Family Practice Research Networks: Experiences from 3 Countries
Access to data about the clinical problems, patients, and processes that characterise family practice is essential for the development of this specialty. Practice-based research networks (PBRNs) play an increasing role in obtaining these data.
We compared 3 PBRNs: one in Wisconsin in the United States, one in Wessex in the United Kingdom, and one in Nijmegen in the Netherlands. We organized our data into 4 key areas for review: the mission of the network, its contribution to the evidence base of family medicine, the management of the network, and the financing of the network infrastructure.
Extending the evidence base of family practice is the overriding objective of these networks, and their main focus is on common morbidities. They provide access to unselected patient populations, but there are differences in their size.
There are aspects of PBRNs that are common in countries with different health care systems, despite the fact that local circumstances—the research mission or the characteristics of the health care system under which they operate—determine their form and structure. Networks develop over time and their focus and activities may evolve. Financial support for these networks continues to be a problem.
The recent financial support for networks in the Netherlands8 and the United Kingdom9 heralds the increasing awareness of the importance of primary care evidence. Within the last year in the US Agency for Healthcare Research and Quality (AHRQ) has for the first time offered direct support for building PBRN infrastructure. But because the structure of research networks depend on the research agenda, there is a need for more appropriate financing of their infrastructures. The increasing awareness of the importance of practice-based research is further highlighted by the formation of the Federation of Practice-Based Research Networks (FPBRN), which is working to help networks communicate and collaborate on projects across national and international boundaries.
Conclusions
Family practice research networks are an important way of facilitating research in primary care and of assuring sufficient primary care emphasis in clinical studies. The scientific products of these networks, as judged from their publications, make valuable contributions to the evidence base of primary care.
