sweden.
Karolinska institutet, Stockholm, Sweden.
Karolinska institutet, Stockholm, Sweden.
Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare. Karolinska institutet, Stockholm, Sweden. (HAL)ORCID iD: 0000-0002-4771-8349
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2020 (English)In: Implementation Research and Practice, ISSN 2633-4895Article in journal (Refereed) Published
Abstract [en]

Achieving an evidence-based practice not only depends on implementation of evidence-based interventions (programs, methods, etc.) but also requires de-implementing interventions that are not evidence-based, that is, low-value care (LVC). Thus, de-implementation is the other side of the coin of an evidence-based practice. However, this is quite a new topic and knowledge is lacking concerning how de-implementation and implementation processes and determinants might differ. It is almost mandatory for implementation researchers to use theories, models, and frameworks (i.e., “theoretical approaches”) to describe, guide, or explain implementation processes and determinants. To what extent are such approaches also used with regard to de-implementation of LVC? And what are the characteristics of such approaches when analyzing de-implementation processes? We reviewed the literature to explore issues such as these. We identified only 10 studies describing theoretical approaches that have been used concerning de-implementation of LVC. Five studies presented approaches developed specifically for de-implementation of LVC and five studies applied an already-existing approach usually applied to analyze implementation processes. Most of the theoretical approaches we found suggest a multi-level understanding of de-implementation of LVC, that is, successfully de-implementing LVC may require strategies that target teams, departments, and organizations and merely focus on individual health care practitioners. The findings point to the need for more research to identify the most important processes and determinants for successful de-implementation of LVC, and to explore differences between de-implementation and implementation. In terms of practice and policy implications, the study underscores the relevance of addressing multiple levels when attempting to de-implement LVC.

Place, publisher, year, edition, pages
2020.
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Health Sciences
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URN: urn:nbn:se:mdh:diva-52926OAI: oai:DiVA.org:mdh-52926DiVA, id: diva2:1512360
Available from: 2020-12-22 Created: 2020-12-22 Last updated: 2022-11-25Bibliographically approved

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