Expectations of general practitioners on a practice based research network in Germany- a qualitative study within the Bavarian Research Practice Network (BayFoNet).
General practice
Implementation science
Participatory research
Practice based research network
Primary health care
Journal
BMC primary care
ISSN: 2731-4553
Titre abrégé: BMC Prim Care
Pays: England
ID NLM: 9918300889006676
Informations de publication
Date de publication:
02 Jan 2024
02 Jan 2024
Historique:
received:
18
07
2023
accepted:
11
12
2023
medline:
4
1
2024
pubmed:
4
1
2024
entrez:
3
1
2024
Statut:
epublish
Résumé
Despite general practitioners' (GPs') key role in Germany`s primary health care, clinical research in general practice is scarce. Clinical research is mainly conducted at inpatient facilities, although their results are rarely transferable. German GPs have no extra time or funding for research, as well as limited research training. To support clinical research in German primary health care, practice-based research networks (PBRNs) are developed. As they will be based on an active involvement of GPs, we need more information on GPs` participation-readiness. The aim of this study was to explore facilitators and barriers to participation in the Bavarian Research Practice Network (BayFoNet) from the GPs`perspective before clinical trials will be performed. We have performed semi-structured qualitative interviews with a purposive sample of 20 Bavarian GPs in 2022 under the application of the consolidated framework for implementation research (CFIR). Transcriptions were analysed according to Kuckartz` qualitative content analysis. The five domains of the CFIR framework served as initial deductive codes. N = 14 interviewees already agreed to participate in BayFoNet, whereas n = 6 interviewees opted not to participate in BayFoNet at the time of data collection. Main facilitators to conduct clinical research within BayFoNet were the motivation to contribute to evidence strength and quality in general practice, professional development and training of practice staff, as well as networking. Barriers for an active participation were bad experiences with previous clinical studies and lack of resources. PBRNS in Germany have to be promoted and the entire practice team has to be involved at an early stage of development. Professional training of general practice staff and a living network might enhance engagement. Participatory approaches could help to develop acceptable and feasible study designs. Furthermore, PBRNs should support patient recruitment and data collection in general practices and disseminate the results of their research projects regularly to maintain GPs` engagement. DRKS00028805, NCT05667207.
Sections du résumé
BACKGROUND
BACKGROUND
Despite general practitioners' (GPs') key role in Germany`s primary health care, clinical research in general practice is scarce. Clinical research is mainly conducted at inpatient facilities, although their results are rarely transferable. German GPs have no extra time or funding for research, as well as limited research training. To support clinical research in German primary health care, practice-based research networks (PBRNs) are developed. As they will be based on an active involvement of GPs, we need more information on GPs` participation-readiness. The aim of this study was to explore facilitators and barriers to participation in the Bavarian Research Practice Network (BayFoNet) from the GPs`perspective before clinical trials will be performed.
METHODS
METHODS
We have performed semi-structured qualitative interviews with a purposive sample of 20 Bavarian GPs in 2022 under the application of the consolidated framework for implementation research (CFIR). Transcriptions were analysed according to Kuckartz` qualitative content analysis. The five domains of the CFIR framework served as initial deductive codes.
RESULTS
RESULTS
N = 14 interviewees already agreed to participate in BayFoNet, whereas n = 6 interviewees opted not to participate in BayFoNet at the time of data collection. Main facilitators to conduct clinical research within BayFoNet were the motivation to contribute to evidence strength and quality in general practice, professional development and training of practice staff, as well as networking. Barriers for an active participation were bad experiences with previous clinical studies and lack of resources.
CONCLUSIONS
CONCLUSIONS
PBRNS in Germany have to be promoted and the entire practice team has to be involved at an early stage of development. Professional training of general practice staff and a living network might enhance engagement. Participatory approaches could help to develop acceptable and feasible study designs. Furthermore, PBRNs should support patient recruitment and data collection in general practices and disseminate the results of their research projects regularly to maintain GPs` engagement.
TRIAL REGISTRATION
BACKGROUND
DRKS00028805, NCT05667207.
