Psychological Medicine


The place of implementation science in the translational medicine continuum

G. Thornicrofta1 c1, H. Lemppa2a3 and M. Tansellaa4

a1 Health Service and Population Research Department, Institute of Psychiatry, King's College London, De Crespigny Park, London, UK

a2 NIHR Comprehensive Biomedical Research Centre, Guy's and St Thomas' Foundation NHS Trust, King's College London, UK

a3 Academic Department of Rheumatology, Weston Education Centre, London, UK

a4 Section of Psychiatry and Clinical Psychology, Department of Public Health and Community Medicine, University of Verona, Verona, Italy

There is a growing consensus that the transfer of knowledge from biomedical discoveries into patient and public benefit should be accelerated. At the same time there is a persistent lack of conceptual clarity about the precise nature of the phases of the translational continuum necessary to implement this. In this paper, we: (i) propose an integrated schema to understand the five sequential phases that link basic biomedical research with clinical science and implementation; (ii) discuss the nature of three blocks along this translational pathway; (iii) outline key issues that need to be addressed in removing such barriers. The five research phases described are: (0) basic science discovery; (1) early human studies; (2) early clinical trials; (3) late clinical trials; (4) implementation (which includes adoption in principle, early implementation and persistence of implementation). This schema also sets out three points at which communication blocks can occur. The application of ‘implementation science’ is in its early stages within mental health and psychiatric research. This paper therefore aims to develop a consistent terminology to understand the discovery, development, dissemination and implementation of new interventions. By better understanding the factors that promote or delay knowledge to flow across these blocks, we can accelerate progression along translational medicine pathways and so realize earlier patient benefit.

(Received July 22 2010)

(Revised January 06 2011)

(Accepted January 06 2011)

(Online publication February 15 2011)