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Table 3 QCA parsimonious solutions

From: Identifying core strategies and mechanisms for spreading a national medicines optimisation programme across England—a mixed-method study applying qualitative thematic analysis and Qualitative Comparative Analysis

Outcome

Successful TCAM spread

Unsuccessful TCAM spread

QCA solution

TIMELY * PHARMA

timely + pharma

AHSNs covered by solution (ID)

4; 6, 13, 14; 8, 9; 15

1; 2; 3; 12;

1; 5, 7, 11; 10

Raw coverage

1.0

0.5

0.625

Unique coverage

1.0

0.375

0.5

Solution coverage

1.0

1.0

Solution consistency

1.0

1.0

  1. Upper case letter = condition is present; lower case letters = condition is absent; * = combination of conditions (Boolean AND); + = non-combined/alternative conditions (Boolean OR)
  2. The solution for success explained 100% of successful cases (raw coverage = 1.0, solution coverage = 1.0) and was the only solution explaining all cases of successful outcome (unique coverage = 1.0, solution consistency = 1). The solution term for unsuccessful TCAM spread contains two alternative pathways. Four unsuccessful AHSNs had a delayed start (pathway 1), and five unsuccessful AHSNs did not have a pharmacist employed to facilitate spread work (pathway 2). One of these AHSNs had both a delay and did not have a pharmacist employed. The solution for unsuccessful outcomes explained all eight unsuccessful cases (solution coverage = 1.0). Each alternative pathway in the solution is covering about half of the cases (raw coverage = 0.5 and 0.625). Each pathway is not solely explaining a number of unsuccessful cases, but one case is covered by both solutions (unique coverage = 0.375 and 0.5). The low level of coverage of the separate pathways or conditions included in the solution explaining unsuccessful TCAM spread confirms the validity of the solution for successful TCAM spread. Only the combination of the two strategies/mechanisms led to successful TCAM spread, and whenever this combination of strategies is absent, the spread of TCAM was unsuccessful (solution consistency = 1, solution coverage = 1.0)