Research undertaken in the primary care environment – thereby including primary care patients, practitioners and practitioner perspectives – is crucial to evidence-based practice.
Within Linnaeus, an average of between two and three research studies are produced by our primary care practices each year. Of these, some are clinical studies and others non-clinical, such as leadership research. However, this volume does not reflect the high interest in research in our primary care teams, which are passionate about contributing to evidence-based medicine and helping to raise the quality of care our industry delivers.
Typically, primary care practitioners will collaborate on a study that may be based in a referral centre and is usually led by a specialist. Yet the number of clinicians in primary care developing their own research projects is increasing. At Linnaeus, we are also seeing more primary care practices auditing their outcomes for a particular condition and benchmarking this data against referral sites to measure their quality of care, which we actively encourage.
To encourage more primary care teams to undertake clinical research, the veterinary profession must understand and overcome the barriers that may prevent this
To encourage more primary care teams to undertake clinical research, the veterinary profession must understand and overcome the barriers that may prevent this. Our initial enquiries suggest that finding time to conduct research, identifying or securing funding, lack of knowledge of how to undertake research and difficulty in collecting data in the primary care setting may all contribute to this.
In response to these challenges, specific support is needed for those with an interest in research in a primary care setting. From education to practical advice and funding, there are many steps throughout the research process where guidance from employers, peers, colleagues and membership organisations can really help.
Funding is, of course, a critical element of any research project, and there may already be options available in a primary care practice or group. For example, Linnaeus’s open access publication charge (OAPC) fund covers the fees to publish a research paper in an open access scientific journal. Open access is important because it means the research is available for anyone to view free of charge (ie not behind a paywall), which maximises accessibility of the research findings so we can all learn from it. External grants to fund research are also available from organisations such as the British Small Animal Veterinary Association (BSAVA) PetSavers. Critically, primary care practitioners need to be aware of these opportunities and the applications required.
Ongoing engagement between primary care and referral centres also remains important as this creates opportunities for specialists and primary care practitioners with similar interests and skillsets to spark conversations about different projects and identify potential co-researchers. Joining networks of shared interest either within your organisation or through groups such as the Small Animal Medicine Society or regional groups within the BSAVA will help to broaden expertise and spark ideas.
Once a research project is identified, the main challenge underlying the collection and collation of data is ensuring the data is consistent
Once a research project is identified, the main challenge underlying the collection and collation of data is ensuring the data is consistent. Having a unified coding system for groups or practices will greatly increase opportunities to extract and analyse meaningful data from electronic health records, providing researchers with valuable access to large data sets. (Linnaeus is currently implementing a unified coding system across its estate, which is expected to be hugely valuable across the group.)
The exploration of such data enables research that is based in primary care practices to be conducted, which is of significant value. Most patient contacts will begin and end in primary care, meaning that the broad spectrum of disease and patient subjects in the population is represented. In addition, use of primary care data avoids bias that can occur when using data only from referral populations. A further benefit is the ability to explore long-term disease progression and outcomes, with pets often attending one primary care practice for their whole lifetime.
Creating pathways for sharing information and building a culture that welcomes auditing while encouraging curiosity helps to encourage primary care teams to take part in research activity
There are still hurdles for primary care vets or nurses wishing to take part in research, which must continue to be addressed. Creating pathways for sharing information and building a culture that welcomes auditing while encouraging curiosity helps to encourage primary care teams to take part in research activity. The value they bring is certainly worth it.