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ANALYSIS: Frank Sullivan, Chris Butler, Margaret Cupples, and Ann-Louise Kinmonth Primary care research networks in the United Kingdom BMJ 2007; 334: 1093-1094 [Full text]

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Primary care research networks in the UK and the MRC

Irwin Nazareth, Louise Letley (Senior Nurse Manager), Tamsin D'Estrube (Operation Manager) & Greta Rait (Senior Clinical Scientist)   (6 June 2007)

Towards a research-oriented culture in primary care

Lieke J.A. Franke, Tim C. olde Hartman   (6 June 2007)

Primary care research networks in the UK and the MRC 6 June 2007
Irwin Nazareth, Director MRC GPRF & Professor of Primary Care & Population Sciences, UCL Stephenson House, 158-160 North Gower Street, London NW1 2ND, Louise Letley (Senior Nurse Manager), Tamsin D'Estrube (Operation Manager) & Greta Rait (Senior Clinical Scientist) Send response to journal: Re: Primary care research networks in the UK and the MRC	We welcome Sullivan et al (1) informative paper on the new UK primary care research networks and their contribution to the UK Clinical Research Network. Additionally, we would like to highlight the important role of the MRC General Practice Research Framework (MRC GPRF), which was established in 1973 for the MRC mild hypertension trial(2). Since then it has made a significant contribution to clinical research in the UK through its conduct of research both in and on primary care. The network has managed high quality research and successfully recruited participants to large trials and other studies in primary care(3-7). The MRC GPRF is composed of 935 research general practices located in England, Wales, Scotland and Northern Ireland. Its co-ordinating centre has already started working closely with the other UK primary care research networks to realise the vision of effective UK wide networking in research. Despite the range of cultures and priorities in the research and service arms of health care serving the four nations, this collaborative approach of joint working between all the existing UK networks will provide unrivalled opportunities for the development of a future primary care research infrastructure which may be the only one of its kind in the world. Such collaborations have the potential to deliver on the conduct of the very best quality primary care research in clinical practice. References 1. Sullivan F, Butler C, Cupples M & Kinmonth AL. Primary care research networks in the United Kingdom. BMJ 2007:334:1093-94. 2. Medical Research Council Working Party. MRC trial of treatment of mild hypertension: principal results. BMJ 1985; 291: 97-104 3. Meade T, Zuhrie R, Cook C, Cooper J. Bezafibrate in men with lower extremity arterial disease: randomised controlled trial. BMJ, 2002;325:1139. 4. Smeeth L Fletcher A, Ng ESW, Stirling S, Nunes M, Breeze E, Bulpitt CJ, Jones D, Tulloch A. Reduced hearing, ownership and use of hearing aids in elderly people in the UK: the MRC Trial of the Assessment and Management of Older People in the Community. Lancet, 2002;359:1466-1470. 5. UK BEAM Trial Team. United Kingdom back pain exercise and manipulation (UK BEAM) randomised trial: cost effectiveness of physical treatments for back pain in primary care. BMJ, Dec 2004;329:1381-1385 6. Buszewicz M, Rait G, Griffin M, Patel A, Nazareth I, Atkinson A, Balow J & Haines A ., An RCT of an Arthritis Self Management Programme in Primary Care. British Medical Journal 2006;333: 879-80. 7. J A Cervilla, E Molina, M Rivera, F Torres-González, J A Bellón, B Moreno, J D Luna, J A Lorente, F Mayoral, M King and I Nazareth the PREDICT Study Core Group and B Gutiérrez. The risk for depression conferred by stressful life events is modified by variation at the serotonin transporter 5HTTLPR genotype: evidence from PREDICT-Gene cohort. Molecular Psychiatry 2007 (web: doi:10.1038/sj.mp.4001981) Competing interests: IN, LL, TE & GR are funded by the MRC to work with the General Practice Research Framework
Towards a research-oriented culture in primary care 6 June 2007
Lieke J.A. Franke, GP registrar Dep. Fam. Med. 117, Radboud University Nijmegen, PO Box 9101, 6500 HB Nijmegen, the Netherlands, Tim C. olde Hartman Send response to journal: Re: Towards a research-oriented culture in primary care	Sullivan et al. start their analysis with the finding that conducting research has been a low priority for primary care clinicians.(1) There is a culture where research is not much expected, valued or rewarded. They describe the UK Clinical Research Network (UKCRN) as a new research strategy aiming to re-engineer the environment in which clinical research is conducted in primary care. We think that this approach is promising because it contains important elements such as funding and research assistance to support appropriate management of research projects. Establishing a good clinical research network might get general practitioners (GPs) to cooperate in research projects. However, it does not change the non-research-oriented culture in primary care. In order to change this culture we need to expose GPs to research at an earlier moment in their career, for example during undergraduate teaching and specialty training. Fortunately, most residency training programmes yet contain research curricula.(2) But although these curricula create more positive attitudes towards research, they do not increase GPs’ research participation.(3) During our own residency training we experienced a very low level of interest in research among our colleague-registrars. Therefore, attractive integration of research into residency programmes should have high priority in order to create more positive experiences with research. Registrars might be motivated by an attractive research programme, enthusiastic faculty,(4) and colleague-peers who are interested in research. In the Netherlands, research-interested registrars can combine their vocational training with a research training programme. This combined programme leads to both a qualification as a GP and a PhD thesis. It is our experience that these research-interested registrars can motivate their colleague-registrars positively. In that way they contribute to a more research-oriented culture in primary care. We therefore hope that this combined programme will be implemented on a broader scale world-wide. References: (1) Sullivan F, Butler C, Cupples M, Kinmonth AL. Primary care research networks in the United Kingdom. BMJ 2007; 334(7603):1093-1094. (2) Hebert RS, Levine RB, Smith CG, Wright SM. A systematic review of resident research curricula. Acad Med 2003; 78(1):61-68. (3) Smith M. Research in residency: do research curricula impact post -residency practice? Fam Med 2005; 37(5):322-327. (4) Carek PJ, Araujo D, Nalin PM. Scholarly activity and residency training: seeking strategic partnerships. Ann Fam Med 2005; 3(6):560-561. Competing interests: None declared