Tailored implementation for chronic diseases: cardiovascular risk management

This application is linked to the EU project TICD, which concerns methods for tailoring implementation interventions to local barriers and needs ('op maat leveren van implementatie'). The project focuses on chronic illness care, including prevention; the Dutch contribution concerns cardiovascular risk management. In the EU peer review the TICD project received 14 out of 15 points, well above the funding threshold of 12 points. Background and project aim. Chronic diseases represent an important challenge facing healthcare systems. Research has consistently shown gaps between knowledge and practice for chronic illness care. Tailoring implementation interventions implies that the choice and content of implementation interventions are based on assessment of local barriers and enabling factors. It is widely believed that tailoring contributes to effective implementation, but little is known about specific methods and models for tailoring. The project ‘Tailoring implementation for chronic diseases’ (TICD) aims to develop better methods of tailoring implementation interventions to barriers and enablers for knowledge implementation in chronic illness care. Project plan. The 48-month project has been organized in 4 research work packages, a dissemination work package and a project management work package. WP1 will systematically review evidence on methods and models for tailoring implementation interventions. WP2 will test different methods and models for identifying barriers and enablers for implementation. WP3 will test different methods and models for matching implementation interventions to barriers and enablers. WP4 comprises of evaluations of the effectiveness of the resulting implementation interventions, and the influence of hypothesized barriers and enablers. We will perform comparitve evaluations, focusing on five chronic conditions: cardiovascular risk , obesity, mental health, asthma and COPD, and multimorbidity. Deliverables of the TICD project are: scientific papers on the validity and effectiveness of specific tailoring methods and models, practical guidelines on tailoring for stakeholders, and specific evidence on improving medical care for the targeted chronic conditions. The TICD consortium comprises of 7 research groups with extensive experience in implementation research, who have successfully worked together in different configurations for over 15 years. The Dutch contribution (IQ healthcare) concerns overall projectcoordination (Wensing), coordination of WP3 , and all research on cardiovascular risk in workpackages 2, 3 and 4 (van Lieshout). Our Dutch project will include patients with high risk for cardiovascular disease (but not yet established cardiovascular disease), targetting both life style change and preventive medication.