Fig 1.
SPIRIT Schedule of Enrollment, Interventions, and Assessments summarizing all 3 work packages of the nationwide hybrid effectiveness de-implementation trial (adapted to fit the study design).
a This part of the study recruits patients who underwent total hip or knee arthroplasty approximately 10 years ago. Only the RFU and Active COD cohorts will undergo prospective assessments, while for the Passive COD cohort only retrospective registry data will be collected. b The time points referred to as “3-month,” “6-month,” and “1-year” assessments should be understood as 10 years + 3 months, 10 years + 6 months, and 11 years after surgery. These labels reflect the time elapsed since enrolment in this follow-up phase, not since the original procedure. c This part of the study is a nested qualitative study including focus groups with patients from WP1 and WP2 and interviews with health care professionals. It explores experiences, perceptions, and acceptability of RFU and COD in order to identify barriers and facilitators for implementation. This SPIRIT schedule is adapted from the figure published in 2025 in the related qualitative study by de Jong et al. [22]. COD, check-up on demand; HCP, health care professional; RFU, routine follow-up; WP, Work Package.
Table 1.
Anticipated monthly patient inclusion per hospital in the stepped-wedge design.
Table 2.
Overview of the study procedures and timing of assessments.