Primary care research for all: two proof-of-concept studies using the Primary care Academic CollaboraTive (PACT) network

Conference:

SAPC ASM 2023 - Brighton

Talk Code:

3D.5

Presenter:

Polly Duncan

Twitter:

@PACTGP

Co-authors:

Polly Duncan, Jessica Watson, Ian Bennett-Britton, Alexander Burrell, Rupert Payne, Victoria Silverwood, Orla Whitehead, Salman Waqar, Beth Winn, Samuel W D Merriel.

Author institutions:

University of Bristol, University of Exeter, Keele University, University of Southampton, University of Oxford, University of Newcastle, University of Manchester

Problem

There is often a disconnect between academic GPs, perceived as not ‘real GPs’, and clinicians working at the coalface of general practice, with few opportunities to develop and test their own research ideas. PACT is a new UK-wide research collaborative that aims to engage primary healthcare professionals (hereinafter ‘PACT members’) in high-quality research. The feasibility of using the PACT model is being evaluated in two studies. ‘Why Test’ aims to explore why tests are requested in primary care and how test results are communicated to patients. ‘Care of Housebound patients in Primary care’ (the ‘CHiP study’) aims to describe the characteristics and healthcare use of older (≥65 years) housebound patients – an under-researched group.

Approach

For the ‘Why Test’ study, PACT members reviewed 50 patients’ blood test results in each of their practices and inputted data into a database. For the ‘CHiP study’, PACT members will identify 20 older housebound and non-housebound people and collect both coded data and free text data (e.g. from hospital letters) from their GP records (target 20 practices, 400 housebound, 400 non-housebound). In both studies, a report with practice-level data, benchmarked against other practices, will be sent to all participating PACT members to identify areas for quality improvement. We will examine the feasibility of using the PACT network by collecting data about PACT members and practices who sign up and complete data collection and by assessing the quality of data collected.

Findings

Data collection for ‘Why Test’ is complete in 57 GP practices (target 50 practices) for 2572 eligible patients. 84% of PACT members who completed the project were not in formal academic training and 28% had never previously engaged with research. Half of practices surveyed have already used the reports for quality improvement, education or practice learning. For the ‘CHiP study’, data collection procedures have been developed and piloted, eight practices have been recruited and data collection has started. By this summer, we expect to have recruited our target of 20 practices and completed data collection.

Consequences

The ‘Why Test’ and ‘CHiP’ studies demonstrate that it is feasible to use a network of trainees and healthcare professionals with no formal academic training to conduct high quality primary care research. Using the PACT model, clinically trained PACT members extract non-coded data from the electronic GP records, answering important research questions which cannot be answered using routinely collected data. Furthermore, PACT members with little or no research experience, are provided with opportunities to take part in high quality research. Practices have been resoundingly positive about receiving practice-level reports, benchmarked against other practices. The PACT network is growing with 700 PACT members currently. Our next challenge will be to support PACT members to develop and test their own research ideas.

Submitted by:

Polly Duncan

Funding acknowledgement:

The ‘Why Test’ study is funded by NIHR Research Capability Funding (RCF) from Bristol, North Somerset and South Gloucestershire CCG (RCF21/22-1JW) and is also supported by the NIHR Applied Research Collaborative West (ARC West). The CHiP study is funded by the Royal College of General Practitioners (RCGP) Scientific Foundation Board (SFB 2019-14) and Dr Duncan’s NIHR Doctoral Research Fellowship (NIHR301824). The views expressed are those of the authors and not necessarily those of the NIHR, the Department of Health and Social Care or the RCGP.