Miriam C. Faes and Miriam F. Reelick contributed equally as first authors.
Developing and Evaluating Complex Healthcare Interventions in Geriatrics: The Use of the Medical Research Council Framework Exemplified on a Complex Fall Prevention Intervention
Version of Record online: 5 OCT 2010
© 2010, Copyright the Authors. Journal compilation © 2010, The American Geriatrics Society
Journal of the American Geriatrics Society
Volume 58, Issue 11, pages 2212–2221, November 2010
How to Cite
Faes, M. C., Reelick, M. F., Esselink, R. A. and Rikkert, M. G. O. (2010), Developing and Evaluating Complex Healthcare Interventions in Geriatrics: The Use of the Medical Research Council Framework Exemplified on a Complex Fall Prevention Intervention. Journal of the American Geriatrics Society, 58: 2212–2221. doi: 10.1111/j.1532-5415.2010.03108.x
- Issue online: 4 NOV 2010
- Version of Record online: 5 OCT 2010
- complex interventions;
- frail older persons;
- MRC framework
Geriatrics focuses on a variety of multiorgan problems in a heterogeneous older population. Therefore, most geriatric healthcare interventions are complex interventions. The UK Medical Research Council (MRC) has developed a framework to systematically design, evaluate, and implement complex interventions. This article provides an overview of this framework and illustrates its use in geriatrics by showing how it was used to develop and evaluate a fall prevention intervention. The consecutive phases of the framework are described:
Phase I: Development. This phase began with a literature review, which provided the existing evidence and the theoretical understanding of the process of change. This understanding was further developed through focus groups with experts and interviews with patients and caregivers. The intervention was modeled using qualitative testing of the preliminary intervention through focus groups and through the completion of Delphi surveys by independent specialists.
Phase II: Feasibility and piloting. In this phase, a pilot study was conducted in a group of patients and caregivers. The feasibility of the intervention and evaluation was also discussed in focus groups of participants and instructors.
Phase III: Evaluation. The information from phases I and II shaped the design of a randomized controlled trial to test the effectiveness of the intervention.
Phase IV: Dissemination. The purpose of the final phase is to examine the implementation of the intervention into practice.
The MRC framework provides an innovative and useful methodology for the development and evaluation of complex geriatric interventions that deserves greater dissemination and implementation.