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García-Huidobro D, Aracena M, Bravo P, González K, Soto M, von Borries P, Sapag JC. Perceived importance and interest in research by Chilean primary care providers. Fam Pract 2024; 41:610-614. [PMID: 36723858 DOI: 10.1093/fampra/cmad012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND Primary care providers (PCPs) are relevant stakeholders for primary care research (PCR). OBJECTIVE We report the perceived importance and interest in PCR of a national sample of Chilean PCPs. METHODS We conducted a cross-sectional study targeting Chilean PCPs. An electronic survey assessing perceived relevance of PCR, research training and experience, training interests, and demographics was disseminated through emails and WhatsApp messages. Descriptive statistics were used to summarize data. Logistic regression models were used to estimate adjusted probabilities and 95% confidence intervals for high interest in PCR, high interest in using research methods, and high interest in receiving research training, and predictors of these outcomes. RESULTS A total of 387 providers completed the online survey. Only 26.4% of PCPs had research experience as a principal or co-investigator. However, most clinicians perceived PCR as very important (92.5%) and were interested in using research methods (90.7%) and receiving training (94.3%). There were no statistically significant differences in these perceptions between provider's discipline, role, sex, age, and geographical location after adjusting for covariates. CONCLUSIONS Despite few Chilean PCPs have research training, a large majority perceive it as important, are interested in using it in their practice and would like to receive training.
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Affiliation(s)
- Diego García-Huidobro
- Department of Family Medicine, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
- Department of Family Medicine and Community Health, University of Minnesota, Minneapolis, MN, United States
| | - Marcela Aracena
- School of Psychology, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Paulina Bravo
- School of Nursing, Pontificia Universidad Católica de Chile, Santiago, Chile
- ANID-Millennium Science Initiative Program-Millennium Nucleus Authority and Power Asymmetries, Santiago, Chile
- Instituto Oncológico Fundación Arturo López Pérez, Santiago, Chile
| | - Karla González
- School of Social Work, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Mauricio Soto
- Department of Family Medicine, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Pamela von Borries
- Department of Family Medicine, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Jaime C Sapag
- Department of Family Medicine, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
- Department of Public Health, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
- Clinical Public Health División, Dalla Lana School.of Public Health, University of Toronto, Toronto, ON, Canada
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, ON, Canada
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Mohr M, Büttner M, Deuster O, Heckmann J, Huwer F, Krämer I, Lippold C, Siegrist B, Singer S, Veith M, Zinke A, Hardt R. E-Health-based, trans-sectoral, geriatric health service - Geriatric Network (GerNe). Sci Rep 2024; 14:17326. [PMID: 39068175 PMCID: PMC11283534 DOI: 10.1038/s41598-024-67624-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Accepted: 07/15/2024] [Indexed: 07/30/2024] Open
Abstract
Currently, exchange of information between the geriatric clinic and the attending general practitioner (GP) occurs primarily through the doctor's letter after discharging from the clinic. The aim of our study was to reduce readmissions of multimorbid, geriatric patients to the clinic by establishing a new form of care via an electronic case file (ECF) and a consultation service (CS). The discharging geriatric clinic filled out an online ECF. The patient's GP should document quarterly follow-ups in the ECF. The case file was monitored by the discharging clinic due to a consultation service. The primary efficacy endpoint was the rehospitalization rate within one year. The hospitalization rate for patients managed in the project was 83.1/100 person years (PY), while the control group from insurance data had a rate of 69.0/100 PY. The primary endpoint did not show a statistically significant difference (p = 0.15). A total of 195 contacts were documented via CS for 171 participants, mostly initiated by the clinics. The clinical queries primarily concerned drug therapy. The Covid pandemic had an overall impact on hospitalizations. There are many approaches to reducing hospital readmissions after discharge of older patients. Supporting the transition from inpatient to outpatient care by different professional groups or care systems has been shown to have a positive effect. Furthermore, the utilisation of an ECF can also be beneficial in this regard.
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Affiliation(s)
- Michael Mohr
- Geriatric Department, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany.
| | - Matthias Büttner
- Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI), University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Oliver Deuster
- Interdisciplinary Center for Clinical Trials (IZKS), University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | | | - Frank Huwer
- BARMER Rheinland-Pfalz/Saarland, Mainz, Germany
| | - Irene Krämer
- Pharmacy, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | | | - Bettina Siegrist
- Pharmacy, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Susanne Singer
- Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI), University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Marina Veith
- Geriatric Department, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Ariane Zinke
- St. Marien- und St. Annastifts Hospital Ludwigshafen, Ludwigshafen, Germany
| | - Roland Hardt
- Geriatric Department, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
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3
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Kfoury P, Stout JC, Palacios VJ, Yang W, Molin NL, Firpo MA, Park AH. Perspectives on the Impact of the COVID-19 Pandemic on Research: A Cross-Sectional Survey of Pediatric Otolaryngologists. Cureus 2024; 16:e60436. [PMID: 38883003 PMCID: PMC11179676 DOI: 10.7759/cureus.60436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/16/2024] [Indexed: 06/18/2024] Open
Abstract
OBJECTIVE To investigate the perspectives of pediatric otolaryngologists on the impact of the coronavirus disease 2019 (COVID-19) pandemic on their research. METHODS Two surveys were sent to members of the American Society of Pediatric Otolaryngology (ASPO) in 2019 and 2021 to assess research perspectives before and during the COVID-19 pandemic. The surveys contained questions about research engagement, barriers, time allocation, and shifts in research focus. RESULTS The COVID-19 pandemic reshaped research within pediatric otolaryngology, with a mixed impact on the amount of time allocated to research endeavors. Almost half of respondents reported a change in research focus to COVID-19-related studies. Protected time and funding were significant pre-pandemic barriers, whereas reduced staff, collaboration opportunities, and enrollment limitations emerged as key pandemic-related obstacles. A personal commitment to research was most strongly correlated with time spent on this endeavor. During the pandemic, women were less likely to report an increase in research activity when compared to men, possibly due to a disproportionate burden of caregiving on women during school closures and stay-at-home orders. CONCLUSION Overall, the pandemic prompted both increases and decreases in research time allocation, depending on individual circumstances and priorities. Despite new challenges, pediatric otolaryngologists remain committed to research and have continued to remain productive.
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Affiliation(s)
- Peter Kfoury
- Department of Otolaryngology - Head and Neck Surgery, University of Utah School of Medicine, Salt Lake City, USA
| | - Jordan C Stout
- Department of Otolaryngology - Head and Neck Surgery, University of Utah School of Medicine, Salt Lake City, USA
| | | | - Wei Yang
- School of Public Health, University of Nevada, Reno, USA
| | - Nicole L Molin
- Department of Sleep Medicine, Thomas Jefferson University Hospital, Philadelphia, USA
| | - Matthew A Firpo
- Department of Surgery, University of Utah School of Medicine, Salt Lake City, USA
| | - Albert H Park
- Department of Otolaryngology - Head and Neck Surgery/Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, USA
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4
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Vergara-Mejía A, Niño-Garcia R, Zeta-Solis L, Soto-Becerra P, Al-kassab-Córdova A, Pereyra-Elías R, Cabieses B, Mezones-Holguin E. Disparities in scientific research activity between doctors and nurses working in the Peruvian health care system: Analysis of a nationally representative sample. PLoS One 2022; 17:e0273031. [PMID: 36054092 PMCID: PMC9439198 DOI: 10.1371/journal.pone.0273031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Accepted: 08/01/2022] [Indexed: 11/19/2022] Open
Abstract
AIM To evaluate disparities in the frequency of scientific activity between medical doctors and nurses in Peru. METHODS We carried out a secondary data analysis of the National Health Services Users' Satisfaction Survey (ENSUSALUD), 2016. This nationally representative survey evaluates doctors and nurses working in clinical settings. We defined scientific activity as i) having published an original article (journal indexed in Web of Science, Scopus or Medline); and ii) having authored an abstract in a national or international conference. We estimated crude and adjusted disparities prevalence ratios (aDPR) and 95% confidence intervals (95%CI). RESULTS We included 2025 doctors and 2877 nurses in the analysis; 71% of doctors doctor were male, and 93% of nurses were female (p<0.001). Among doctors, 13.9% had published an article, and 8.4% presented an abstract at a conference in the last two years, while these proportions were 0.6% and 2.5% for nurses, respectively. The adjusted models showed that doctors, when compared to nurses, were approximately 27 times likely to have published a paper (aDPR = 27.86; 95% CI 10.46 to 74.19) and twice as likely to have authored a conference abstract (aDPR = 2.51; 95% CI 1.39 to 4.53). CONCLUSIONS There are important disparities in scientific activity between doctors and nurses working in clinical settings in Peru. Disparities are more significant for article publication than for authoring in conference abstracts. We suggest public policies that promote research dissemination between health professionals, with emphasis on nurses.
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Affiliation(s)
- Angélica Vergara-Mejía
- Universidad Nacional Hemilio Valdizán, Escuela de Postgrado, Huánuco, Perúa
- Seguro Social en Salud (EsSalud), Hospital Nacional Guillermo Almenara Irigoyen, Lima, Peru
| | - Roberto Niño-Garcia
- Universidad Nacional de Piura, Facultad de Ciencias de la Salud, Sociedad Científica de Estudiantes de Medicina de la Universidad Nacional de Piura (SOCIEMUNP), Piura, Peru
| | - Ludwing Zeta-Solis
- Universidad Nacional de Piura, Facultad de Ciencias de la Salud, Sociedad Científica de Estudiantes de Medicina de la Universidad Nacional de Piura (SOCIEMUNP), Piura, Peru
| | - Percy Soto-Becerra
- Universidad San Ignacio de Loyola, Centro de Excelencia en Investigaciones Económicas y Sociales en Salud, Lima, Peru
- Epi-gnosis Solutions, Piura, Peru
| | - Ali Al-kassab-Córdova
- Universidad San Ignacio de Loyola, Centro de Excelencia en Investigaciones Económicas y Sociales en Salud, Lima, Peru
| | - Reneé Pereyra-Elías
- Nuffield Department of Population Health, University of Oxford, National Perinatal Epidemiology Unit, Oxford, United Kingdom
- Facultad de Ciencias de la Salud, Universidad Peruana de Ciencias Aplicadas, Lima, Peru
| | - Báltica Cabieses
- Facultad de Medicina Clínica Alemana, Universidad del Desarrollo, Programa de Estudios Sociales en Salud-Instituto de Ciencias e Innovación en Salud, Santiago de Chile, Chile
| | - Edward Mezones-Holguin
- Universidad San Ignacio de Loyola, Centro de Excelencia en Investigaciones Económicas y Sociales en Salud, Lima, Peru
- Epi-gnosis Solutions, Piura, Peru
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5
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Adler L, Gabay L, Yehoshua I. Primary care physicians' attitudes toward research: a cross-sectional descriptive study. Fam Pract 2020; 37:306-313. [PMID: 31786591 DOI: 10.1093/fampra/cmz075] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Clinical research in family medicine can improve health outcomes and increase physicians' professionalism, yet is modest compared to other disciplines and receives little funding. OBJECTIVES To identify factors that promote and impede engagement of family physicians in research and to compare characteristics of family physicians who do and do not engage in research. METHODS During September to October 2018, e-mail questionnaires were sent to 1424 primary care physicians of one health maintenance organization. Respondents were classified as researchers and non-researchers based on their research experience. Responses were analysed using univariate analysis, principal component analysis and multivariate logistic regression. RESULTS Of 235 respondents, 48 (20.4%) were categorized as researchers. The respondents generally agreed that research in primary care improves medical services and provides professional prestige; and that workload, bureaucracy and lack of dedicated time hinder engagement in research. Logistic regression analysis identified several factors associated with being a researcher, including advanced research training (P = 0.001, AOR = 8.49, 95% CI [2.49-29.14]), reading more research articles (P = 0.013, AOR = 14.16, 95% CI [1.76-113.5] and self-employment (P = 0.005, AOR = 5.92, 95% CI [1.71-20.44]). In a factor analysis, only 'importance of research' was associated with being a researcher (P = 0.039, AOR = 1.89, 95% CI [1.03-3.48]). Compared to non-researchers, researchers were older (83.3% versus 51.3% aged >40 years, P < 0.001), more often men (60.4% versus 37.4%, P = 0.02) and worked more (41.7% versus 16.7% worked >41 hours weekly, P = 0.02). CONCLUSIONS Providing time dedicated to research, administrative support, research training and education about the importance of research could increase participation in research by primary care physicians.
