P034 Exploring implementation of a general practice nurse-delivered model of care

Abstract Introduction Limited access to best practice OSA and chronic insomnia care has prompted investigation of general practice nurse-delivered models of care (MOC) to improve access to care. Despite evidence of efficacy, these models are not yet integrated into routine care. This study was conducted to explore the barriers and facilitators to implementation of a general practice nurse-delivered MOC for chronic insomnia and OSA to inform future implementation trials of nurse-delivered MOCs. Methods Semi-structured interviews and focus groups were conducted with patients and general practice staff. Patient data was analysed by conducting a deductive Framework Analysis, using implementation science theory, and an inductive thematic analysis. An Interpretive Phenomenological Analysis was conducted to explore the experiences and perspectives of practice staff as they implemented the MOC. Results Thirty-one patients, five general practitioners, two managers, and one nurse participated. Improved access to best practice sleep health care for patients motivated the practice staff to deliver the MOC. Patient engagement with treatment was facilitated by trust in the staff delivering the intervention, severity of their condition, and fear of negative consequences of not treating OSA once they were diagnosed. No access to government-subsidised CPAP machines in general practice was identified as a significant barrier to future translation of the OSA pathway. Discussion This study has identified important factors that need to be addressed for successful translation of MOCs into clinical practice. It highlights the need for MOCs to be co-designed with patients and clinicians to ensure they are feasible and accepted by key stakeholders.