Project opportunity
This Earmarked Scholarship project is aligned with a recently awarded Category 1 research grant. It offers you the opportunity to work with leading researchers and contribute to large projects of national significance.
RELEASE: Redressing Long-tErm Antidepressant uSe in General Practice is a user-informed multi-modal intervention based in general practice that targets both GPs and patients and has the following guiding principles:
- All prescribing decisions are made as usual by the GP and patient together.
- Empowering patients.
- Acceptable and translatable in routine general practice.
- Resources developed to raise awareness, prompt medication review, support decision-making, and guide safe cessation of long-term antidepressants where indicated.
The RELEASE intervention has been designed to perform the following:
- Awareness raising (Medicine Information brochure; e-Learning module)
- Prompting medication review (Letter of invitation)
- Supporting decision-making (Decision Aid)
- Guiding discontinuation (Tapering protocol; Outreach visit training)
- Reassurance and support (GP follow-up)
RELEASE will be evaluated in a cluster RCT (effectiveness-implementation hybrid type 1) in 24 general practices in south-east Queensland. In a type 1 hybrid design, the primary objective is to determine effectiveness of the intervention and the secondary objective is to assess determinants of implementation success, acceptability, feasibility and cost-effectiveness.
Aim: Evaluate the RELEASE antidepressant discontinuation intervention and associated implementation strategies in the Australian general practice context.
Primary objective: Evaluate RELEASE effectiveness compared to usual care.
Secondary objective: Evaluate RELEASE implementation barriers and enablers, acceptability, feasibility and cost-effectiveness.
Primary hypothesis: The RELEASE antidepressant discontinuation intervention and implementation strategies will significantly increase the proportion of people who stop long-term antidepressants.
Secondary hypothesis: RELEASE is acceptable to both GPs and patients, scalable, and cost-effective in the Australian general practice context.
The focus for the successful PhD candidate’s program of research will be assessing implementation of RELEASE.
A multi-method approach to evaluate determinants and implementation outcomes will be used to assess acceptability of RELEASE to patients and GPs (e.g., content and complexity); appropriateness - whether GPs consider RELEASE a ‘good fit’ for practice workflows and could be translated into routine care; adoption - number of practices and GPs approached to take part, interested in taking part, and taking part, number of patients de-selected by GPs and why, % of eligible patients that enrol; fidelity: % GPs engage with the one-on-one outreach training and interactive e-Learning module, % patients attend medication review and follow-up visits with GP.
Quantitative data: implementation and participation tracking data (fidelity and adoption outcomes), website analytics, and GP log recording reasons for patient de-selection (adoption outcomes). Quantitative data will be analysed using descriptive statistics.
Qualitative data: in-depth interviews with a purposive sample of 15-20 GPs and 15-20 patients. Recruitment for these interviews will commence at about 6-months post the first randomisation tranche of GP practices. Interviews will take place face-to-face or via telephone or zoom guided by an interview schedule. Interviews will be audio-recorded with permission and transcribed verbatim. Interviews will be analysed using a combination of inductive and deductive coding, beginning with an emphasis on barriers and facilitators and expanding to measure implementation outcomes including acceptability and appropriateness. Theory informed deductive analysis will be guided by the five domains of the Consolidated Framework for Implementation Research to identify determinants crucial in understanding what happens (and why) and optimising our likelihood of effecting change through identification and resolution of actionable barriers and enhancement of identified enablers. Normalisation Process Theory (NPT) will be used to assess sustainability. NPT is an internationally utilised methodology that provides a framework for understanding processes that enable new ways of working to be ‘normalised’ within health service delivery and is an ideal framework to underpin our assessment of the extent to which RELEASE is embedded within routine general practice.
Evidence will be used to track implementation and modify implementation strategies for scale-up.
Scholarship value
As a scholarship recipient, you'll receive:
- living stipend of $32,192 per annum tax free (2023 rate), indexed annually
- tuition fees covered
- single Overseas Student Health Cover (OSHC)
An additional top-up of $10,000 per annum is also available.
Supervisor
Faculty of Medicine
Email: k.wallis@uq.edu.au
Preferred educational background
Your application will be assessed on a competitive basis.
We take into account your
- previous academic record
- publication record
- honours and awards
- employment history.
A working knowledge of implementation science and health services research would be of benefit to someone working on this project.
The applicant will demonstrate academic achievement in the field(s) of health services research and the potential for scholastic success.
A background or knowledge of health services research is highly desirable.
Latest commencement date
If you are the successful candidate, you must commence by Research Quarter 2, 2023. You should apply at least 3 months prior to the research quarter commencement date.
If you are an international applicant, you may need to apply much earlier for visa requirements.
How to apply
You apply for this project as part of your PhD program application.