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Affiliation(s)
- Limor Adler
- Department of Family Medicine, Maccabi Healthcare Services, Tel Aviv, Israel.,Department of Family Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Linoy Gabay
- Department of Family Medicine, Maccabi Healthcare Services, Tel Aviv, Israel
| | - Ilan Yehoshua
- Department of Family Medicine, Maccabi Healthcare Services, Tel Aviv, Israel.,Department of Family Medicine, Ben Gurion University, Israel
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6
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Youens D, Moorin R, Harrison A, Varhol R, Robinson S, Brooks C, Boyd J. Using general practice clinical information system data for research: the case in Australia. Int J Popul Data Sci 2020; 5:1099. [PMID: 34164582 PMCID: PMC8188523 DOI: 10.23889/ijpds.v5i1.1099] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
General practice is often a patient’s first point of contact with the health system and the gateway to specialist services. In Australia, different aspects of the health system are managed by the Commonwealth Government and individual state / territory governments. Although there is a long history of research using administrative data in Australia, this split in the management and funding of services has hindered whole-system research. Additionally, the administrative data typically available for research are often collected for reimbursement purposes and lack clinical information. General practices collect a range of patient information including diagnoses, medications prescribed, results of pathology tests ordered and so on. Practices are increasingly using clinical information systems and data extraction tools to make use of this information. This paper describes approaches used on several research projects to access clinical, as opposed to administrative, general practice data which to date has seen little use as a resource for research. This information was accessed in three ways. The first was by working directly with practices to access clinical and management data to support research. The second involved accessing general practice data through collaboration with Primary Health Networks, recently established in Australia to increase the efficiency and effectiveness of health services for patients. The third was via NPS MedicineWise’s MedicineInsight program, which collects data from consenting practices across Australia and makes these data available to researchers. We describe each approach including data access requirements and the advantages and challenges of each method. All approaches provide the opportunity to better understand data previously unavailable for research in Australia. The challenge of linking general practice data to other sources, currently being explored for general practice data, is discussed. Finally, we describe some general practice data collections used for research internationally and how these compare to collections available in Australia.
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Affiliation(s)
- D Youens
- School of Public Health, Curtin University, Perth, Australia
| | - R Moorin
- School of Public Health, Curtin University, Perth, Australia.,School of Population and Global Health, University of Western Australia
| | - A Harrison
- School of Public Health, Curtin University, Perth, Australia
| | - R Varhol
- School of Public Health, Curtin University, Perth, Australia
| | - S Robinson
- School of Public Health, Curtin University, Perth, Australia
| | - C Brooks
- Swansea University Medical School, Singleton Park, Swansea, UK
| | - J Boyd
- Health Systems & Economics, School of Public Health, Curtin University.,Department of Public Health, School of Psychology and Public Health, College of Science, Health and Engineering, La Trobe University
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7
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Parker BL, Achilles MR, Subotic-Kerry M, O’Dea B. Youth StepCare: a pilot study of an online screening and recommendations service for depression and anxiety among youth patients in general practice. BMC FAMILY PRACTICE 2020; 21:2. [PMID: 31910811 PMCID: PMC6945483 DOI: 10.1186/s12875-019-1071-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/04/2019] [Accepted: 12/16/2019] [Indexed: 11/25/2022]
Abstract
BACKGROUND General Practitioners (GPs) are ideally placed to identify and manage emerging mental illness in young people, however, many report low levels of confidence in doing so. A web-based universal screening service delivered via a mobile tablet, Youth StepCare, was developed to assist GPs in identifying depression and anxiety symptoms in youth patients. This service also provided evidence-based treatment recommendations and fortnightly monitoring of symptoms. The current study assessed the feasibility and acceptability of delivering the Youth StepCare service in Australian general practices. METHODS A 12-week uncontrolled trial was undertaken between August 2018 and January 2019 in two general practices in NSW, Australia. The service was offered to all youth patients aged 14 to 17 years who visited a participating GP during the screening period with their parent or guardian. Youth patients reported the presence of depressive and anxiety symptoms using the self-report Patient Health Questionnaire-9 and the Generalised Anxiety Disorder Questionnaire-7. New cases were defined as those who reported symptoms but were not currently seeking help from their GP, nor had sought help in the past. Feasibility and acceptability among GPs and practice staff were assessed using a battery of questionnaires. RESULTS Five GPs and 6 practice staff took part. A total of 46 youth patients were approached, 28 consented, and 19 completed the screener (67.9%). Nine reported symptoms of anxiety or depression, two of which were new cases (22.2%). GPs and practice staff were satisfied with the service, reporting that there was a need for the service and that they would use it again. CONCLUSIONS The Youth StepCare service appears to be a useful tool for identifying youth with unidentified symptoms of mental illness that can be easily embedded into general practice. Further research would benefit from exploring the factors affecting initial GP uptake and a larger trial is required to determine the efficacy of the service on young people's symptom reduction.
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Affiliation(s)
- Belinda Louise Parker
- Black Dog Institute, Prince of Wales Hospital, Hospital Road, Randwick, Sydney, NSW 2031 Australia
| | - Melinda Rose Achilles
- Black Dog Institute, Prince of Wales Hospital, Hospital Road, Randwick, Sydney, NSW 2031 Australia
| | - Mirjana Subotic-Kerry
- Black Dog Institute, Prince of Wales Hospital, Hospital Road, Randwick, Sydney, NSW 2031 Australia
| | - Bridianne O’Dea
- Black Dog Institute, Prince of Wales Hospital, Hospital Road, Randwick, Sydney, NSW 2031 Australia
- Faculty of Medicine, University of New South Wales, High Street, Kensington, Sydney, NSW 2052 Australia
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8
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Tan ACW, Clemson L, Mackenzie L, Sherrington C, Roberts C, Tiedemann A, Pond CD, White F, Simpson JM. Strategies for recruitment in general practice settings: the iSOLVE fall prevention pragmatic cluster randomised controlled trial. BMC Med Res Methodol 2019; 19:236. [PMID: 31829133 PMCID: PMC6907149 DOI: 10.1186/s12874-019-0869-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2019] [Accepted: 11/14/2019] [Indexed: 01/01/2023] Open
Abstract
Background Falls are common among older people, and General Practitioners (GPs) could play an important role in implementing strategies to manage fall risk. Despite this, fall prevention is not a routine activity in general practice settings. The iSOLVE cluster randomised controlled trial aimed to evaluate implementation of a fall prevention decision tool in general practice. This paper sought to describe the strategies used and reflect on the enablers and barriers relevant to successful recruitment of general practices, GPs and their patients. Methods Recruitment was conducted within the geographical area of a Primary Health Network in Northern Sydney, Australia. General practices and GPs were engaged via online surveys, mailed invitations to participate, educational workshops, practitioner networks and promotional practice visits. Patients 65 years or older were recruited via mailed invitations, incorporating the practice letterhead and the name(s) of participating GP(s). Observations of recruitment strategies, results and enabling factors were recorded in field notes as descriptive and narrative data, and analysed using mixed-methods. Results It took 19 months to complete recruitment of 27 general practices, 75 GPs and 560 patients. The multiple strategies used to engage general practices and GPs were collectively useful in reaching the targeted sample size. Practice visits were valuable in engaging GPs and staff, establishing interest in fall prevention and commitment to the trial. A mix of small, medium and large practices were recruited. While some were recruited as a whole-practice, other practices had few or half of the number of GPs recruited. The importance of preventing falls in older patients, simplicity of research design, provision of resources and logistic facilitation of patient recruitment appealed to GPs. Recruitment of older patients was successfully achieved by mailed invitations which was a strategy that was familiar to practice staff and patients. Patient response rates were above the expected 10% for most practices. Many practices (n = 17) achieved the targeted number of 20 or more patients. Conclusions Recruitment in general practice settings can be successfully achieved through multiple recruitment strategies, effective communication and rapport building, ensuring research topic and design suit general practice needs, and using familiar communication strategies to engage patients. Trial registration The trial was prospectively registered on 29 April 2015 with the Australian New Zealand Clinical Trial Registry www.anzctr.org.au (trial ID: ACTRN12615000401550).
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Affiliation(s)
- Amy C W Tan
- Faculty of Health Sciences, The University of Sydney, Lidcombe, New South Wales, Australia
| | - Lindy Clemson
- Faculty of Health Sciences, The University of Sydney, Lidcombe, New South Wales, Australia.
| | - Lynette Mackenzie
- Faculty of Health Sciences, The University of Sydney, Lidcombe, New South Wales, Australia
| | - Catherine Sherrington
- Sydney School of Public Health, The University of Sydney, Camperdown, New South Wales, Australia
| | - Chris Roberts
- Sydney Medical School, The University of Sydney, Camperdown, New South Wales, Australia
| | - Anne Tiedemann
- Sydney School of Public Health, The University of Sydney, Camperdown, New South Wales, Australia
| | - Constance D Pond
- School of Medicine & Public Health (General Practice), University of Newcastle, Newcastle, New South Wales, Australia
| | - Fiona White
- Faculty of Health Sciences, The University of Sydney, Lidcombe, New South Wales, Australia
| | - Judy M Simpson
- Sydney School of Public Health, The University of Sydney, Camperdown, New South Wales, Australia
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9
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Evidence summary resources may influence clinical decision making: A case-based scenario evaluation of an evidence summary tool. J Crit Care 2019; 55:9-15. [PMID: 31670150 DOI: 10.1016/j.jcrc.2019.10.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Accepted: 10/02/2019] [Indexed: 12/31/2022]
Abstract
PURPOSE Evidence summary resources are popular with clinicians but it is unknown whether they can influence clinical decision making. We evaluated whether an extremely condensed and explicit evidence summary tool could influence clinical decision making. MATERIALS AND METHODS An evidence summary tool was developed using a formal mapping exercise and graphic design principles. An invitation to participate was sent to subscribers of a critical care e-mail discussion list. Participants received a study package (evidence summary tool précising prone positioning in severe ARDS; case-based scenario describing a patient with severe ARDS plus evaluation questionnaire). Influence on clinical decisions was captured regarding six competing interventions, with Belief in benefit measured before and after reading the summary tool. RESULTS Among 93 participants, 87% were male with a mean age of 49.6(SD9.3) years. Mean ICU experience was 20.0(SD9.9) years. The evidence summary tool significantly influenced clinical decision making: belief in benefit of prone positioning increased (P < .001), belief in benefit of higher PEEP decreased (P = .002) and belief in benefit in ECMO decreased (P = .07). CONCLUSIONS Using a before-after evaluation, we demonstrated an extremely condensed and explicit information format can influence clinical decision making. Evidence summary tools may be a useful adjunct to support closing evidence-practice gaps.
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10
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Ferrand Devouge E, Biard M, Beuzeboc J, Tavolacci MP, Schuers M. Motivations and willingness of general practitioners in France to participate in primary care research as investigators. Fam Pract 2019; 36:552-559. [PMID: 30605509 DOI: 10.1093/fampra/cmy126] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Clinical research is mostly conducted among hospitalized patients, which restricts the generalizability of research results. The involvement of GPs in research has been consistently highlighted as a factor associated with successful study recruitment. OBJECTIVES To assess GPs' motivations and willingness to participate in primary care research as investigators and to identify factors associated with their willingness. METHODS We conducted an observational, cross-sectional study in Normandy, France, with a self-questionnaire sent to 3002 GPs. We collected data on GPs' socio-demographic characteristics, their experiences and their expectations regarding research, and their reasons for non-participation. RESULTS Overall, 489 questionnaires were collected. Two hundred and forty-six GPs (50.3%) were interested in participating in clinical research as investigators. The two main conditions for participation as investigators were the relevance of the study topic for clinical practice (80.5%) and the feedback of study results (80.1%). The two main reasons for non-participation were lack of time (79.4%) and administrative burden (43.6%). Age between 27 and 34 years (adjusted odds ratio [AOR] = 2.86, P = 0.004) and GP trainer status (AOR = 2.41, P < 0.001) were associated with willingness to participate in primary care research. Age between 60 and 70 years (AOR = 0.53, P = 0.03) and locum status (AOR = 0.40, P = 0.04) were associated with non-participation in research. CONCLUSIONS Based on our results, we were able to establish a profile of GPs willing to participate in primary care research as investigators. GPs' involvement should be based on their preferred areas of research. Different incentives such as a dedicated clinical research nurse or financial support could also be considered.