Identifiants
pubmed: 38166677
doi: 10.1186/s12875-023-02239-7
pii: 10.1186/s12875-023-02239-7
doi:
Banques de données
ClinicalTrials.gov
['NCT05667207']
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
10Subventions
Organisme : German Ministry of Education and Research
ID : 01GK1903A-D
Organisme : German Ministry of Education and Research
ID : 01GK1903A-D
Organisme : German Ministry of Education and Research
ID : 01GK1903A-D
Organisme : German Ministry of Education and Research
ID : 01GK1903A-D
Organisme : German Ministry of Education and Research
ID : 01GK1903A-D
Organisme : German Ministry of Education and Research
ID : 01GK1903A-D
Organisme : German Ministry of Education and Research
ID : 01GK1903A-D
Organisme : German Ministry of Education and Research
ID : 01GK1903A-D
Organisme : German Ministry of Education and Research
ID : 01GK1903A-D
Organisme : German Ministry of Education and Research
ID : 01GK1903A-D
Organisme : German Ministry of Education and Research
ID : 01GK1903A-D
Organisme : German Ministry of Education and Research
ID : 01GK1903A-D
Organisme : German Ministry of Education and Research
ID : 01GK1903A-D
Organisme : German Ministry of Education and Research
ID : 01GK1903A-D
Investigateurs
Andrea Baumgärtel
(A)
Isabell Endrich
(I)
Maike Ermster
(M)
Jan Gehrmann
(J)
Alexander Hapfelmeier
(A)
Susann Hueber
(S)
Merle Klanke
(M)
Christian Kretzschmann
(C)
Peter Konstantin Kurotschka
(PK)
Klaus Linde
(K)
Klara Lorenz
(K)
Linda Sanftenberg
(L)
Antonius Schneider
(A)
Stefanie Stark
(S)
Til Uebel
(T)
Fabian Walter
(F)
Informations de copyright
© 2023. The Author(s).
Références
Royen PV, Beyer M, Chevallier P, Eilat-Tsanani S, Lionis C, Peremans L, et al. The research agenda for general practice/family medicine and primary health care in Europe. Part 3. Results: Person centred care, comprehensive and holistic approach. Eur J Gen Pract. 2010;16(2):113–9.
Schloemer T, Schröder-Bäck P. Criteria for evaluating transferability of health interventions: a systematic review and thematic synthesis. Implement Sci. 2018;13(1):88.
doi: 10.1186/s13012-018-0751-8
pubmed: 29941011
pmcid: 6019740
Rosemann T, Szecsenyi J. General practitioners’ attitudes towards research in primary care: qualitative results of a cross sectional study. BMC Fam Pract. 2004;5(1):31.
doi: 10.1186/1471-2296-5-31
pubmed: 15613246
pmcid: 545488
Buntinx F, Mant D, Van den Bruel A, Donner-Banzhof N, Dinant GJ. Dealing with low-incidence serious diseases in general practice. Br J Gen Pract. 2011;61(582):43–6.
doi: 10.3399/bjgp11X548974
pubmed: 21401991
pmcid: 3020049
Lane NE, Ling V, Glazier RH, Stukel TA. Primary care physician volume and quality of care for older adults with dementia: a retrospective cohort study. BMC Fam Pract. 2021;22(1):51.
doi: 10.1186/s12875-021-01398-9
pubmed: 33750310
pmcid: 7945328
Holmberg C, Sarganas G, Mittring N, Braun V, Dini L, Heintze C, et al. Primary prevention in general practice - views of German general practitioners: a mixed-methods study. BMC Fam Pract. 2014;15:103.
doi: 10.1186/1471-2296-15-103
pubmed: 24885100
pmcid: 4046439
Goodyear-Smith F, Bazemore A, Coffman M, Fortier R, Howe A, Kidd M, et al. Primary care research priorities in low-and middle-income countries. Ann Fam Med. 2019;17(1):31–5.
doi: 10.1370/afm.2329
pubmed: 30670392
pmcid: 6342597
Beasley JW, Dovey S, Geffen LN, Gómez-Clavelina FJ, Haq CL, Inem V, et al. The contribution of family doctors to primary care research: a global perspective from the International Federation of Primary Care Research Networks (IFPCRN). Prim Health Care Res Dev. 2004;5(4):307–16.
doi: 10.1191/1463423604pc221oa
van Braak M, Visser M, Holtrop M, Statius Muller I, Bont J, van Dijk N. What motivates general practitioners to change practice behaviour? A qualitative study of audit and feedback group sessions in Dutch general practice. BMJ Open. 2019;9(5): e025286.
