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      General practitioners' attitudes towards research in primary care: qualitative results of a cross sectional study

      research-article
      1 , , 1
      BMC Family Practice
      BioMed Central

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          Abstract

          Background

          Research in General Practice requires the participation of General practitioners (GPs). In Germany there is little tradition of research in this field, and GPs are not used to be participants in research. Little is known about German GPs attitudes towards research. Therefore the aim of our study was to assess the willingness of German General Practitioners to participate in primary care research and their attitude towards research in general practice. The results should enable a more successful approach to GPs in further studies.

          Methods

          Cross sectional study using semi-structured interviews with a random sample of 76 General Practitioners who participate in the teaching of medical students at the University of Heidelberg.

          Results

          Despite little experience, over 85 % of GPs appreciated research in their field. Important reasons for scepticism about research were the gap between theoretical research and practical work of GPs and the domination of research by specialists. Main barriers for participation are clinical workload, administrative overload and the newly introduced Disease Management Programs. The highest motivation for GPs to participate in research emanates from the will to substantiate their quality of care with solid research data.

          Conclusions

          Financial incentives and personal support e.g. with study nurses are certainly necessary to establish a research culture and to overcome main barriers against participation. The most successful approach to motivate GPs to participate is to convince them that research documents their quality of care. This data may reflect the facts on which the financial resources are provided in the future health care system.

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          Most cited references16

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          Shared understanding of the qualitative research process. Guidelines for the medical researcher.

          K Malterud (1993)
          The qualitative research process is presented and discussed as a model, emphasizing matters frequently experienced as unfamiliar by the medical researcher. This model represents a prescriptive methodology, implying underlying values on construction of scientific knowledge where shared understanding--intersubjectivity--is considered as essential. Various stages of the research process are demonstrated, drawing attention to matters that influence analysis and the paths to knowledge, especially preconceptions and theoretical frames of reference. Principles and procedures related to analysis of qualitative data, as decontextualizing and recontextualizing, are explained. The structure of this model, accentuating the researcher's responsibility to give access to all levels of the research process, underlies all kinds of scientific inquiry. Such principles should probably more often be explicitly questioned and accounted for in all sorts of medical research.
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            A randomized controlled trial of a pharmacist consultation program for family physicians and their elderly patients.

            Pharmacists can improve patient outcomes in institutional and pharmacy settings, but little is known about their effectiveness as consultants to primary care physicians. We examined whether an intervention by a specially trained pharmacist could reduce the number of daily medication units taken by elderly patients, as well as costs and health care use. We conducted a randomized controlled trial in family practices in 24 sites in Ontario. We randomly allocated 48 randomly selected family physicians (69.6% participation rate) to the intervention or the control arm, along with 889 (69.5% participation rate) of their randomly selected community-dwelling, elderly patients who were taking 5 or more medications daily. In the intervention group, pharmacists conducted face-to-face medication reviews with the patients and then gave written recommendations to the physicians to resolve any drug-related problems. Process outcomes included the number of drug-related problems identified among the senior citizens in the intervention arm and the proportion of recommendations implemented by the physicians. After 5 months, seniors in the intervention and control groups were taking a mean of 12.4 and 12.2 medication units per day respectively (p = 0.50). There were no statistically significant differences in health care use or costs between groups. A mean of 2.5 drug-related problems per senior was identified in the intervention arm. Physicians implemented or attempted to implement 72.3% (790/1093) of the recommendations. The intervention did not have a significant effect on patient outcomes. However, physicians were receptive to the recommendations to resolve drug-related problems, suggesting that collaboration between physicians and pharmacists is feasible.
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              General practice research: attitudes and involvement of Queensland general practitioners.

              To determine general practitioners' (GPs') attitudes towards and involvement in general practice research. Postal survey and semi-structured interviews conducted from May to September 2001. 467 of 631 GPs in four Queensland Divisions of General Practice responded to the survey (74% response rate); 18 selected GPs were interviewed. Survey - attitudes to research; access to information resources; and involvement in research. Interviews - the need for general practice research; barriers against and factors enabling greater participation in research. 389/463 (84%) GPs, especially younger and more recent graduates, had positive attitudes to research, but only 29% wanted more involvement. 223/462 (48%) were aware they had access to MEDLINE, although presumably all those with Internet access (89%) would have free access via PubMed. Barriers included the general practice environment (especially fee-for-service funding), and the culture of general practice. Enabling factors included academic mentors; opportunities to participate in reputable, established research activities relevant to general practice; and access to information resources. Although Australian general practice has a weak research culture, about a third of GPs would like to increase their involvement in research. However, the research must be perceived as relevant, and structured to minimise the inherent barriers in the environment and culture of general practice.
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                Author and article information

                Journal
                BMC Fam Pract
                BMC Family Practice
                BioMed Central (London )
                1471-2296
                2004
                21 December 2004
                : 5
                : 31
                Affiliations
                [1 ]Department. of General Practice and Health Services Research, University of Heidelberg, Voßstr. 2, 69115 Heidelberg, Germany
                Article
                1471-2296-5-31
                10.1186/1471-2296-5-31
                545488
                15613246
                7492ddae-68f1-4ce5-b924-d39957b4e865
                Copyright © 2004 Rosemann and Szecsenyi; licensee BioMed Central Ltd.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 30 June 2004
                : 21 December 2004
                Categories
                Research Article

                Medicine
                Medicine

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