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Affiliation(s)
- Eglantine Ferrand Devouge
- Department of General Practice, University of Rouen, Rouen, France.,INSERM CIC-CRB 1404, Rouen University Hospital, Rouen, France
| | - Morgane Biard
- Department of General Practice, University of Rouen, Rouen, France.,INSERM CIC-CRB 1404, Rouen University Hospital, Rouen, France
| | - Jean Beuzeboc
- Department of General Practice, University of Rouen, Rouen, France
| | - Marie-Pierre Tavolacci
- INSERM CIC-CRB 1404, Rouen University Hospital, Rouen, France.,INSERM U 1073, Normandy University, Rouen, France
| | - Matthieu Schuers
- Department of General Practice, University of Rouen, Rouen, France.,Department of Medical Informatics, Rouen University Hospital, Rouen, France.,INSERM U 1142, LIMICS, Paris, France
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11
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Bilal M, Haseeb A, Mari A, Ahmed S, Sher Khan MA, Saad M. Knowledge, Attitudes, and Barriers Toward Research Among Medical Students of Karachi. Cureus 2019; 11:e5599. [PMID: 31700712 PMCID: PMC6822902 DOI: 10.7759/cureus.5599] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Introduction Our study was meant to assess the knowledge, attitude, and barriers towards research in medical students of Pakistan. By assessing the factors, we aim to increase the role of medical students in research, which will eventually help developing countries like Pakistan to achieve self-reliance in health care. Methods Undergraduate and postgraduate students of medicine, dentistry, and pharmacy schools of Dow University of Health Sciences, Karachi, were enrolled from February-March 2018 in a cross-sectional, descriptive study using questionnaires to provide details of the parameters of attitude to the knowledge of and barriers towards research for each individual. All data were coded for each of the parameters. Data analyses were performed by one-way analysis of variance (ANOVA)/Tukey and Student’s t-test, Pearson’s correlation, and Chi-squared tests. Results A total of 850 questionnaires were received. The overall mean scores of students on attitude, knowledge, and barriers were 69.27 ± 13.44, 70.39 ± 15.67, and 72.46 ± 13.46, respectively; 81.8% of students’ scores fell above the middle of the maximum score for knowledge, but 84.5% of attitude scores came in at below the middle of the maximum score. Undergraduate students had a more positive attitude to research than postgraduate students (69.20 ± 11.10 vs 64.23 ± 10.98; p = 0.002). Male students had a better attitude than females (72.97 ± 20.54 vs 67.09 ± 21.56; p = 0.010). Barriers highlighted by students most significantly included a lack of funding support and preference for instruction over research. Conclusion Students showed good knowledge of research, but their attitude was not up to the mark. The barriers highlighted suggest a need for a change in the strategies for research. Attention should be paid to inculcate research as part of the student curriculum and to make available incentives, information, and mentors to solve the problems most students face in the field of research.
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Affiliation(s)
- Muhammad Bilal
- Internal Medicine, Dr Ruth KM Pfau Civil Hospital, Karachi, PAK
| | - Abdul Haseeb
- Internal Medicine, The Wright Center for Graduate Medical Education, Scranton, USA
| | - Anum Mari
- Internal Medicine, Ziauddin Medical University, Karachi, PAK
| | - Sana Ahmed
- Internal Medicine, Ziauddin Medical University, Karachi, PAK
| | | | - Muhammad Saad
- Internal Medicine, University Hospital Kerry, Tralee, IRL
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Bernardes CM, Ratnasekera IU, Kwon JH, Somasundaram S, Mitchell G, Shahid S, Meiklejohn J, O'Beirne J, Valery PC, Powell E. Contemporary Educational Interventions for General Practitioners (GPs) in Primary Care Settings in Australia: A Systematic Literature Review. Front Public Health 2019; 7:176. [PMID: 31316961 PMCID: PMC6609323 DOI: 10.3389/fpubh.2019.00176] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2018] [Accepted: 06/12/2019] [Indexed: 11/26/2022] Open
Abstract
Background: The primary purpose of educational interventions is to optimize the clinical management of patients. General practitioners (GPs) play a major role in the detection and management of diseases. This systematic literature review will describe the type and outcomes of educational interventions designed for general practitioners (GPs) in the Australian context. Methods: PubMed, CINHAL, and Scopus databases were systematically searched for studies on educational interventions conducted for GPs in Australia during 1st January 2008 to 11th June 2018. Data collected on the methodology of the interventions, GPs satisfaction regarding the educational intervention, changes in knowledge, confidence, skills and clinical behavior of the GPs. We also assessed whether the acquired clinical competencies had an impact on organizational change and on patient health. Results: Thirteen publications were included in this review. The methods with which educational interventions were developed and implemented varied substantially and rigorous evaluation was generally lacking particularly in detailing the outcomes. The reported GP response rate varied between 2 and 96% across studies, depending upon the method of recruitment, the type of intervention and the study setting (rural vs. urban). The most effective recruitment strategy was a combination of initial contact coupled with a visit to GP practices. Nine of the studies reviewed reported improvement in at least one outcome measure: gaining knowledge, improving skills or change in clinical behavior which was translated into clinical practice. In the 3 pre- and post-intervention analysis studies, 90–100% of the participating GPs reported improvement in their knowledge and attitudes. Conclusion: Education interventions for GPs in Australia had low response (recruitment) and retention (GPs that participated in follow-ups) rates, even when financial benefits or CPD points were used as incentives. Higher GP response rates were achieved through multiple recruitment strategies. Multifaceted interventions were more likely to achieve the primary outcome by improving knowledge, skills or changing practice, but the effect was often modest. Inconsistent results were reported in studies involving the use of multiple contact methods within an intervention and conducting online interventions.
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Affiliation(s)
| | | | - Joo Hyun Kwon
- Department of Population Health, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
| | - Sivagowri Somasundaram
- Department of Population Health, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
| | - Geoff Mitchell
- School of Medicine, University of Queensland, Brisbane, QLD, Australia
| | - Shaouli Shahid
- Centre for Aboriginal Studies, Curtin University, Perth, WA, Australia
| | | | - James O'Beirne
- Sunshine Coast Hospital and Health Service, Birtinya, QLD, Australia
| | - Patricia Casarolli Valery
- Department of Population Health, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
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13
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Pallamparthy S, Basavareddy A. Knowledge, attitude, practice, and barriers toward research among medical students: A cross-sectional questionnaire-based survey. Perspect Clin Res 2019; 10:73-78. [PMID: 31008073 PMCID: PMC6463502 DOI: 10.4103/picr.picr_1_18] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
Introduction: Research in medicine has an impact on prevention, diagnosis, and newer treatment for the medical ailments. It has brought reforms in policies for health-care programs. Involvement of undergraduates in research was less, so this study was planned to determine the factors and their perception toward the same. Objective: The objective of the study was to evaluate knowledge, attitude, experience, and the barriers of research among medical undergraduates. Materials and Methods: A cross-sectional questionnaire-based study was conducted after the protocol was approved by the Institutional Ethics Committee and obtaining written informed consent from participants. The predesigned validated questionnaire containing 34 questions was used. Filled questionnaires were received from the medical undergraduates of different phases of MBBS from our institute. Data were analyzed using descriptive statistics. Results: A total of 89% (267/300) responded, 140/267 were females. The knowledge score regarding the concept of research and its methodology was 2405/3458 (70%). Sixty percent strongly agreed to include research in undergraduate curriculum, 57% believed that it would facilitate better understanding of the subject and clinical practice (41%). Nearly 56% opined that research was not waste of time and does not interfere in studies. Barriers for research were lack of awareness (53%), interest (54%), funds (62%), time (59%), and difficulty in follow-up of patients (67%). Almost 59% of students disagreed to lack of encouragement by faculty. Conclusion: Most of the participants had knowledge regarding research and expressed positive attitude toward involvement in research activity. Some of barriers were lack of awareness, time, funds, and difficulty in patient follow-up.
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Affiliation(s)
- Srivani Pallamparthy
- Department of Pharmacology, Sri Devaraj Urs Medical College, Sri Devaraj Urs Academy of Higher Education and Research, Kolar, Karnataka, India
| | - Asha Basavareddy
- Department of Pharmacology, Sri Devaraj Urs Medical College, Sri Devaraj Urs Academy of Higher Education and Research, Kolar, Karnataka, India
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General practitioners' willingness to participate in research: A survey in central Switzerland. PLoS One 2019; 14:e0213358. [PMID: 30822332 PMCID: PMC6396922 DOI: 10.1371/journal.pone.0213358] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2018] [Accepted: 02/20/2019] [Indexed: 11/19/2022] Open
Abstract
It is difficult to enlist the participation of medical general practitioners (GPs) in research studies. We aimed to determine the willingness of GPs in central Switzerland to participate in research, and to identify factors that facilitate or hinder research participation by GPs. To that end, we conducted a postal questionnaire survey of all 268 active GPs in the canton of Lucerne. The survey explored their interest in participating in research projects (yes/no) and factors that potentially influence their participation (5-point Likert scale from “very important” to “not at all important”). We contacted all non-responders by phone. Background information of the GPs was retrieved from the database of the cantonal association of physicians. Associations between willingness to participate in research and GP’s age, gender, type and location of practice, and the perceived relevance of facilitators were investigated via multiple logistic regression. Out of 268 GPs, 115 (43%) agreed to be contacted for future research projects. Willingness was associated with age (willing: 55% ≤ 40 y vs. 33% > 60 y) and gender (44% male vs. 38% female), and to some degree with the type of practice (50% group vs. 31% single), and location (46% urban vs. 38% rural), independently from each other. Scientists should develop methods to motivate and support GPs in single and rural practices to participate so research is representative of primary care as a whole.
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Ogrin R, Aylen T, Rice T, Audehm R, Appannah A. Engagement of primary care practice in Australia: learnings from a diabetes care project. Aust J Prim Health 2019; 25:82-89. [PMID: 30696545 DOI: 10.1071/py18057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2018] [Accepted: 10/22/2018] [Indexed: 11/23/2022]
Abstract
Effective community-based chronic disease management requires general practice engagement and ongoing improvement in care models. This article outlines a case study on contributing factors to insufficient participant recruitment through general practice for an evidence-based diabetes care pilot project. Key stakeholder semi-structured interviews and focus groups were undertaken at cessation of the pilot project. Participants (15 GPs, five practice nurses, eight diabetes educators) were healthcare providers engaged in patient recruitment. Through descriptive analysis, common themes were identified. Four major themes were identified: (1) low perceived need for intervention; (2) communication of intervention problematic; (3) translation of research into practice not occurring; and (4) the service providing the intervention was not widely viewed as a partner in chronic disease care. Engaging GPs in new initiatives is challenging, and measures facilitating uptake of new innovations are required. Any new intervention needs to: be developed with GPs to meet their needs; have considerable lead-in time to develop rapport with GPs and raise awareness; and ideally, have dedicated support staff within practices to reduce the demand on already-overburdened practice staff. Feasible and effective mechanisms need to be developed to facilitate uptake of new innovations in the general practice setting.
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Affiliation(s)
- Rajna Ogrin
- Bolton Clarke Research Institute, Suite 1.01, 973 Nepean Highway, Bentleigh, Vic. 3204, Australia; and Corresponding author.
| | - Tracy Aylen
- Bolton Clarke, Ravenhall, 279 Robinson Road, Ravenhall, Vic. 3023, Australia
| | - Toni Rice
- Bolton Clarke Research Institute, Suite 1.01, 973 Nepean Highway, Bentleigh, Vic. 3204, Australia
| | - Ralph Audehm
- University of Melbourne, 200 Berkeley Street, Carlton, Vic. 3053, Australia
| | - Arti Appannah
- Bolton Clarke Research Institute, Suite 1.01, 973 Nepean Highway, Bentleigh, Vic. 3204, Australia; and Present address: Latrobe University, Kingsbury Drive, Bundoora, Vic. 3083, Australia
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16
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Khalaf AJ, Aljowder AI, Buhamaid MJ, Alansari MF, Jassim GA. Attitudes and barriers towards conducting research amongst primary care physicians in Bahrain: a cross-sectional study. BMC FAMILY PRACTICE 2019; 20:20. [PMID: 30684954 PMCID: PMC6347740 DOI: 10.1186/s12875-019-0911-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/03/2018] [Accepted: 01/18/2019] [Indexed: 11/12/2022]
Abstract
Background Research in primary care is essential for disease diagnosis, management and prevention in relation to the individuals, families and the community. This research aims to study the attitude of primary care physicians towards conducting research in Bahrain and to identify the main barriers encountered during research. Methods A cross-sectional study was conducted amongst 200 randomly selected primary care physicians registered in Ministry of Health affiliated primary healthcare centers in Bahrain. A self-administered validated questionnaire was adopted and used for data collection. Research data was analyzed using the Statistical Package for Social Sciences (SPSS) version 23. Results Primary care physicians had a positive attitude towards conducting research with a total mean score (SD) of 4.47(0.65) (on a scale from 1 to 5 with higher scores indicating more positive attitudes). The total mean score (SD) for barriers encountered by physicians during research was 3.34 (0.80). Insufficient research allotted time (76.5%), insufficient financial support (63%), lack of financial incentives (51%) and lack of statistical support (50%) were major barriers. Physicians designation and board certificate were significantly associated with attitudes and barriers towards research (P-value < 0.05). Conclusion The majority or primary care physicians had positive attitudes towards conducting research. The major difficulties faced by physicians in conducting research are: Insufficient research allotted time, lack of financial incentives and inadequate statistical support. The study addressed a gap in building research capacity which should be embraced by many institutions through partnership and collaboration. Electronic supplementary material The online version of this article (10.1186/s12875-019-0911-1) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Abeer J Khalaf
- Family Practice Residency Program, Ministry of Health, PO Box 12, Juffair, Bahrain
| | - Aysha I Aljowder
- Family Practice Residency Program, Ministry of Health, PO Box 12, Juffair, Bahrain
| | - Meead J Buhamaid
- Family Practice Residency Program, Ministry of Health, PO Box 12, Juffair, Bahrain
| | - Mona F Alansari
- Family Practice Residency Program, Ministry of Health, PO Box 12, Juffair, Bahrain
| | - Ghufran A Jassim
- Family Medicine, Royal College of Surgeons in Ireland-Medical University in Bahrain, PO Box 15503, Adliya, Bahrain.