doi: 10.1136/bmjopen-2018-025286
pubmed: 31154299
pmcid: 6549704
van Weel C, de Grauw W. Family practices registration networks contributed to primary care research. J Clin Epidemiol. 2006;59(8):779–83.
van Royen P, Beyer M, Chevallier P, Eilat-Tsanani S, Lionis C, Peremans L, et al. Series: The research agenda for general practice/family medicine and primary health care in Europe. Part 5: Needs and implications for future research and policy. Eur J Gen Pract. 2010;16(4):244–8.
Hummers-Pradier E, Bleidorn J, Schmiemann G, Joos S, Becker A, Altiner A, et al. General practice-based clinical trials in Germany - a problem analysis. Trials. 2012;13(205).
Wörz M, Busse R. Analysing the impact of health-care system change in the EU member states–Germany. Health Econ. 2005;14(Suppl 1):S133–49.
doi: 10.1002/hec.1032
pubmed: 16161188
Sanftenberg L, Dreischulte T, Härdtlein A, Kosub H, Gagyor I, Kurotschka PK, et al. Process evaluation in practice based research networks: a study protocol for a mixed-methods implementation study. BMJ Open. 2023;13(7): e065947.
doi: 10.1136/bmjopen-2022-065947
pubmed: 37438058
pmcid: 10347461
Kurotschka PK, Borgulya G, Bucher E, Figueiras A, Gensichen J, Hapfelmeier A, et al. Dipsticks and point-of-care Microscopy to reduce antibiotic use in women with an uncomplicated Urinary Tract Infection (MicUTI)- randomized controlled pilot trial in primary care. BMJopen (under review). 2023.
Kohler B, Kellerer C, Schultz K, Wittmann M, Atmann O, Linde K, et al. An Internet-Based Asthma Self-Management Program Increases Knowledge About Asthma. Dtsch Arztebl Int. 2020;117(5):64–71.
pubmed: 32070472
pmcid: 7054593
Eck S, Hapfelmeier A, Linde K, Schultz K, Gensichen J, Sanftenberg L, et al. Effectiveness of an online education program for asthma patients in general practice: study protocol for a cluster randomized controlled trial. BMC Pulm Med. 2022;22(1):457.
doi: 10.1186/s12890-022-02217-2
pubmed: 36456965
pmcid: 9713723
Tong A, Sainsbury P, Craig J. Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups. Int J Qual Health Care. 2007;19(6):349–57.
doi: 10.1093/intqhc/mzm042
pubmed: 17872937
Damschroder LJ, Aron DC, Keith RE, et al. Fostering implementation of health services research findings into practice: a consolidated framework for advancing implementation science. Implementation Sci 2009;4(50 ).
Damschroder LJ, Reardon CM, Sperber N, Robinson CH, Fickel JJ, Oddone EZ. Implementation evaluation of the Telephone Lifestyle Coaching (TLC) program: organizational factors associated with successful implementation. Transl Behav Med. 2017;7(2):233–41.
doi: 10.1007/s13142-016-0424-6
pubmed: 27688249
Witzel A. Das problemzentrierte interview: Beltz; 1985.
Helfferich C. Die Qualität qualitativer Daten: Manual für die Durchführung qualitativer Interviews Wiesbaden: VS Verlag für Sozialwissenschaften Wiesbaden; 2011. VII, 209 p.
Kuckartz U, Rädiker S. Datenaufbereitung und Datenbereinigung in der qualitativen Sozialforschung. In: Baur N, Blasius J, editors. Handbuch Methoden der empirischen Sozialforschung. Wiesbaden: Springer Fachmedien Wiesbaden; 2022. p. 501–16.
doi: 10.1007/978-3-658-37985-8_32
Research Team-Center for Clinical Management Research. Consolidated framework for implementation research. 2021. Available from: https://cfirguide.org /.
Mayring P. Qualitative content analysis basic skills and methods. Beltz, editor. Weinheim 2010.
