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This qualitative study seeks to understand the difficulties faced during the trial by investigating stakeholders' views on and experiences of its implementation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>Semi\u2010structured interview and focus group transcripts, and trial management and oversight group meeting minutes from May 2020\u2010June 2022 were analysed using thematic analysis. Participants were 47 clinicians and co\u2010investigators involved with the DAISIES trial. The Non\u2010Adoption, Abandonment, Scale\u2010up, Spread, and Sustainability (NASSS) framework was applied to the interpretive themes to classify barriers and facilitators to implementation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Five themes were identified: incompatible participation interests; changing standard practice; concerns around clinical management; systemic capacity and capability issues; and Covid\u201019 disrupting implementation. Applying the NASSS framework indicated the greatest implementation challenges to arise with the adopters (e.g. patients, clinicians), the organisational systems (e.g. service capacity), and the wider socio\u2010political context (e.g. Covid\u201019 closing services).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Our findings emphasise the top\u2010down impact of systemic\u2010level research implementation challenges. The impact of the Covid\u201019 pandemic accentuated pre\u2010existing organisational barriers to trial implementation within intensive eating disorder services, further limiting the capacity for research.<\/jats:p><\/jats:sec>","DOI":"10.1002\/erv.2975","type":"journal-article","created":{"date-parts":[[2023,3,23]],"date-time":"2023-03-23T17:14:25Z","timestamp":1679591665000},"page":"489-504","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Autopsy of a failed trial part 1: A qualitative investigation of clinician's views on and experiences of the implementation of the DAISIES trial in UK\u2010based intensive eating disorder services"],"prefix":"10.1002","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8250-5560","authenticated-orcid":false,"given":"Matthew","family":"Phillips","sequence":"first","affiliation":[{"name":"Section of Eating Disorders Department of Psychological Medicine Institute of Psychiatry, Psychology, and Neuroscience King's College London  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1177-3490","authenticated-orcid":false,"given":"Ba\u015fak","family":"\u0130nce","sequence":"additional","affiliation":[{"name":"Section of Eating Disorders Department of Psychological Medicine Institute of Psychiatry, Psychology, and Neuroscience King's College London  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1599-8195","authenticated-orcid":false,"given":"Hannah","family":"Webb","sequence":"additional","affiliation":[{"name":"Section of Eating Disorders Department of Psychological Medicine Institute of Psychiatry, Psychology, and Neuroscience King's College London  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0898-1926","authenticated-orcid":false,"given":"Bethan","family":"Dalton","sequence":"additional","affiliation":[{"name":"Section of Eating Disorders Department of Psychological Medicine Institute of Psychiatry, Psychology, and Neuroscience King's College London  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4456-5121","authenticated-orcid":false,"given":"Catherine","family":"McCombie","sequence":"additional","affiliation":[{"name":"Department of Health Service and Population Research Institute of Psychiatry, Psychology &amp; 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