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Lockery JE, Collyer TA, Abhayaratna WP, Fitzgerald SM, McNeil JJ, Nelson MR, Orchard SG, Reid C, Stocks NP, Trevaks RE, Woods R. Recruiting general practice patients for large clinical trials: lessons from the Aspirin in Reducing Events in the Elderly (ASPREE) study. Med J Aust 2018; 210:168-173. [PMID: 30835844 DOI: 10.5694/mja2.12060] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2018] [Accepted: 10/31/2018] [Indexed: 12/22/2022]
Abstract
OBJECTIVE To assess the factors that contributed to the successful completion of recruitment for the largest clinical trial ever conducted in Australia, the Aspirin in Reducing Events in the Elderly (ASPREE) study. DESIGN Enrolment of GPs; identification of potential participants in general practice databases; screening of participants. SETTING, PARTICIPANTS Selected general practices across southeast Australia (Tasmania, Victoria, Australian Capital Territory, New South Wales, South Australia). MAJOR OUTCOMES Numbers of patients per GP screened and randomised to participation; geographic and demographic factors that influenced screening and randomising of patients. RESULTS 2717 of 5833 GPs approached (47%) enrolled to recruit patients for the study; 2053 (76%) recruited at least one randomised participant. The highest randomised participant rate per GP was for Tasmania (median, 5; IQR, 1-11), driven by the high rate of participant inclusion at phone screening. GPs in inner regional (adjusted odds ratio [aOR], 1.45; 95% CI, 1.14-1.84) and outer regional areas (aOR, 1.86; 95% CI, 1.19-2.88) were more likely than GPs in major cities to recruit at least one randomised participant. GPs in areas with a high proportion of people aged 70 years or more were more likely to randomise at least one participant (per percentage point increase: aOR, 1.10; 95% CI, 1.05-1.15). The number of randomised patients declined with time from GP enrolment to first randomisation. CONCLUSION General practice can be a rich environment for research when barriers to recruitment are overcome. Including regional GPs and focusing efforts in areas with the highest proportions of potentially eligible participants improves recruitment. The success of ASPREE attests to the clinical importance of its research question for Australian GPs.
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Affiliation(s)
| | | | - Walter P Abhayaratna
- College of Health and Medicine, Australian National University School of Clinical Medicine, Canberra, ACT.,Canberra Hospital, Canberra, ACT
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Al-Tannir MA, Katan HM, Al-Badr AH, Al-Tannir MM, Abu-Shaheen AK. Knowledge, attitudes, practices and perceptions of clinicians towards conducting clinical trials in an Academic Tertiary Care Center. Saudi Med J 2018; 39:191-196. [PMID: 29436569 PMCID: PMC5885097 DOI: 10.15537/smj.2018.2.21093] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Objectives: To investigate the knowledge, attitudes practices and perceptions of clinicians concerning the conducting of clinical trials (CTs). Methods: A cross-sectional study was conducted on clinicians at King Fahad Medical City, Riyadh, Saudi Arabia. Data were collected using a self-administered questionnaire which divided into 5 sections: Section 1 covered respondents’ demographics. The other 4 sections explored respondents’ knowledge, attitudes, perceptions and practice towards conducting CTs. Results: A total of 316 clinicians completed the questionnaire. The majority were assistant consultants and consultants 125 (39.5%) and 108 (34.2%), respectively. One hundred sixty-nine (56%) respondents were not aware of the Declaration of Helsinki at all. Two hundred seventy-five (88.4%) respondents expressed interest in conducting CTs and 61.7% and participants showed their willingness to facilitate and assist in CTs conducted by other clinicians. Moreover, 112 (35.9%) respondents participated in CTs previously. Regarding the disadvantages in conducting CTs, participants indicated that the paperwork was complicated and they believed that they might lose patients from their clinical practice once they are recruited in CTs. Lack of research protected time for clinicians 295 (97.7%), and a shortage of clinical research coordinators 293 (97%) were the main problems reported by respondents. Conclusions: Although the majority of participants had an unsatisfactory level of knowledge and misperceptions about CTs, they showed an interest in and positive attitudes about conducting CTs.
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Affiliation(s)
- Mohamad A Al-Tannir
- Research Center, King Fahad Medical City, Riyadh, Kingdom of Saudi Arabia. E-mail.
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Ajjawi R, Crampton PES, Rees CE. What really matters for successful research environments? A realist synthesis. MEDICAL EDUCATION 2018; 52:936-950. [PMID: 30043516 PMCID: PMC6120529 DOI: 10.1111/medu.13643] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/19/2018] [Revised: 03/12/2018] [Accepted: 05/16/2018] [Indexed: 05/19/2023]
Abstract
CONTEXT Research environments, or cultures, are thought to be the most influential predictors of research productivity. Although several narrative and systematic reviews have begun to identify the characteristics of research-favourable environments, these reviews have ignored the contextual complexities and multiplicity of environmental characteristics. OBJECTIVES The current synthesis adopts a realist approach to explore what interventions work for whom and under what circumstances. METHODS We conducted a realist synthesis of the international literature in medical education, education and medicine from 1992 to 2016, following five stages: (i) clarifying the scope; (ii) searching for evidence; (iii) assessing quality; (iv) extracting data, and (v) synthesising data. RESULTS We identified numerous interventions relating to research strategy, people, income, infrastructure and facilities (IIF), and collaboration. These interventions resulted in positive or negative outcomes depending on the context and mechanisms fired. We identified diverse contexts at the individual and institutional levels, but found that disciplinary contexts were less influential. There were a multiplicity of positive and negative mechanisms, along with three cross-cutting mechanisms that regularly intersected: time; identity, and relationships. Outcomes varied widely and included both positive and negative outcomes across subjective (e.g. researcher identity) and objective (e.g. research quantity and quality) domains. CONCLUSIONS The interplay among mechanisms and contexts is central to understanding the outcomes of specific interventions, bringing novel insights to the literature. Researchers, research leaders and research organisations should prioritise the protection of time for research, enculturate researcher identities, and develop collaborative relationships to better foster successful research environments. Future research should further explore the interplay among time, identity and relationships.
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Affiliation(s)
- Rola Ajjawi
- Centre for Research in Assessment and Digital Learning (CRADLE)Deakin UniversityGeelongVictoriaAustralia
| | - Paul E S Crampton
- Research Department of Medical EducationUniversity College LondonLondonUK
- Monash Centre for Scholarship in Health Education (MCSHE)Faculty of Medicine, Nursing and Health SciencesMonash UniversityClaytonVictoriaAustralia
| | - Charlotte E Rees
- Monash Centre for Scholarship in Health Education (MCSHE)Faculty of Medicine, Nursing and Health SciencesMonash UniversityClaytonVictoriaAustralia
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20
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Tong SF, Ng CJ, Lee VKM, Lee PY, Ismail IZ, Khoo EM, Tahir NA, Idris I, Ismail M, Abdullah A. Decision making process and factors contributing to research participation among general practitioners: A grounded theory study. PLoS One 2018; 13:e0196379. [PMID: 29694439 PMCID: PMC5919004 DOI: 10.1371/journal.pone.0196379] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2017] [Accepted: 04/12/2018] [Indexed: 11/18/2022] Open
Abstract
INTRODUCTION The participation of general practitioners (GPs) in primary care research is variable and often poor. We aimed to develop a substantive and empirical theoretical framework to explain GPs' decision-making process to participate in research. METHODS We used the grounded theory approach to construct a substantive theory to explain the decision-making process of GPs to participate in research activities. Five in-depth interviews and four focus group discussions were conducted among 21 GPs. Purposeful sampling followed by theoretical sampling were used to attempt saturation of the core category. Data were collected using semi-structured open-ended questions. Interviews were recorded, transcribed verbatim and checked prior to analysis. Open line-by-line coding followed by focus coding were used to arrive at a substantive theory. Memoing was used to help bring concepts to higher abstract levels. RESULTS The GPs' decision to participate in research was attributed to their inner drive and appreciation for primary care research and their confidence in managing their social and research environments. The drive and appreciation for research motivated the GPs to undergo research training to enhance their research knowledge, skills and confidence. However, the critical step in the GPs' decision to participate in research was their ability to align their research agenda with priorities in their social environment, which included personal life goals, clinical practice and organisational culture. Perceived support for research, such as funding and technical expertise, facilitated the GPs' participation in research. In addition, prior experiences participating in research also influenced the GPs' confidence in taking part in future research. CONCLUSIONS The key to GPs deciding to participate in research is whether the research agenda aligns with the priorities in their social environment. Therefore, research training is important, but should be included in further measures and should comply with GPs' social environments and research support.
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Affiliation(s)
- Seng Fah Tong
- Department of Family Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Chirk Jenn Ng
- Department of Primary Care Medicine, University of Malaya Primary Care Research Group, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Verna Kar Mun Lee
- Department of Family Medicine, School of Medicine, International Medical University, Seremban, Malaysia
| | - Ping Yein Lee
- Department of Family Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Malaysia
| | - Irmi Zarina Ismail
- Department of Family Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Malaysia
| | - Ee Ming Khoo
- Department of Primary Care Medicine, University of Malaya Primary Care Research Group, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Noor Azizah Tahir
- Cyberjaya University College of Medical Science, Cyberjaya, Malaysia
| | - Iliza Idris
- Klinik Kesihatan Ampangan, Seremban, Malaysia
| | | | - Adina Abdullah
- Department of Primary Care Medicine, University of Malaya Primary Care Research Group, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
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Guillemin M, McDougall R, Martin D, Hallowell N, Brookes A, Gillam L. Primary care physicians' views about gatekeeping in clinical research recruitment: A qualitative study. AJOB Empir Bioeth 2017; 8:99-105. [PMID: 28949839 DOI: 10.1080/23294515.2017.1305007] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND Clinical research is increasingly being undertaken in primary care settings. This development offers both benefits and challenges. The ethical challenges of occupying the roles of both clinician and researcher may be accentuated in primary care settings, where relationships are longer lasting and medical conditions are less acute. This article examines primary care physicians' experiences of undertaking research, particularly their decision making about recruiting patients in the context of their own dual roles. METHODS This project comprised in-depth interviews with eight Australian primary care physicians working in general or specialist practices that were involved in clinical research. Data were analyzed using inductive thematic analysis. RESULTS Physicians involved in recruiting their patients into clinical trials acted as gatekeepers; they were selective about which patients to recruit and did not necessarily approach all patients who met the research eligibility criteria. Physicians' accounts suggested they prioritized their clinician role over their researcher role. In addition to the rigor and merit of the research, physicians considered the possible benefit of trial participation for individual patients. Physicians described making recruitment decisions based on their perceived knowledge of patients' personal, behavioral, and attitudinal characteristics-often derived from their long-standing relationships with their patients. CONCLUSION Our data show evidence of gatekeeping by primary care physicians when deciding to participate in, and recruit their patients to, clinical studies. We argue that such gatekeeping is a way of addressing the dual and sometimes conflicting roles of clinician and researcher. It need not be ethically problematic, but primary care physicians should be reflexive about their recruitment practices and biases. In addition, this form of gatekeeping should be explicitly recognized in protocol design and the analysis of trial findings.
