Supporting Better Science in Primary Care: A Description of Practice-based Research Networks (PBRNs) in 2011.
ABSTRACT Bound by a shared commitment to improving medical care through systematic inquiry, practice-based research networks (PBRNs) provide a basic laboratory for primary care research and dissemination.
Data from US primary care PBRNs were collected as part of the 2011 Agency for Healthcare Research and Quality PBRN registration process. Data addressed PBRN characteristics, research activities, and perceived strengths and weaknesses.
One hundred forty-three primary care PBRNs were registered with the resource center in 2011, including 131 that were identified as either eligible for Agency for Healthcare Research and Quality recognition (n = 121) or as developing (n = 10). These PBRNs included 12,981 practices with more than 63,000 individual members providing care to approximately 47.5 million people. PBRNs had an average of 482 individual members (median, 170) from 101 practices (median, 32).
PBRNs are growing in experience and research capacity. With member practices serving approximately 15% of the US population, PBRNs are adopting more advanced study designs, disseminating and implementing practice change, and participating in clinical trials. PBRNs provide valuable capacity for investigating questions of importance to clinical practice, disseminating results, and implementing evidence-based strategies. PBRNs are well positioned to support the emerging public health role of primary care providers and provide an essential component of a learning health care system.
- SourceAvailable from: Guri RortveitScandinavian Journal of Primary Health Care 08/2014; DOI:10.3109/02813432.2014.943981 · 1.61 Impact Factor
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ABSTRACT: Background Asthma is a common disease that affects people of all ages and has significant morbidity and mortality. Poor outcomes and health disparities related to asthma result in part from the difficulty of disseminating new evidence and care delivery methods such as shared decision making (SDM) into clinical practice.This 3-year study explores the ideal framework for rapid dissemination of an evidence-based SDM toolkit for asthma management. The study leverages a partnership between the North Carolina (NC) statewide Medicaid network and the NC Network Consortium of practice-based research networks (PBRN).Methods/designThis non-blinded study will randomize 30 primary care clinics in NC stratified by four PBRNs. We will test dissemination across these practices using a facilitator-led participatory approach to dissemination (FLOW), a novel method of participatory dissemination involving key principles of community-based participatory research, and a more typical ¿lunch and learn¿ dissemination method. Specifically, we will use cluster randomization to assign each of the 30 practices to one of three arms: (1) control, no dissemination; (2) traditional dissemination, one didactic session a year and distribution of educational material; and (3) FLOW dissemination. We hypothesize that at the unit of randomization, the clinic, patients in the FLOW dissemination arm will be more likely to share in their treatment decisions compared to patients in the traditional dissemination or control arms. All outcomes will be measured at the level of the clinic. Adoption of the SDM approach will be evaluated by 1) asthma exacerbations, 2) level of patient involvement in the decision making process, and 3) qualitative assessments from patients and providers.The research question is: What dissemination strategy most effectively increases practice level adoption of a shared decision making approach to asthma management? This study will provide important data to support best practices in dissemination of an evidence-based toolkit and implementation of shared decision making into primary care practices.Trial registrationThe trial was registered on January 27, 2014 through the United States National Institutes of Health¿s ClinicalTrials.gov NCT02047929 (http://clinicaltrials.gov/show/NCT02047929) and funded by the Patient-Centered Outcomes Research Institute (PCORI).Implementation Science 10/2014; 9(1):158. DOI:10.1186/s13012-014-0158-0 · 3.47 Impact Factor
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ABSTRACT: There is increased interest nationally in multicenter clinical trials to answer questions about clinical effectiveness, comparative effectiveness, and safety in real-world community settings. Primary care practice-based research networks (PBRNs), comprising community- and/or academically affiliated practices committed to improving medical care for a range of health problems, offer ideal settings for these trials, especially pragmatic clinical trials. However, many researchers are not familiar with working with PBRNs.The Journal of the American Board of Family Medicine 11/2014; 27(6):750-758. DOI:10.3122/jabfm.2014.06.140166 · 1.85 Impact Factor