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Table 2 Context-Mechanism-Outcome configurations concerning access and engagement

From: Understanding the implementation and adoption of a technological intervention to improve medication safety in primary care: a realist evaluation




General Practitioner monitoring individual patients

Focuses attention on medications

Attention focused on patients most in need of review

General Practitioner prescribing audited and monitored in practices

Proactively conducting own audits

Practice prescribing patterns benchmarked against each other across the Clinical Commissioning Group

Communication between Clinical Commissioning Group and General Practitioner

Real time feedback

Patients reviewed to ensure appropriate monitoring, to optimise medications, or to avoid dangerous combinations of drugs

Clinical Commissioning Group conducting searches of prescribing based upon “projects” and “initiatives”

Prescribing patterns and trends benchmarked against national targets and guidelines

Clinical Commissioning Group encouraging clinicians to be engaged in more proactive safety management

Engagement of practices in using the system for feedback

Voluntary engagement by clinicians

Audits conducted as a means of support to General Practitioners

The effectiveness of safety initiatives audited more quickly

Improved engagement with safety monitoring of prescribing