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Building an international network for a primary care research program: reflections on challenges and solutions in the set-up and delivery of a prospective observational study of acute cough in 13 European countries

Building an international network for a primary care research program: reflections on challenges and solutions in the set-up and delivery of a prospective observational study of acute cough in 13 European countries
Building an international network for a primary care research program: reflections on challenges and solutions in the set-up and delivery of a prospective observational study of acute cough in 13 European countries
BACKGROUND: Implementing a primary care clinical research study in several countries can make it possible to recruit sufficient patients in a short period of time that allows important clinical questions to be answered. Large multi-country studies in primary care are unusual and are typically associated with challenges requiring innovative solutions. We conducted a multi-country study and through this paper, we share reflections on the challenges we faced and some of the solutions we developed with a special focus on the study set up, structure and development of Primary Care Networks (PCNs).

METHOD: GRACE-01 was a multi-European country, investigator-driven prospective observational study implemented by 14 Primary Care Networks (PCNs) within 13 European Countries. General Practitioners (GPs) recruited consecutive patients with an acute cough. GPs completed a case report form (CRF) and the patient completed a daily symptom diary. After study completion, the coordinating team discussed the phases of the study and identified challenges and solutions that they considered might be interesting and helpful to researchers setting up a comparable study.

RESULTS: The main challenges fell within three domains as follows:i) selecting, setting up and maintaining PCNs;ii) designing local context-appropriate data collection tools and efficient data management systems; andiii) gaining commitment and trust from all involved and maintaining enthusiasm.The main solutions for each domain were:i) appointing key individuals (National Network Facilitator and Coordinator) with clearly defined tasks, involving PCNs early in the development of study materials and procedures.ii) rigorous back translations of all study materials and the use of information systems to closely monitor each PCNs progress;iii) providing strong central leadership with high level commitment to the value of the study, frequent multi-method communication, establishing a coherent ethos, celebrating achievements, incorporating social events and prizes within meetings, and providing a framework for exploitation of local data.

CONCLUSIONS: Many challenges associated with multi-country primary care research can be overcome by engendering strong, effective communication, commitment and involvement of all local researchers. The practical solutions identified and the lessons learned in implementing the GRACE-01 study may assist in establishing other international primary care clinical research platforms.
1471-2296
Nuttall, J.
b5ae8614-d0fa-4488-80f6-33593bb48129
Hood, K.
12e14eb3-2c75-409f-a69d-add733644d89
Verheij, T.J.
809e3576-51ad-48e2-9762-e5d1ab873728
Little, P.
1bf2d1f7-200c-47a5-ab16-fe5a8756a777
Brugman, C.
0b8f1212-dcf8-483a-b30c-99a86b62951e
Veen, R.E.
e4ffaea6-5523-4fb9-8240-6a6f61bcecb7
Goossens, H.
533640f7-b568-4d95-a7c1-28158d154ba8
Butler, C.C.
736f78ad-3e18-4c63-900f-c2249577b645
Nuttall, J.
b5ae8614-d0fa-4488-80f6-33593bb48129
Hood, K.
12e14eb3-2c75-409f-a69d-add733644d89
Verheij, T.J.
809e3576-51ad-48e2-9762-e5d1ab873728
Little, P.
1bf2d1f7-200c-47a5-ab16-fe5a8756a777
Brugman, C.
0b8f1212-dcf8-483a-b30c-99a86b62951e
Veen, R.E.
e4ffaea6-5523-4fb9-8240-6a6f61bcecb7
Goossens, H.
533640f7-b568-4d95-a7c1-28158d154ba8
Butler, C.C.
736f78ad-3e18-4c63-900f-c2249577b645

Nuttall, J., Hood, K., Verheij, T.J., Little, P., Brugman, C., Veen, R.E., Goossens, H. and Butler, C.C. (2011) Building an international network for a primary care research program: reflections on challenges and solutions in the set-up and delivery of a prospective observational study of acute cough in 13 European countries. BMC Family Practice, 12 (78). (doi:10.1186/1471-2296-12-78). (PMID:21794112)

Record type: Article

Abstract

BACKGROUND: Implementing a primary care clinical research study in several countries can make it possible to recruit sufficient patients in a short period of time that allows important clinical questions to be answered. Large multi-country studies in primary care are unusual and are typically associated with challenges requiring innovative solutions. We conducted a multi-country study and through this paper, we share reflections on the challenges we faced and some of the solutions we developed with a special focus on the study set up, structure and development of Primary Care Networks (PCNs).

METHOD: GRACE-01 was a multi-European country, investigator-driven prospective observational study implemented by 14 Primary Care Networks (PCNs) within 13 European Countries. General Practitioners (GPs) recruited consecutive patients with an acute cough. GPs completed a case report form (CRF) and the patient completed a daily symptom diary. After study completion, the coordinating team discussed the phases of the study and identified challenges and solutions that they considered might be interesting and helpful to researchers setting up a comparable study.

RESULTS: The main challenges fell within three domains as follows:i) selecting, setting up and maintaining PCNs;ii) designing local context-appropriate data collection tools and efficient data management systems; andiii) gaining commitment and trust from all involved and maintaining enthusiasm.The main solutions for each domain were:i) appointing key individuals (National Network Facilitator and Coordinator) with clearly defined tasks, involving PCNs early in the development of study materials and procedures.ii) rigorous back translations of all study materials and the use of information systems to closely monitor each PCNs progress;iii) providing strong central leadership with high level commitment to the value of the study, frequent multi-method communication, establishing a coherent ethos, celebrating achievements, incorporating social events and prizes within meetings, and providing a framework for exploitation of local data.

CONCLUSIONS: Many challenges associated with multi-country primary care research can be overcome by engendering strong, effective communication, commitment and involvement of all local researchers. The practical solutions identified and the lessons learned in implementing the GRACE-01 study may assist in establishing other international primary care clinical research platforms.

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More information

Published date: 27 July 2011
Organisations: Primary Care & Population Sciences

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Local EPrints ID: 350011
URI: http://eprints.soton.ac.uk/id/eprint/350011
ISSN: 1471-2296
PURE UUID: eef66b51-b4e1-4b7e-b750-2eb16bedbcd4

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Date deposited: 15 Mar 2013 12:14
Last modified: 14 Mar 2024 13:19

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Contributors

Author: J. Nuttall
Author: K. Hood
Author: T.J. Verheij
Author: P. Little
Author: C. Brugman
Author: R.E. Veen
Author: H. Goossens
Author: C.C. Butler

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