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Affiliation(s)
- Marilys Guillemin
- a Melbourne School of Population and Global Health , University of Melbourne
| | - Rosalind McDougall
- a Melbourne School of Population and Global Health , University of Melbourne
| | - Dominique Martin
- b Melbourne School of Population and Global Health , University of Melbourne and School of Medicine, Deakin University
| | - Nina Hallowell
- c Ethox Centre, Nuffield Department of Population Health , University of Oxford
| | - Alison Brookes
- a Melbourne School of Population and Global Health , University of Melbourne
| | - Lynn Gillam
- a Melbourne School of Population and Global Health , University of Melbourne
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22
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Henihan AM, McCombe G, Klimas J, Swan D, Leahy D, Anderson R, Bury G, Dunne CP, Keenan E, Lambert JS, Meagher D, O'Gorman C, O'Toole TP, Saunders J, Shorter GW, Smyth BP, Kaner E, Cullen W. Feasibility of alcohol screening among patients receiving opioid treatment in primary care. BMC FAMILY PRACTICE 2016; 17:153. [PMID: 27816057 PMCID: PMC5097838 DOI: 10.1186/s12875-016-0548-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/24/2016] [Accepted: 10/21/2016] [Indexed: 11/10/2022]
Abstract
Background Identifying and treating problem alcohol use among people who also use illicit drugs is a challenge. Primary care is well placed to address this challenge but there are several barriers which may prevent this occurring. The objective of this study was to determine if a complex intervention designed to support screening and brief intervention for problem alcohol use among people receiving opioid agonist treatment is feasible and acceptable to healthcare providers and their patients in a primary care setting. Methods A randomised, controlled, pre-and-post design measured feasibility and acceptability of alcohol screening based on recruitment and retention rates among patients and practices. Efficacy was measured by screening and brief intervention rates and the proportion of patients with problem alcohol use. Results Of 149 practices that were invited, 19 (12.8 %) agreed to participate. At follow up, 13 (81.3 %) practices with 81 (62.8 %) patients were retained. Alcohol screening rates in the intervention group were higher at follow up than in the control group (53 % versus 26 %) as were brief intervention rates (47 % versus 19 %). Four (18 %) people reduced their problem drinking (measured by AUDIT-C), compared to two (7 %) in the control group. Conclusions Alcohol screening among people receiving opioid agonist treatment in primary care seems feasible. A definitive trial is needed. Such a trial would require over sampling and greater support for participating practices to allow for challenges in recruitment of patients and practices. Electronic supplementary material The online version of this article (doi:10.1186/s12875-016-0548-2) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Anne Marie Henihan
- Graduate Entry Medical School, Faculty of Education & Health Sciences, University of Limerick, Limerick, Ireland
| | - Geoff McCombe
- Graduate Entry Medical School, Faculty of Education & Health Sciences, University of Limerick, Limerick, Ireland.,UCD School of Medicine, University College Dublin , Belfield, Dublin 4, Ireland
| | - Jan Klimas
- Graduate Entry Medical School, Faculty of Education & Health Sciences, University of Limerick, Limerick, Ireland.,UCD School of Medicine, University College Dublin , Belfield, Dublin 4, Ireland.,British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, 608-1081 Burrard Street, Vancouver, BC, V6Z 1Y6, Canada
| | - Davina Swan
- Graduate Entry Medical School, Faculty of Education & Health Sciences, University of Limerick, Limerick, Ireland.,UCD School of Medicine, University College Dublin , Belfield, Dublin 4, Ireland.,Addictions Department, Institute of Psychiatry, Psychology & Neuroscience, King's College London, 4 Windsor Walk, Denmark Hill, London, SE5 8BB, UK
| | - Dorothy Leahy
- Graduate Entry Medical School, Faculty of Education & Health Sciences, University of Limerick, Limerick, Ireland
| | - Rolande Anderson
- Addiction Counsellor, Suite 33, The Morrison Chambers, 32, Nassau Street, Dublin 2, Ireland
| | - Gerard Bury
- UCD School of Medicine, University College Dublin , Belfield, Dublin 4, Ireland
| | - Colum P Dunne
- Graduate Entry Medical School, Faculty of Education & Health Sciences, University of Limerick, Limerick, Ireland
| | - Eamon Keenan
- Addiction Services, Health Services Executive, Dublin, Ireland
| | - John S Lambert
- UCD School of Medicine, University College Dublin , Belfield, Dublin 4, Ireland
| | - David Meagher
- Graduate Entry Medical School, Faculty of Education & Health Sciences, University of Limerick, Limerick, Ireland
| | - Clodagh O'Gorman
- Graduate Entry Medical School, Faculty of Education & Health Sciences, University of Limerick, Limerick, Ireland
| | - Tom P O'Toole
- Brown-Alpert Medical School, Providence, Rhode Island, USA.,Department of Veterans' Affairs, Washington DC, USA
| | - Jean Saunders
- Graduate Entry Medical School, Faculty of Education & Health Sciences, University of Limerick, Limerick, Ireland.,CSTAR Centre, University of Limerick (UL), Limerick, Ireland
| | - Gillian W Shorter
- Trinity Centre for Practice and Healthcare Innovation, School of Nursing and Midwifery, Trinity College Dublin, Dublin, Ireland
| | - Bobby P Smyth
- Trinity Centre for Practice and Healthcare Innovation, School of Nursing and Midwifery, Trinity College Dublin, Dublin, Ireland.,Department of Public Health and Primary Care, Trinity College Dublin, Dublin, Ireland
| | - Eileen Kaner
- Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK
| | - Walter Cullen
- Graduate Entry Medical School, Faculty of Education & Health Sciences, University of Limerick, Limerick, Ireland. .,UCD School of Medicine, University College Dublin , Belfield, Dublin 4, Ireland. .,Department of Veterans' Affairs, Washington DC, USA.
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Messner DA, Moloney R, Warriner AH, Wright NC, Foster PJ, Saag KG. Understanding practice-based research participation: The differing motivations of engaged vs. non-engaged clinicians in pragmatic clinical trials. Contemp Clin Trials Commun 2016; 4:136-140. [PMID: 29736476 PMCID: PMC5935887 DOI: 10.1016/j.conctc.2016.08.003] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2016] [Revised: 08/15/2016] [Accepted: 08/22/2016] [Indexed: 11/17/2022] Open
Abstract
Background/Aims Pragmatic clinical trials (PCTs) represent an increasingly used strategy for “real-world” trials. Successful PCTs typically require participation of community-based practices. However, community clinicians often have limited interest or experience in clinical research. Many barriers to practice-based research have been described, but possible motivations to participate among community practices not active in research have not been well explored. The tendency is for researchers to assume similar motivations and priorities across all candidate practices. This is not necessarily the case. A better understanding of the range of reasons clinicians might see for participating in pragmatic trials could be key to promoting this type of practice-based research. Methods Semi-structured interviews were conducted with 30 clinicians and staff members. Half of the interviewees had experience doing practice-based clinical trials and half did not. Individuals in these two groups were also diversified in terms of their practice size and location. Participants were asked about motivations and barriers to doing practice-based research in the context of a planned osteoporosis pragmatic clinical trial. Interviews were transcribed, coded, and analyzed. Results Barriers identified for both experienced and not-experienced clinicians and staff members included: a lack of time, increased paperwork, disruption to work flows, and concern over practice finances. Similar findings have been reported in the US, UK, Europe, and Australia. However, regarding positive motivations of practices to participate, we found systematic differences in attitude between research-engaged and research-naïve practices that have not been previously reported. The research-experienced group offered a greater number and variety of reasons to take part than the not-experienced group. While both groups expressed motivations related to patient care, clinicians and staff members experienced in practice-based clinical trials were much more likely to cite intellectual, professional, and societal benefits not envisioned by the other group. Conclusions We conclude that clinicians not already participating in practice-based trials may have a narrower range of motivations than those already participating. The lack of a broader view of possible benefits to participation may also translate into more obdurate recruiting challenges. These results point to the need for recruitment, engagement, and messaging approaches differentially tailored to the needs and interests of non-participating practices.
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Affiliation(s)
| | | | - Amy H Warriner
- Division of Endocrinology, Diabetes and Metabolism, University of Alabama at Birmingham, USA
| | - Nicole C Wright
- Department of Epidemiology, University of Alabama at Birmingham, USA
| | - Phillip J Foster
- Division of Clinical Immunology and Rheumatology, University of Alabama at Birmingham, USA
| | - Kenneth G Saag
- Division of Clinical Immunology and Rheumatology, University of Alabama at Birmingham, USA
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Hange D, Björkelund C, Svenningsson I, Kivi M, Eriksson MC, Petersson EL. Experiences of staff members participating in primary care research activities: a qualitative study. Int J Gen Med 2015; 8:143-8. [PMID: 25926753 PMCID: PMC4403682 DOI: 10.2147/ijgm.s78847] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Background The aim of this paper was to study primary care staff members’ experiences and perceptions of participating in a randomized controlled trial concerning Internet therapy. Methods Data were collected via five focus groups, each containing four to eight nurses or general practitioners. The systematic text condensation method described by Malterud was used for thematic analysis of meaning and content of data across cases. Results The informants believed it was important to conduct research within the primary care setting, but it was difficult to combine clinical work and research. They stressed also that there was a need for continuous information and communication between primary care centers and researchers as well as internally at each primary care center. Conclusion Staff members’ experiences of participating in a research study were positive, although associated with various difficulties. It is important to include staff members when designing clinical studies; information should be given continuously during the study and communication facilitated between different occupational groups working at the primary care center.
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Affiliation(s)
- Dominique Hange
- Department of Primary Health Care/Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Cecilia Björkelund
- Department of Primary Health Care/Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Irene Svenningsson
- Närhälsan Research and Development Primary Health Care, Region Västra Götaland, University of Gothenburg, Gothenburg, Sweden
| | - Marie Kivi
- Department of Psychology, University of Gothenburg, Gothenburg, Sweden
| | - Maria C Eriksson
- Department of Primary Health Care/Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Eva-Lisa Petersson
- Department of Primary Health Care/Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden ; Närhälsan Research and Development Primary Health Care, Region Västra Götaland, University of Gothenburg, Gothenburg, Sweden
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Foster JM, Sawyer SM, Smith L, Reddel HK, Usherwood T. Barriers and facilitators to patient recruitment to a cluster randomized controlled trial in primary care: lessons for future trials. BMC Med Res Methodol 2015; 15:18. [PMID: 25887970 PMCID: PMC4369080 DOI: 10.1186/s12874-015-0012-3] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2014] [Accepted: 02/20/2015] [Indexed: 11/20/2022] Open
Abstract
Background Primary-care based randomized controlled trials (RCTs) build an important evidence base for general practice but little evidence exists about barriers to recruitment which often hamper such trials. We investigated the issues that impeded and facilitated recruitment to a clinical trial in general practice. Methods GPs participating in a cluster RCT that tested interventions for improving medication adherence and asthma control completed a survey comprising quantitative and free text questions about their recruitment experiences. We used backward regression to analyze quantitative data and coded free text responses into themes. Results 40/55 of enrolled GPs recruited patients, but only one-third reached the planned recruitment target (5 patients/GP). In univariate analyses, poor patient recruitment by GPs was significantly associated with longer time to first patient enrolment, GP-perceived poor access to eligible patients and GP working in a practice training medical students. In regression analysis, only the first was significant (p = 0.001); the explained variance of the model was 48%. Themes from free text responses described recruitment barriers at the level of GP (e.g. GPs excluding patients for whom research appeared too challenging), practice (e.g. practice cultures disempowered GPs), patient (e.g. reluctance to change treatment for research) and study (e.g. protocol requirements complicating recruitment). Facilitators included GPs perceiving good support from the research team. Conclusion Targeted recruitment support early in the recruitment phase may enhance recruitment rates. Over time, interventions to enhance a general practice research culture are also likely to enhance skills to recruit patients, even for complex interventions. We recommend systematic evaluation of recruitment approaches and outcomes in future RCTs to optimize feasibility and success of these important trials. Trial registration Australian and New Zealand Clinical Trials Registry ACTRN12610000854033 (date registered 14/10/2010).
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Affiliation(s)
- Juliet M Foster
- Clinical Management Group, Woolcock Institute of Medical Research, University of Sydney, Sydney, Australia.
| | - Susan M Sawyer
- Centre for Adolescent Health, Royal Children's Hospital Melbourne, Melbourne, Australia. .,Department of Paediatrics, The University of Melbourne, Melbourne, Australia. .,Murdoch Childrens Research Institute, Melbourne, Australia.
| | - Lorraine Smith
- Faculty of Pharmacy, University of Sydney, Sydney, Australia.
| | - Helen K Reddel
- Clinical Management Group, Woolcock Institute of Medical Research, University of Sydney, Sydney, Australia.
| | - Tim Usherwood
- Department of General Practice Sydney Medical School Westmead, University of Sydney, Sydney, Australia.
