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Implementation Science Featured

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Introduction

How can you ensure medical advances are not just discovered but effectively implemented? Implementation science is a powerful methodology for translating research evidence into healthcare delivery. Medical affairs professionals are uniquely positioned to harness implementation science to improve patients’ lives, starting earlier in the product lifecycle than you may think.

Authors

Evelyn R. Hermes-DeSantis, PharmD, BCPS, Director, Research and Publication, phactMI, Professor Emerita, Rutgers, The State University of New Jersey

Diana Morgenstern, MD, Executive Strategist, IQVIA US Medical Affairs

With writing support by: Kate Bankaitis, Director, Medical Communications, IQVIA

In collaboration with MAPS Evidence Generation and Customer Engagement & Scientific Communications Domain Teams

It takes an estimated 17 years for only 14% of published evidence intended to benefit patients to be adopted into routine care.1 Fortunately, actively addressing the implementation of medical advances can accelerate improvements to patients’ lives.

What Is Implementation Science?

Delays in the adoption of medical advancements are due to a variety of factors or barriers,
such as resistance to change, lack of awareness, and limited accessibility. Implementation science offers a scientific approach to identifying barriers and developing and testing strategies to overcome them.

Implementation research is the scientific study of methods to promote the systematic uptake of research findings and other evidence-based practices into routine practice, and, hence, to improve the quality and effectiveness of health services. It includes the study of influences on healthcare professional and organizational behaviors.2

The goal is to close gaps between what is known and what is done through healthcare policy and practice, the lynchpin to impacting public health.3

The Role of Medical Affairs Professionals

Medical affairs professionals play a strategic role in connecting company research to clinical practice, placing them in an ideal position to use implementation science to improve appropriate uptake of the medicines, vaccines, and devices they support.

Applying a familiar scientific approach to implementation science, medical affairs professionals can facilitate the adoption of care advances through 4 key phases:

Implementation Science Figure

Importantly, this approach can be used during integrated evidence generation planning at every stage in the product lifecycle. For example, implementation science can be applied to effectively inform Phase I study design during research and development through successful management of the product in real-world scenarios after regulatory approval.2,4-6

Implementation Science Doesn’t End With Implementation

Imagine a medical affairs professional working to implement a phamarcotherapy for alcohol use disorders in primary care clinics. They already know that gaps in provider knowledge need to be overcome to accelerate adoption, and they begin an implementation trial.

As the trial progresses, ongoing evaluations inform a change in strategy to include marketing for increased patient demand, in addition to the focus on provider education. Using this information, they overcome barriers to adoption and successfully implement the new therapy in primary care, where a significant number of patients will benefit. This is a true story based on actual studies7-10, and it illustrates an important final point:

…no matter how carefully an implementation strategy is planned in advance, the experience of actual implementation leads to insights which can be utilized to improve the strategy even further.7

Conclusion

The gap that exists between generating research evidence and translating it into routine practice has been a significant challenge in healthcare. Implementation science offers medical affairs professionals a scientific approach to ensure medical advances are not only evidenced, but also effectively implemented to ultimately improve patient outcomes.

The time is now to harness implementation science no matter where a product is in its lifecycle.

References

  1. Livet M, Haines ST, Curran GM, et al. Implementation science to advance care delivery: a primer for pharmacists and other health professionals. Pharmacotherapy. 2018;38(5):490-502. doi:10.1002/phar.2114
  2. Eccles MP, Mittman BS. Welcome to implementation science. Implementation Sci. 2006;1:1-3. doi:10.1186/1748-5908-1-1
  3. Bauer MS, Kirchner J. Implementation science: what is it and why should I care? Psychiatry Res. 2020;283:112376. doi:10.1016/j.psychres.2019.04.025
  4. Glasgow RE, Vinson C, Chambers D, Khoury MJ, Kaplan RM, Hunter C. National Institutes of Health approaches to dissemination and implementation science: current and future directions. Am J Public Health. 2012;102(7):1274-1281. doi:2105/AJPH.2012.300755
  5. Bernet AC, Willens DE, Bauer MS. Effectiveness-implementation hybrid designs: implications for quality improvement science. Implement Sci. 2013;8(1):1-2. doi:10.1186/1748-5908-8-S1-S2
  6. Douglas NF, Campbell WN, 11. Hinckley JJ. Implementation Science: Buzzword or Game Changer? J Speech Lang Hear Res. December 2015;58(6):S1827-S1836. doi:10.1044/2015_JSLHR-L-15-0302
  7. Bauer MS, Damschroder L, Hagedorn H, Smith J, Kilbourne AM. An introduction to implementation science for the non-specialist. BMC Psychology. 2015;3(1):32. doi:10.1186/s40359-015-0089-9
  8. Ajzen I. The theory of planned behavior. Organ Behav Hum Decis Process. 1991;50(2):179-211. doi:10.1016/0749-5978(91)90020-T
  9. Hagedorn HJ, Noorbaloochi S, Simon AB, et al. Rewarding early abstinence in Veterans Health Administration addiction clinics. J Subst Abuse Treat. 2013;45(1):109-117. doi:10.1016/j.jsat.2013.01.006
  10. Hagedorn HJ, Stetler CB, Bangerter A, Noorbaloochi S, Stitzer ML, Kivlahan D. An implementation-focused process evaluation of an incentive intervention effectiveness trial in substance use disorders clinics at two Veterans Health Administration medical centers. Addict Sci Clin Pract. 2014;9(1):12. doi:10.1186/1940-0640-9-12
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