Glanville J, Kendrick T, McNally R, Campbell J, Hobbs FDR. Research output on primary care in Australia, Canada, Germany, the Netherlands, the United Kingdom, and the United States: Bibliometric analysis. BMJ. 2011;342: d1028.
doi: 10.1136/bmj.d1028
pubmed: 21385804
pmcid: 3050436
Tsiligianni I, Oikonomou N, Papaioannou A, Tatsioni A, Gougourelas D, Birka S, et al. Exploring primary care physician experiences conducting practice-based research on adult vaccination: a qualitative evaluation study in Greece. Fam Pract. 2020;37(6):828–33.
doi: 10.1093/fampra/cmaa063
pubmed: 32779702
Hoffmann AE, Leege EK, Plane MB, Judge KA, Irwin AL, Vidaver RM, et al. Clinician and Staff Perspectives on Participating in Practice-based Research (PBR): A Report from the Wisconsin Research and Education Network (WREN). J Am Board Fam Med. 2015;28(5):639–48.
doi: 10.3122/jabfm.2015.05.150038
pubmed: 26355136
pmcid: 4934613
Huas C, Petek D, Diaz E, Muñoz-Perez MA, Torzsa P, Collins C. Strategies to improve research capacity across European general practice: the views of members of EGPRN and Wonca Europe. Eur J Gen Pract. 2019;25(1):25–31.
doi: 10.1080/13814788.2018.1546282
pubmed: 30607993
pmcid: 6394293
Virnau L, Braesigk A, Deutsch T, Bauer A, Kroeber ES, Bleckwenn M, et al. General practitioners’ willingness to participate in research networks in Germany. Scand J Prim Health Care. 2022;40(2):237–45.
Güthlin C, Beyer M, Erler A, Gensichen J, Hoffmann B, Mergenthal K, et al. Rekrutierung von Hausarztpraxen für Forschungsprojekte. Z Allgemeinmed. 2012;88(4):173–81.
Kimberly JR, Evanisko MJ. Organizational innovation: the influence of individual, organizational, and contextual factors on hospital adoption of technological and administrative innovations. Acad Manage J. 1981;24(4):689–713.
doi: 10.2307/256170
pubmed: 10253688
Greenhalgh T, Robert G, Macfarlane F, Bate P, Kyriakidou O. Diffusion of innovations in service organizations: systematic review and recommendations. Milbank Q. 2004;82(4):581–629.
doi: 10.1111/j.0887-378X.2004.00325.x
pubmed: 15595944
pmcid: 2690184
O’Regan A, Hayes P, O’Connor R, Casey M, O’Dwyer P, Culhane A, et al. The University of Limerick Education and Research Network for General Practice (ULEARN-GP): practice characteristics and general practitioner perspectives. BMC Fam Pract. 2020;21(1):25.
Soós M, Temple-Smith M, Gunn J, Johnston-Ata’Ata K, Pirotta M. Establishing the victorian primary care practice based research network. Aust Fam Physician. 2010;39(11):857–62.
Mergenthal K, Schulz-Rothe S, Siebenhofer A, Gerlach FM, Dauth S, Petersen JJ. Aufgabenteilung im hausärztlichen Praxisteam bei der Durchführung von Versorgungsstudien. Z Allg Med. 2021;97(6):281–85.
Tawo S, Gasser S, Gemperli A, Merlo C, Essig S. General practitioners’ willingness to participate in research: A survey in central Switzerland. PLoS One. 2019;14(3):e0213358.
Cadwallader JS, Lebeau JP, Lasserre E, Letrilliart L. Patient and professional attitudes towards research in general practice: the RepR qualitative study. BMC Fam Pract. 2014;15:136.
doi: 10.1186/1471-2296-15-136
pubmed: 25047280
pmcid: 4115489
Brodaty H, Gibson LH, Waine ML, Shell AM, Lilian R, Pond CD. Research in general practice: a survey of incentives and disincentives for research participation. Ment Health Fam Med. 2013;10(3):163–73.
pubmed: 24427184
pmcid: 3822664
Rieser S. Viele Fragen, zu wenig Forschung. Deutsches Ärzteblatt 2015;Jg. 112(Heft 15).
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(5):552-9.
doi: 10.1093/fampra/cmy126
pubmed: 30605509
Richardson A, Sutherland M, Wells E, Toop L, Plumridge L. Factors affecting general practitioner involvement in a randomised controlled trial in primary care. N Z Med J. 2002;115:153–5.
pubmed: 12033481