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Omolase CO, Egberongbe AA, Komolafe OO, Olasinde AA, Omolase BO, Adeosun OA. Practice of bio-medical research amongst doctors in Owo. S Afr Fam Pract (2004) 2015. [DOI: 10.1080/20786190.2014.978104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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Memarpour M, Fard AP, Ghasemi R. Evaluation of attitude to, knowledge of and barriers toward research among medical science students. ASIA PACIFIC FAMILY MEDICINE 2015; 14:1. [PMID: 25705121 PMCID: PMC4336721 DOI: 10.1186/s12930-015-0019-2] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/04/2014] [Accepted: 01/27/2015] [Indexed: 05/24/2023]
Abstract
BACKGROUND Plans to increase the role of students in health research require data on students' knowledge and views of research. The aim of the study was to evaluate these factors toward research among medical science students. METHODS Undergraduate and postgraduate students of three medicine, dentistry and pharmacy schools in Shiraz were enrolled in a cross-sectional descriptive study using questionnaires to provide details of the parameters of attitude to, knowledge of and barriers toward research for each individual. All data was coded for each of the parameters. Data analyses were performed by one-way ANOVA/Tukey and Student's t, Pearson's correlation and Chi-squared tests. RESULTS A total of 384 questionnaires were returned complete. Mean student scores for attitude, knowledge and barriers were 68.97 ± 12.56, 70.99 ± 20.97 and 75.27 ± 15.38, respectively. On the knowledge parameter, 77.8% of students' scores fell above the middle of the possible attainable score, but 90% of attitude scores came in at below the middle of the possible attainable score. Undergraduate students (70.27 ± 12.00) showed a more positive attitude to research than postgraduate students (65.57 ± 13.06) (p = 0.001). Female students (72.97 ± 20.54) had greater knowledge than males (67.09 ± 21.56) (p = 0.010). Many barriers were highlighted by students such as lack of funding support and lack of time for research. CONCLUSIONS Students showed favorable knowledge of research, but their attitude to the field was inadequate. More attention must be placed on these parameters in the curriculum to improve student interest in health research. The impact of barrier factors on research demonstrates that there is a need for greater availability of information in order to solve the problems and change strategies for research.
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Affiliation(s)
- Mahtab Memarpour
- />Department of Pediatric Dentistry, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Ali Poostforoush Fard
- />Department of Epidemiology, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Roghieh Ghasemi
- />Student Research Committee, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
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Paliadelis P, Parker V, Parmenter G, Maple M. ‘Right' for publication: strategies for supporting novice writers across health and medical disciplines. AUST HEALTH REV 2015; 39:165-168. [DOI: 10.1071/ah14104] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2014] [Accepted: 11/03/2014] [Indexed: 11/23/2022]
Abstract
The idea that scholarly writing is an integral part of academic and clinical work is not new; however, increasing expectations that health professionals contribute to research output through publication, regardless of level of employment or experience, creates anxiety and dissonance for many novice and sometimes not-so-novice writers. Publications and the impact of scholarly work have become the key indicators not only of the performance of individual health academics, but also of health disciplines and universities more broadly. In Australia, as in many other countries, publications as the measure of research impact and outputs are expected in professional disciplines, universities and schools. Research impact is assessed and rated against other institutions and used as a means of allocating scarce research funding. Publishing has become a matter of professional reputation and sustainability. This paper reports on a project designed to enhance publication rates across health disciplines based at a rural university, where many staff members combine academic work with ongoing clinical roles. Without deliberate and focused support to enhance skills and confidence in writing it was unlikely that these academics and clinical staff members would be able to develop the kind of track record required for a successful academic career or promotion. This paper outlines the development, delivery and outcomes of this university-funded project, which drew on evidence in the literature to increase the publication rates across two Schools (Health and Medicine) at a rural university. What is known about the topic? The dissemination of scholarly work is an expectation in most health disciplines, and there are numerous strategies presented in the literature designed to boost publication rates. However, the expectation to publish becomes more challenging because many teaching positions straddle both clinical and academic roles. This article reports on a project focused on increasing the rate of published work by implementing some of the strategies discussed in the literature. What does this paper add? This paper describes the development, delivery and outcomes of a project focused on implementing strategies discussed in the literature to increase the confidence and competence of clinical and academic health professionals to publish their scholarly, project-based and research work. What are the implications for practitioners? With many health professionals combining clinical and teaching roles, there is an expectation that as they progress through their careers they can demonstrate evidence of scholarly publications. This paper provides an overview of the development and delivery of a strategy to encourage health professionals to publish that may be useful across a range of health settings.
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Paget SP, Lilischkis KJ, Morrow AM, Caldwell PHY. Embedding research in clinical practice: differences in attitudes to research participation among clinicians in a tertiary teaching hospital. Intern Med J 2014; 44:86-9. [PMID: 24450523 DOI: 10.1111/imj.12330] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2013] [Accepted: 04/24/2013] [Indexed: 11/28/2022]
Abstract
Despite a drive to increase research in healthcare settings, clinician participation in research remains infrequent. This paper describes an online survey comparing attitudes with research participation among clinicians (doctors, nurses and allied health professionals) at an Australian tertiary children's hospital. Differences between professional groups support the existence of different professional cultures surrounding research, suggesting that multiple strategies are required to improve participation in research.
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Affiliation(s)
- S P Paget
- The Children's Hospital at Westmead, Sydney, New South Wales, Australia; Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia
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Cadwallader JS, Lebeau JP, Lasserre E, Letrilliart L. Patient and professional attitudes towards research in general practice: the RepR qualitative study. BMC FAMILY PRACTICE 2014; 15:136. [PMID: 25047280 PMCID: PMC4115489 DOI: 10.1186/1471-2296-15-136] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/25/2014] [Accepted: 07/15/2014] [Indexed: 11/10/2022]
Abstract
BACKGROUND Since the 1990s, professional institutions worldwide have emphasised the need to develop research in general practice to improve the health of the population. The recent creation of professorships in general practice in French Universities should foster research in this field. Our aim was to explore the views of patients and relevant professionals on research in general practice. METHODS Qualitative study, using the grounded theory approach according to Strauss and Corbin, conducted in 2010 in three French regions. Nine focus groups were run to data saturation, and included 57 participants in four different categories: patients, non-academic GPs, academic GPs, academics in other disciplines. RESULTS Most of the participants in the four categories described research in general practice as specific to the population managed and relevant for health care. They considered that its grounding in day-to-day practice enabled pragmatic approaches. The influence of the pharmaceutical industry, rivalries between university disciplines and a possible gap between research and practice were considered as pitfalls. The barriers identified were representations of the medical researcher as a "laboratory worker", the lack of awareness of any research in the discipline, and lack of time and training. While the views of patients and non-academic GPs are mostly focused on professional issues and the views of academics other than GPs on technical issues, academic GPs are in a position to play a role of interface between the universities and general practices. CONCLUSIONS Although the role of GPs in research is perceived differently by the various protagonists, research in general practice has an undisputed legitimacy in France. Solutions for overcoming the identified barriers include research networks with appropriate resources and training and scientifically sound collaborative research projects, as already implemented in leading countries.
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Affiliation(s)
- Jean-Sébastien Cadwallader
- Department of General Practice, University of Tours, 10 Boulevard Tonnellé, BP 3223, Tours, Cedex 1 37032, France.
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Jahan S, Henary B. Attitudes of primary health care physician managers toward research: a pre-experimental study. Aust J Prim Health 2013; 19:171-6. [PMID: 22950877 DOI: 10.1071/py11146] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2011] [Accepted: 03/14/2012] [Indexed: 11/23/2022]
Abstract
Research in primary health care (PHC) is underdeveloped and scarce, especially in developing countries. It is important to understand the attitudes and aspirations of PHC physicians for the promotion of research. The aim of this study was to determine the attitudes of PHC physician managers toward research in Qassim province and to identify barriers that impede performing research in the PHC system. The study was based on social cognitive theory framework, and was pre-experimental with a 'one-group pre-test-post-test' design. The study participants were physician managers in PHC administration, Qassim. The participants' attitudes were measured by adapting statements from the Attitude Towards Research scale. The intervention was the 1-day training program 'Introduction to Research in Primary Health Care'. A total of 23 PHC physicians participated in the study. The mean age of the participants was 45.4 (±1.6) years, and the mean years of work experience was 16.2 (±2.2) years. Only one participant had an article published in a peer-reviewed journal. The results of the study showed that PHC physicians had a baseline positive attitude toward research that was further enhanced after participating in an introductory research-training program. During the pre-test, out of the total score of 63, the mean score on attitude toward research was 48.35 (±6.8) while the mean total attitude score in the post-test was 49.7 (±6.6). However, the difference was not statistically significant at P<0.05. The item with the highest score regarded the role of research in the improvement of health care services, while the lowest-scoring item was about support from administration to conduct research. The participants recognised lack of skills, lack of training and inadequate resources as major barriers in conducting research. Our study results suggest that the PHC physicians' positive attitudes toward research can be further improved through in-service training. To promote research in PHC in Qassim, regular research-training programs and incentives for conducting research should be provided to the PHC physicians.
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Affiliation(s)
- Saulat Jahan
- Primary Health Care Administration, Qassim, Saudi Arabia.
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Simpson PM, Bendall JC, Patterson J, Middleton PM. Beliefs and expectations of paramedics towards evidence-based practice and research. INT J EVID-BASED HEA 2013; 10:197-203. [PMID: 22925616 DOI: 10.1111/j.1744-1609.2012.00273.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The objective of this cross-sectional online survey was to better understand the beliefs of paramedics towards research and evidence-based practice and their expectations regarding its impact on their ability to provide patient care. METHODS An online survey of frontline paramedical staff in New South Wales, Australia, was conducted in March, 2010. Paramedics were asked to respond to five questions relating to their beliefs and expectations relating to prehospital research and evidence-based practice, using a four-point Likert scale for each. Descriptive statistics are used to describe responses to survey questions. Tests for trend between nominal and ordinal explanatory variables and ordinal survey responses were performed using χ(2) statistics. RESULTS There were 892 responses to the survey throughout the 1-month study period. The vast majority of paramedics believed prehospital research and paramedic participation in research were very important. Ninety per cent believed prehospital research would improve patient care, while 92% reported being likely to change clinical practice as a result of prehospital evidence. Paramedics with shorter lengths of service and those with tertiary education were significantly more supportive of, and had higher expectations of, research and evidence-based practice. CONCLUSIONS Paramedics who responded to this online survey appear to have generally positive expectations of and perceptions towards evidence-based practice and research and their impact on prehospital care. Tertiary education and shorter length of service were associated with more positive expectations of, and higher level of support for, evidence-based practice.
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Affiliation(s)
- Paul M Simpson
- Ambulance Service of New South Wales Biostatistical Training Program, New South Wales Department of Health, Sydney, New South Wales, Australia.
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Pinto RM, Wall M, Yu G, Penido C, Schmidt C. Primary care and public health services integration in Brazil's unified health system. Am J Public Health 2012; 102:e69-76. [PMID: 22994254 DOI: 10.2105/ajph.2012.300972] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES We examined associations between transdisciplinary collaboration, evidence-based practice, and primary care and public health services integration in Brazil's Family Health Strategy. We aimed to identify practices that facilitate service integration and evidence-based practice. METHODS We collected cross-sectional data from community health workers, nurses, and physicians (n = 262). We used structural equation modeling to assess providers' service integration and evidence-based practice engagement operationalized as latent factors. Predictors included endorsement of team meetings, access to and consultations with colleagues, familiarity with community, and previous research experience. RESULTS Providers' familiarity with community and team meetings positively influenced evidence-based practice engagement and service integration. More experienced providers reported more integration and engagement. Physicians reported less integration than did community health workers. Black providers reported less evidence-based practice engagement than did Pardo (mixed races) providers. After accounting for all variables, evidence-based practice engagement and service integration were moderately correlated. CONCLUSIONS Age and race of providers, transdisciplinary collaboration, and familiarity with the community are significant variables that should inform design and implementation of provider training. Promising practices that facilitate service integration in Brazil may be used in other countries.
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Affiliation(s)
- Rogério M Pinto
- School of Social Work, Columbia University, New York, NY 10040, USA.
