The objective of the BOPPP trial is to determine the clinical and cost-effectiveness in using NSBB in patients with small varices in the primary prophylaxis of variceal bleeding.
The trial delivery team are likely to contact the GP to inform them that their patient is participating in the BOPPP trial. Other instances of when the trial team may be in contact are essentially when the team need to determine the patient’s medical history, their asthma status and their history of being on a beta-blocker.
To investigate the trial objective and how it is best delivered in primary care, by general practice, using qualitative approaches and GP interviews to examine barriers and enablers to implementation.
An estimated 20-30 telephone interviews will be conducted with GPs to understand the barriers and enablers to implementation in primary care beyond the trial context in. Interviews will investigate the perceived acceptability, challenges and concerns around dose titration for patients with small oesophageal varices within primary care. The optimal timing of primary care involvement, the role of other primary care professionals, e.g. practice pharmacists, and the information, support and infrastructure required with secondary and tertiary care centres will be examined.
Themes identified in GP interviews, and internal pilot interviews with endoscopists, will inform the topic guide used in two subsequent focus groups with local endoscopists, gastroenterologists, GP’s, practice pharmacists and nurses that will examine strategies and potential solutions to early dose adjustment as part of routine clinical care.