Intervention Component Analysis (ICA): enhancing the “implementability” of review findings on complex interventions

Article type
Authors
Sutcliffe K1, Thomas J1
1EPPI-Centre, Social Science Research Unit, Institute of Education, UCL, United Kingdom
Abstract
Background: Decision-makers often find it difficult to draw clear messages for implementation from systematic reviews due to inadequate detail in their descriptions of complex interventions. Detailed scrutiny of intervention components allows reviewers to consider whether certain features are critical for success, thus uncovering important messages for implementation.

Objectives: To support the implementation of evidence from a systematic review on the efficacy of Paediatric Electronic Prescribing (PEP) interventions.

Methods: To complement a synthesis of statistical evidence establishing the efficacy of PEP, we sought to examine what a successful PEP intervention “looks like”. We drew on the TIDieR (Template for Intervention Description and Replication) framework to examine: a) which features were present in effective PEP systems; b) evidence on the strengths and weaknesses of individual intervention components; c) evidence on developing and implementing successful interventions.

Results: Inconsistency in the level of detail provided, and in the terminology and definitions used, restricted our ability to provide a comprehensive and accurate picture of PEP interventions. However, we were able to identify critical features of PEP interventions. For example, we identified that PEP interventions which were not tailored for use in paediatrics were less successful, and in some cases harmful. Notwithstanding its limitations, thematic analysis of qualitative data, such as authors’ observations of the impact of interventions on working practices, and authors’ hypothetical conclusions regarding associations between intervention features and the success (or otherwise) of PEP interventions, enabled us to identify the key strengths and weakness of different PEP components and the barriers to and facilitators of PEP development and implementation.

Conclusions: Even in the absence of consistently well reported information on the content of PEP interventions, innovative approaches enabled us to identify critical components of PEP, the strengths and weaknesses of individual components, and useful evidence on how to develop and implement successful PEP system.