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Self-care in primary care: findings from a longitudinal comparison study. Prim Health Care Res Dev 2012; 14:29-39. [PMID: 22717510 DOI: 10.1017/s1463423612000199] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
AIM To examine the effects of self-care training workshops for primary healthcare workers on frequently attending patients. BACKGROUND Interventions to promote self-care in frequent users of primary care services have had mixed results. This paper reports an evaluation of a self-care initiative that aimed to develop a practice-based strategy to support self-care. METHODS A 12-month longitudinal-matched comparison study was carried out in seven intervention and four comparison practices. The intervention was a multidisciplinary training package delivered to Primary Care Trusts (PCTs) and practice staff in three workshops, over a three- to six-month period. Twenty-one managers, health professionals and other staff from participating practices and PCTs and 1454 patients were involved in the study. 'Frequently attending' patients were defined as having visited the practice more than eight times in the previous year, and were identified from practice registers and recruited by letter. Three sets of data were obtained: psychometric scores and other data from structured questionnaires; routinely collected data on use of healthcare services; and self-care beliefs and behaviour from qualitative interviews. Findings Study recruitment rate was 20% and retention rate 75%. Of those recruited 66% were female and the majority (94.8%) were White. There was poor uptake of the training programme within the participating practices, with few changes agreed or implemented. Few healthcare professionals consented to take part in the evaluation. No significant changes were seen in patients' use of health services, psychometric scores or self-care beliefs or behaviour. CONCLUSION The initiative did not show any effects during its pilot phase. Uptake and implementation were adversely affected by competing pressures for time and resources in primary care, coupled with a lack of engagement from primary health care professionals.
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Berkhout C, Vandaele-Bétancourt M, Robert S, Lespinasse S, Mitha G, Bradier Q, Vambergue A, Fontaine P. Enhancing field GP engagement in hospital-based studies. Rationale, design, main results and participation in the Diagest 3-GP motivation study. BMC FAMILY PRACTICE 2012; 13:63. [PMID: 22721372 PMCID: PMC3441219 DOI: 10.1186/1471-2296-13-63] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/11/2011] [Accepted: 05/31/2012] [Indexed: 11/29/2022]
Abstract
Background Diagest 3 was a study aimed at lowering the risk of developing type 2 diabetes within 3 years after childbirth. Women with gestational diabetes were enrolled in the study. After childbirth, the subjects showed little interest in the structured education programme and did not attend workshops. Their general practitioners (GPs) were approached to help motivate the subjects to participate in Diagest 3, but the GPs were reluctant. The present study aimed to understand field GPs’ attitudes towards hospital-based studies, and to develop strategies to enhance their involvement and reduce subject drop-out rates. Methods We used a three-step process: step one used a phenomenological approach exploring the beliefs, attitudes, motivations and environmental factors contributing to the GPs’ level of interest in the study. Data were collected in face-to-face interviews and coded by hand and with hermeneutic software to develop distinct GP profiles. Step two was a cross-sectional survey by questionnaire to determine the distribution of the profiles in the GP study population and whether completion of an attached case report form (CRF) was associated with a particular GP profile. In step three, we assessed the impact of the motivation study on participation rates in the main study. Results Fifteen interviews were conducted to achieve data saturation. Theorisation led to the definition of 4 distinct GP profiles. The response rate to the questionnaire was 73%, but dropped to 52% when a CRF was attached. The link between GP profiles and the rate of CRF completion remains to be verified. The GPs provided data on the CRF that was of comparable quality to those collected in the main trial. Our analysis showed that the motivation study increased overall participation in the main study by 23%, accounting for 16% (24/152) of all final visits for 536 patients who were initially enrolled in the Diagest 3 study. Conclusions When a hospital-led study explores issues in primary care, its design must anticipate GP participation early in the trial. Based on our questionnaire response rates, we found that one in two GPs were willing to participate in our hospital-led study, regardless of their initial attitudes.
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Affiliation(s)
- Christophe Berkhout
- Department of General Medicine, University of Lille Nord de France-Lille 2, Faculty of Medicine, 59045, Lille Cedex, France.
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No difference demonstrated between faxed or mailed prenotification in promoting questionnaire response among family physicians: a randomized controlled trial. J Clin Epidemiol 2012; 65:544-52. [DOI: 10.1016/j.jclinepi.2011.08.014] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2011] [Revised: 07/22/2011] [Accepted: 08/09/2011] [Indexed: 11/20/2022]
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Magin PJ, Marshall MJ, Goode SM, Cotter GL, Pond CD, Zwar NA. How generalisable are results of studies conducted in practice‐based research networks? A cross‐sectional study of general practitioner demographics in two New South Wales networks. Med J Aust 2011; 195:210-3. [DOI: 10.5694/j.1326-5377.2011.tb03283.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2011] [Accepted: 07/06/2011] [Indexed: 11/17/2022]
Affiliation(s)
- Parker J Magin
- Discipline of General Practice, University of Newcastle, Newcastle, NSW
| | - Melanie J Marshall
- Primary Health Care Research, Evaluation and Development Program, Research Centre for Primary Health Care and Equity, University of New South Wales, Sydney, NSW
| | - Susan M Goode
- Primary Health Care Research, Evaluation and Development Program, Research Centre for Primary Health Care and Equity, University of New South Wales, Sydney, NSW
| | - Georgina L Cotter
- Discipline of General Practice, University of Newcastle, Newcastle, NSW
| | - C Dimity Pond
- Discipline of General Practice, University of Newcastle, Newcastle, NSW
| | - Nicholas A Zwar
- School of Public Health and Community Medicine, University of New South Wales, Sydney, NSW
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Supper I, Ecochard R, Bois C, Paumier F, Bez N, Letrilliart L. How do French GPs consider participating in primary care research: the DRIM study. Fam Pract 2011; 28:226-32. [PMID: 20829279 DOI: 10.1093/fampra/cmq073] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Recruiting GPs is an issue faced by most research teams in primary care. OBJECTIVES To assess GPs' willingness and expectations with regard to research in French primary care and to identify factors that may increase their participation in research projects. METHODS Cross-sectional study conducted with a representative sample of 452 GPs from the Rhone-Alpes region in France. RESULTS Among 284 GPs (63%) who participated, 85 [29.9%, 95% confidence interval (CI) = 26.4-35.3%] were willing to participate in research as investigators and 83 (29.2%, 95% CI: 23.9-34.5%) had already participated in research projects. Multivariate analysis showed that an earlier participation in research projects [odds ratio (OR) = 3.3], a training practice (OR = 2.3), membership in a research network (OR = 2.1) and younger age (OR = 1.9 for 10 years less) were associated with the willingness to participate in future research projects. Whereas 55% of practitioners who already had an experience in research had participated in a therapeutic trial, those willing to participate in the future preferred to participate in descriptive (26%) or etiologic (22%) studies. Preventive, diagnostic and therapeutic procedures and quality of care were the domains, which interested GPs most. The most expected clinical themes concerned cardiovascular, metabolic, musculoskeletal and respiratory problems. CONCLUSIONS To meet the expectations of French GPs willing to participate in primary care research, it is advisable to diversify studies with respect to their types, domains and themes. Linkage to universities and research networks should also be encouraged.
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Affiliation(s)
- Irène Supper
- Department of General Practice, University of Lyon 1, Lyon, France
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Griffin MF, Hindocha S. Publication practices of medical students at British medical schools: experience, attitudes and barriers to publish. MEDICAL TEACHER 2011; 33:e1-8. [PMID: 21182368 DOI: 10.3109/0142159x.2011.530320] [Citation(s) in RCA: 101] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
INTRODUCTION With research playing a vital role in improving clinical practice, it is important that medical students understand the role of research and submitting articles for publication. Therefore, the aim of this study was to ascertain the experience, motivation and attitude of publishing of medical students. METHODS A cross-sectional survey of British medical students from seven medical schools in the United Kingdom. RESULTS Seventy-two of 515 had submitted an article for publication with a total of 124 articles being submitted. The main motivation to publish was for career progression. For the students that had not published, not having an opportunity to perform research was felt to be the main barrier. Only 49% of students had taken part in a research or audit project. Sixty-two percent of students stated they were not encouraged by the seniors to participate in research projects. From 515 medical students, only 88 students had submitted an article for a scientific meeting. CONCLUSIONS Students have a positive attitude towards publishing and they feel it is important. However, it is clear that students require and would welcome education in writing papers and abstracts, skills that they will need in their postgraduate careers.
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Novak K, Mirić D, Jurin A, Vukojević K, Aljinović J, Carić A, Marinović Guić M, Poljicanin A, Kosta V, Rako D, Marusic A, Marusić M, Puljak L. Awareness and use of evidence-based medicine databases and Cochrane Library among physicians in Croatia. Croat Med J 2010; 51:157-64. [PMID: 20401959 DOI: 10.3325/cmj.2010.51.157] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
AIM To assess awareness and use of evidence-based medicine (EBM) databases and The Cochrane Library among physicians in Croatia. METHODS A cross-sectional study with a telephone survey was performed among 573 physicians (88.6% response rate from 647 contacted physicians) from family practice and 4 major university hospital centers in Croatia. The main outcome measures were physicians' awareness of The Cochrane Collaboration, awareness and use of The Cochrane Library, access to EBM databases, and access to internet at work. RESULTS Overall, 54% of respondents said they had access to EBM databases, but when asked which databases they used, they named mostly non-EBM databases. The question on the highest level of evidence in EBM was correctly answered by 53% respondents, 30% heard of The Cochrane Collaboration, and 34% heard about The Cochrane Library. They obtained information about The Cochrane Library mostly from colleagues and research articles, whereas the information about EBM was gained mainly during continuous medical education. There were more respondents who thought The Cochrane Library could help them in practice (58%) than those who heard about The Cochrane Library (30%). Only 20% of the respondents heard about the initiative for the establishment of the Croatian branch of The Cochrane Collaboration. Family physicians had significantly lower level of awareness, knowledge, and use of EBM and The Cochrane Library than physicians from university hospitals. CONCLUSION There is low awareness about EBM and The Cochrane Library among physicians in Croatia, which creates a need for educational interventions about EBM for the benefit of health care in Croatia.
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Affiliation(s)
- Katarina Novak
- Department of Internal Medicine, University Hospital Center Split, University of Split School of Medicine, Croatia
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Participating in and delivering the ATEAM trial (Alexander technique lessons, exercise, and massage) interventions for chronic back pain: A qualitative study of professional perspectives. Complement Ther Med 2010; 18:119-27. [PMID: 20688257 DOI: 10.1016/j.ctim.2010.05.037] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2009] [Accepted: 05/22/2010] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVES To outline professionals' experiences of participation, perceived benefits and acceptability of the interventions delivered in the ATEAM trial (Alexander technique lessons, exercise, and massage), for patients with chronic or recurrent back pain. DESIGN Qualitative study using in-depth interviews was conducted with a purposeful sample of twenty professionals (general practitioners (GPs), nurses, Alexander technique teachers, and massage therapists). Data were recorded, transcribed, and analysed thematically using the constant comparison method. RESULTS Evidence of effectiveness GPs wanted an evidence base for the interventions, whilst nurses, Alexander technique teachers and massage therapists perceived patient reports of benefit as evidence. Professionals' perception of the acceptability of the intervention: professional perspectives differed, with GPs and nurses viewing the structured nature of exercise prescription and Alexander technique lessons as more beneficial and acceptable than massage in alleviating patients' back pain. Economic cost: the cost to patients pursuing Alexander technique lessons and massage was perceived to be a barrier outside the trial. Inter-professional communication: there was little communication between the professionals groups within the trial. CONCLUSIONS Valuable insights have been gained into the perceived benefits and acceptability of exercise, Alexander technique lessons and massage as interventions for chronic back pain. Lessons in the Alexander technique with or without exercise, was perceived as more beneficial and acceptable than massage by professionals who participated and delivered the ATEAM trial interventions.
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Saini B, Brillant M, Filipovska J, Gelgor L, Mitchell B, Rose G, Smith L. Factors influencing Australian community pharmacists' willingness to participate in research projects - an exploratory study. INTERNATIONAL JOURNAL OF PHARMACY PRACTICE 2010. [DOI: 10.1211/ijpp.14.3.0004] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
Abstract
Objective
To identify the factors influencing Australian community pharmacists' willingness to participate in research projects and their attitudes towards research.
Method
A mixed-method survey instrument comprising demographics, previous participation in research, and perceptions about participation in research was mailed to 267 community pharmacists in New South Wales and the Australian Capital Territory. An analysis of variance test was used to identify similarities and differences between research- and non-research-active respondents. Bivariate correlations and partial least squares (PLS) regression analyses were used to identify barriers and facilitators to research participation.
Key findings
The overall response rate to the survey was 40%. Of these, 70% were classified as previous research participants (PRP), and 30% were classified as non-previous research participants (NPRP). Both groups had mostly favourable attitudes towards research; however, the results revealed several differences between the PRP and NPRP groups. Three items were identified as key facilitators to participation in research for both PRP and NPRP groups - having an interest in the research topic; believing that the research will benefit the customer; and a belief that community pharmacy research is important. Lack of time, either real or perceived, was identified as a key barrier to participation in research for both the PRP and NPRP groups.
Conclusion
Researchers should take into account pharmacists' previous research experience when recruiting pharmacists into research projects. In the case of pharmacists with research experience, emphasis should be on promoting factors that facilitate participation. In the case of pharmacists with little research experience, emphasis should be on reducing barriers to participation.
