General practitioner and patient participation in research projects and clinical trials in general practice

Principles

The RACGP recognises the importance of general practice research and is committed to its advancement.¹

Background

Successful general practice research requires the participation of general practitioners (GPs) and patients in the research process. General practitioners may participate in research in a range of ways, eg:

• principal investigators or co-investigators on research projects
• research participants themselves e. by being the subjects of research projects
• facilitators of recruitment of general practice patients to research studies¹

Investigators on research projects

Researchers involved in general practice research will benefit from including a GP on their research team, both to advise on GP issues and encourage GP buy-in to the project.

Research participants/subjects

Researchers should design research so that demands made on GPs allow for the competing demands for time in general practice. Strategies to reduce the demand on GPs as participants may include a flexible approach to times for interviewing and focus group participation; surveys designed to minimise length and maximise question clarity; and use of research assistants or nurses to extract data from records where possible.

Facilitators of GP patient recruitment

Recruiting patients to general practice research is not feasible without the active support of GPs in facilitating contact between researchers and GP patients. While the support of GPs is essential, there are challenges to GPs facilitating patient recruitment. These include competing demands on GP time and significant undersupport of the infrastructure (eg. equipment, information technology, space for data storage and interviewing for data collection) needed to efficiently and effectively implement general practice research in Australia. This needs to be addressed.

There are ethical and legal responsibilities for both researchers and GPs to protect patient and researcher privacy and safety. These should be carefully considered by all researchers in general practice.

The important contribution of GPs in designing, conducting and aiding the successful implementation of quality research activities needs to be acknowledged and respected. General practitioners can be rewarded for participation with Quality Assurance and Continuing Professional Development (QA&CPD) Category 1 points, and if appropriate, recognition of their work toward the attainment of higher research degrees.

Recommendations

• The RACGP encourages researchers and GPs to facilitate the recruitment of patients for general practice research to improve the evidence base for primary heath care in Australia.
• The RACGP recognises that there are barriers to GPs undertaking research and recommends that researchers ensure that recruitment and other research processes are designed to minimise disruption to clinical practice.
• The RACGP supports the development and adequate funding of the infrastructure needed to support research participation by GPs, their practices and their patients.
• The RACGP supports the inclusion of an experienced GP researcher as an investigator on all studies in general practice.
• The RACGP recommends that researchers ensure that GP participation allows opportunities for appropriate professional development.
• The RACGP encourages researchers in general practice to use evidence based intervention and other strategies such as those on the Cochrane Effective Practice and Organisation of Care (EPOC) group to maximise the effectiveness of their research.
• The RACGP recommends that researchers acknowledge the contribution of participating GPs in an appropriate manner.
• The privacy and wellbeing of participants is of paramount The RACGP therefore recommends that GPs only participate in research which has been approved by a recognised Human Research Ethics Committee (HREC) and abide by the RACGP Handbook for the management of health information in private medical practice.²
• The RACGP recommends that GPs incorporate the potential use of personal information for research studies into their practice’s privacy policy. This includes facilitating dissemination of recruitment information to patients and feedback.
• The RACGP recommends that researchers actively seek consumer and GP participation in the research process and work in partnership with consumers according to the National Health and Medical Research Council (NHMRC) Statement on Consumer and Community Participation in Health and Medical Research.³
• The RACGP expects that research conducted in general practice will be published through a process of peer review.