Protocol for a realist evaluation of a COPD clinical pathway in Saskatchewan, Canada
7 affiliations
- 1Department of Community Health and Epidemiology, College of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada.
- 2Division of Respirology and Sleep Medicine, College of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada.
- 3Saskatchewan Health Authority, Regina, Saskatchewan, Canada.
- 4Northern Institute, Faculty of Arts and Society, Charles Darwin University, Darwin, Australia.
- 5Maple Creek, Saskatchewan, Canada.
- 6North Battleford, Saskatchewan, Canada.
- 7Regina, Saskatchewan, Canada.
Abstract
Chronic obstructive pulmonary disease (COPD) is a complex and common condition with significant health, social, and economic burdens, especially due to frequent hospitalizations and comorbidities. International research shows current care for COPD is limited by delayed diagnosis, poor coordination among providers, and inconsistent adherence to treatment guidelines, which negatively impacts patient outcomes. Clinical pathways offer a promising solution by improving care coordination, aligning treatment with evidence-based guidelines, and enhancing both patient experiences and system efficiency; however, questions remain about how, for whom, and in which contexts they are most effective. Using a realist evaluation approach, our study will evaluate how, for whom, and in which circumstances an integrated clinical pathway for COPD works in Saskatchewan, Canada. First, we will develop initial program theories based on literature and stakeholder input. Second, we will test these theories using administrative data and realist interviews with healthcare staff, managers, providers, COPD patients, and caregivers. Third, we will refine our theories based on data collected. Fourth, we will translate our findings to enhance future implementation. These phases will be repeated over a three-year span to continuously improve pathway implementation processes and monitor improvements in patient outcomes. Findings will be shared through integrated knowledge translation with system decision-makers and patients. Findings will also be disseminated to the broader research community through conference presentations and peer-reviewed publications.
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BibTeX
@article{mazurik2026protocol,
title = {{Protocol for a realist evaluation of a COPD clinical pathway in Saskatchewan, Canada}},
author = {Kathrina Mazurik and Darcy D Marciniuk and Erika Penz and Patricia Comfort and Alireza Ghorbani-Pashakolaei and Tracey-Ann Stitchell and Tracey Carr and Joshua Shitta and Amy Reid and Gill Westhorp and Collin Hartness and Jason Vanstone and Brenda Andreas and Maggie King and Kim Bell and Johnny Ahale and Ghazale Ahmadalitabar and Stacey McHenry and LUCID Project Team and Gary Groot},
journal = {PLOS One},
year = {2026},
month = oct,
doi = {10.1371/journal.pone.0359299},
url = {https://doi.org/10.1371/journal.pone.0359299},
note = {CC BY},
}
RIS
TY - JOUR
TI - Protocol for a realist evaluation of a COPD clinical pathway in Saskatchewan, Canada
AU - Kathrina Mazurik
AU - Darcy D Marciniuk
AU - Erika Penz
AU - Patricia Comfort
AU - Alireza Ghorbani-Pashakolaei
AU - Tracey-Ann Stitchell
AU - Tracey Carr
AU - Joshua Shitta
AU - Amy Reid
AU - Gill Westhorp
AU - Collin Hartness
AU - Jason Vanstone
AU - Brenda Andreas
AU - Maggie King
AU - Kim Bell
AU - Johnny Ahale
AU - Ghazale Ahmadalitabar
AU - Stacey McHenry
AU - LUCID Project Team
AU - Gary Groot
PY - 2026
DA - 2026/10/22
JO - PLOS One
DO - 10.1371/journal.pone.0359299
UR - https://doi.org/10.1371/journal.pone.0359299
AB - Chronic obstructive pulmonary disease (COPD) is a complex and common condition with significant health, social, and economic burdens, especially due to frequent hospitalizations and comorbidities. International research shows current care for COPD is limited by delayed diagnosis, poor coordination among providers, and inconsistent adherence to treatment guidelines, which negatively impacts patient outcomes. Clinical pathways offer a promising solution by improving care coordination, aligning treatment with evidence-based guidelines, and enhancing both patient experiences and system efficiency; however, questions remain about how, for whom, and in which contexts they are most effective. Using a realist evaluation approach, our study will evaluate how, for whom, and in which circumstances an integrated clinical pathway for COPD works in Saskatchewan, Canada. First, we will develop initial program theories based on literature and stakeholder input. Second, we will test these theories using administrative data and realist interviews with healthcare staff, managers, providers, COPD patients, and caregivers. Third, we will refine our theories based on data collected. Fourth, we will translate our findings to enhance future implementation. These phases will be repeated over a three-year span to continuously improve pathway implementation processes and monitor improvements in patient outcomes. Findings will be shared through integrated knowledge translation with system decision-makers and patients. Findings will also be disseminated to the broader research community through conference presentations and peer-reviewed publications.
SN - 1932-6203
ER -