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Affiliation(s)
- B Saini
- Pharmacy Practice, Faculty of Pharmacy, University of Sydney, New South Wales, Australia
| | - M Brillant
- Pharmacy Practice, Faculty of Pharmacy, University of Sydney, New South Wales, Australia
| | - J Filipovska
- Pharmacy Practice, Faculty of Pharmacy, University of Sydney, New South Wales, Australia
| | - L Gelgor
- Pharmacy Practice, Faculty of Pharmacy, University of Sydney, New South Wales, Australia
| | - B Mitchell
- Pharmacy Practice, Faculty of Pharmacy, University of Sydney, New South Wales, Australia
| | - G Rose
- Pharmacy Practice, Faculty of Pharmacy, University of Sydney, New South Wales, Australia
| | - L Smith
- Pharmacy Practice, Faculty of Pharmacy, University of Sydney, New South Wales, Australia
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Sumi E, Murayama T, Yokode M. A survey of attitudes toward clinical research among physicians at Kyoto University Hospital. BMC MEDICAL EDUCATION 2009; 9:75. [PMID: 20025782 PMCID: PMC2805647 DOI: 10.1186/1472-6920-9-75] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/07/2009] [Accepted: 12/22/2009] [Indexed: 05/28/2023]
Abstract
BACKGROUND In Japan, only clinical research related to investigational new drug trials must be notified to regulatory bodies, and this lack of a uniform standard for clinical research has caused a number of difficulties. The objective of this study was to assess the willingness of physicians to participate in clinical research and to identify effective methods to promote and enhance clinical research. METHODS We conducted a cross-sectional survey by administrating questionnaires to physicians in 31 departments in Kyoto University Hospital from October through November 2007. RESULTS A total of 51.5% (310 of 602) of physicians completed the questionnaire. More than two-thirds of them reported currently participating in clinical research, and nearly all believed that clinical research is necessary for physicians. Less than 20% of respondents had specific training regarding clinical research, and most reported a need to acquire concepts and skills regarding clinical research, especially those related to statistics. "Paperwork was complicated and onerous" was the most frequently cited obstacle in conducting clinical research, followed by "few eligible patients" and "lack of time". Previous participation in and prospective participation in clinical research, previous writing a research protocol were positively associated with current participation in clinical research. CONCLUSIONS Physicians in university hospitals need more training regarding clinical research, particularly in biostatistics. They also require administrative assistance. Our findings indicate that the quality of clinical research could be improved if training in clinical research methodology and biostatistics were provided, and if greater assistance in the preparation of study documents requested by the institutional Independent Ethics Committee were available.
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Affiliation(s)
- Eriko Sumi
- Department of Clinical Innovative Medicine, Translational Research Center, Kyoto University Graduate School of Medicine, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto 606-8507, Japan
| | - Toshinori Murayama
- Department of Clinical Innovative Medicine, Translational Research Center, Kyoto University Graduate School of Medicine, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto 606-8507, Japan
| | - Masayuki Yokode
- Department of Clinical Innovative Medicine, Translational Research Center, Kyoto University Graduate School of Medicine, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto 606-8507, Japan
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Sabzwari S, Kauser S, Khuwaja AK. Experiences, attitudes and barriers towards research amongst junior faculty of Pakistani medical universities. BMC MEDICAL EDUCATION 2009; 9:68. [PMID: 19917109 PMCID: PMC2780986 DOI: 10.1186/1472-6920-9-68] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/13/2009] [Accepted: 11/16/2009] [Indexed: 05/28/2023]
Abstract
BACKGROUND The developing world has had limited quality research and in Pakistan, research is still in its infancy. We conducted a study to assess the proportion of junior faculty involved in research to highlight their attitude towards research, and identify the factors associated with their research involvement. METHODS A cross-sectional study was conducted in four medical universities/teaching hospitals in Pakistan, representing private and public sectors. A pre-tested, self-administered questionnaire was used to collect information from 176 junior faculty members of studied universities/hospitals. Logistic regression analysis was used to identify factors related to attitudes and barriers in research among those currently involved in research with those who were not. RESULTS Overall, 41.5% of study subjects were currently involved in research. A highly significant factor associated with current research involvement was research training during the post-graduate period (p < 0.001). Other factors associated with current involvement in research were male gender, working in the public sector and previous involvement in research. Overall, a large majority (85.2%) of doctors considered research helpful in their profession and had a positive attitude towards research; nevertheless this positive attitude was more frequently reported by doctors who were currently involved in research compared to those who were not (OR = 4.69; 95% CI = 1.54-14.26). Similarly, a large proportion (83.5%) of doctors considered research difficult to conduct; higher by doctors who were not presently involved in research (OR = 2.74; 95% CI = 1.20-6.22) CONCLUSION Less than half of the study participants were currently involved in research. Research output may improve if identified barriers are rectified. Further studies are recommended in this area.
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Affiliation(s)
- Saniya Sabzwari
- Department of Family Medicine, Aga Khan University, Karachi, Pakistan
| | - Samreen Kauser
- Department of Family Medicine, Aga Khan University, Karachi, Pakistan
| | - Ali Khan Khuwaja
- Department of Community Health Sciences, Aga Khan University, Karachi, Pakistan
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Peterson GM, Jackson SL, Fitzmaurice KD, Gee PR. Attitudes of Australian pharmacists towards practice-based research. J Clin Pharm Ther 2009; 34:397-405. [DOI: 10.1111/j.1365-2710.2008.01020.x] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Waters D, Crisp J, Rychetnik L, Barratt A. The Australian experience of nurses' preparedness for evidence-based practice. J Nurs Manag 2009; 17:510-8. [PMID: 19531151 DOI: 10.1111/j.1365-2834.2009.00997.x] [Citation(s) in RCA: 52] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Donna Waters
- The College of Nursing, Burwood, Sydney, NSW 1805, Australia.
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Prenatal care and delivery room staff attitudes toward research and the National Children's Study. Matern Child Health J 2008; 12:684-91. [PMID: 18668359 DOI: 10.1007/s10995-008-0393-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2007] [Accepted: 07/21/2008] [Indexed: 10/21/2022]
Abstract
OBJECTIVES The cooperation of healthcare personnel is essential for implementing clinical research, yet little is known about the willingness of staff to facilitate research. This study assessed attitudes of prenatal clinic and delivery room (DR) staff toward facilitation of research, with a particular focus on the National Children's Study (NCS). METHODS Staff from seven sampled prenatal clinics (N=82) and all three DRs in Kent County, MI (N=169) completed anonymous surveys assessing willingness to recruit patients (clinic) or collect biological specimens (DR), desired incentives, and barriers to research in general and the NCS specifically. RESULTS Clinic staff included 36 office workers, 29 nurses, 11 medical assistants and 6 physicians/physician assistants. DR staff included 127 nurses, 19 support staff, 11 physicians and 10 technicians. Clinic staff would hand out brochures (72%) and describe studies (65%), but only 44% wanted outside research staff to recruit patients. Non-White staff were 4.1 times more likely (95% CI. 1.2-14.1) to permit outside staff to recruit. DR staff would collect placentas (84%) and cord blood (77%), and preferred DR staff to perform the collections. In both settings, financial incentives were not required or were modest. Lack of time was the most reported research barrier, followed by patient flow and lack of space. A small fraction of healthcare workers reported refusal to facilitate research tasks. CONCLUSIONS Careful planning of research with all clinic and DR staff will be necessary for successful execution of the NCS or other large-scale clinical research studies.
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Down L, Metcalfe C, Avery K, Noble S, Lane JA, Neal DE, Hamdy FC, Donovan JL. Factors distinguishing general practitioners who more readily participated in a large randomized trial were identified. J Clin Epidemiol 2008; 62:67-73. [PMID: 18619796 DOI: 10.1016/j.jclinepi.2008.02.014] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2007] [Revised: 02/14/2008] [Accepted: 02/18/2008] [Indexed: 10/21/2022]
Abstract
OBJECTIVE To investigate factors associated with the successful recruitment of general practices to a randomized controlled trial. STUDY DESIGN AND SETTING Analysis of accrual of primary care centers to a randomized controlled trial in the UK. RESULTS Those practices promptly agreeing to take part had better target achievement and a higher proportion of white British residents locally. Participating practices had a mean Quality and Outcomes Framework attainment of 92% of the points available, whereas nonparticipating practices achieved 88% (P=0.009). Participating practices were located in areas with a higher proportion of white British residents (mean 89%), in comparison to nonparticipating practices (mean 84%, P=0.004). Reasons given by practices to explain nonparticipation were primarily related to internal factors, with 38% of practices approached saying that they could not participate for such reasons. CONCLUSION There are some small differences between participating practices and nonparticipants in achievement of government targets and in the local ethnic mix. The primary reason given by practices for nonparticipation was workload or time pressures, with over a third of practices reporting being prevented by issues relating to practice organization. It may be that practices with workload or organizational difficulties require additional support to participate in research.
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Affiliation(s)
- Liz Down
- Department of Social Medicine, University of Bristol, Canynge Hall, Whiteladies Road, Bristol BS8 2PR, UK.
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Williamson MK, Pirkis J, Pfaff JJ, Tyson O, Sim M, Kerse N, Lautenschlager NT, Stocks NP, Almeida OP. Recruiting and retaining GPs and patients in intervention studies: the DEPS-GP project as a case study. BMC Med Res Methodol 2007; 7:42. [PMID: 17875219 PMCID: PMC2147023 DOI: 10.1186/1471-2288-7-42] [Citation(s) in RCA: 60] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2007] [Accepted: 09/18/2007] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Recruiting and retaining GPs for research can prove difficult, and may result in sub-optimal patient participation where GPs are required to recruit patients. Low participation rates may affect the validity of research. This paper describes a multi-faceted approach to maximise participation of GPs and their patients in intervention studies, using an Australian randomised controlled trial of a depression/suicidality management intervention as a case study. The paper aims to outline experiences that may be of interest to others considering engaging GPs and/or their patients in primary care studies. METHODS A case study approach is used to describe strategies for: (a) recruiting GPs; (b) encouraging GPs to recruit patients to complete a postal questionnaire; and (c) encouraging GPs to recruit patients as part of a practice audit. Participant retention strategies are discussed in light of reasons for withdrawal. RESULTS The strategies described, led to the recruitment of a higher than expected number of GPs (n = 772). Three hundred and eighty three GPs (49.6%) followed through with the intent to participate by sending out a total of 77,820 postal questionnaires, 22,251 (28.6%) of which were returned. Three hundred and three GPs (37.0%) participated in the practice audit, which aimed to recruit 20 patients per participating GP (i.e., a total of 6,060 older adults). In total, 5,143 patients (84.9%) were represented in the audit. CONCLUSION Inexpensive methods were chosen to identify and recruit GPs; these relied on an existing database, minor promotion and a letter of invitation. Anecdotally, participating GPs agreed to be involved because they had an interest in the topic, believed the study would not impinge too greatly on their time, and appreciated the professional recognition afforded by the Continuing Professional Development (CPD) points associated with study participation. The study team established a strong rapport with GPs and their reception staff, offered clear instructions, and were as flexible and helpful as possible to retain GP participants. Nonetheless, we experienced attrition due to GPs' competing demands, eligibility, personnel issues and the perceived impact of the study on patients. A summary of effective and ineffective methods for recruitment and retention is provided.
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Affiliation(s)
- Michelle K Williamson
- Centre for Health Policy, Programs and Economics, School of Population Health, University of Melbourne, Australia
| | - Jane Pirkis
- Centre for Health Policy, Programs and Economics, School of Population Health, University of Melbourne, Australia
| | - Jon J Pfaff
- WA Centre for Health and Ageing, School of Psychiatry and Clinical Neurosciences, University of Western Australia & Royal Perth Hospital, Australia
| | - Orla Tyson
- WA Centre for Health and Ageing, School of Psychiatry and Clinical Neurosciences, University of Western Australia & Royal Perth Hospital, Australia
| | - Moira Sim
- School of Nursing, Midwifery and Postgraduate Medicine, Edith Cowan University, Australia
| | - Ngaire Kerse
- Department of General Practice and Primary Health Care, University of Auckland, New Zealand
| | - Nicola T Lautenschlager
- WA Centre for Health and Ageing, School of Psychiatry and Clinical Neurosciences, University of Western Australia & Royal Perth Hospital, Australia
| | - Nigel P Stocks
- Discipline of General Practice, University of Adelaide, Australia
| | - Osvaldo P Almeida
- WA Centre for Health and Ageing, School of Psychiatry and Clinical Neurosciences, University of Western Australia & Royal Perth Hospital, Australia
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