Why does primary care need more implementation research?

Implementation research aims to inform policy decisions about how best to use resources to improve the uptake of research findings by testing approaches to change professional and organizational behaviour.

Abstract

Clinical research continually produces new findings that can contribute to effective and efficient patient care. However, such research cannot change patient outcomes unless health services and health care professionals adopt them in practice. Uneven uptake of research findings—and thus inappropriate care—occurs across different health care settings, countries and specialities, as demonstrated by two papers on implementing evidence-based medicine published in this issue of Family Practice.1,2 In primary care, the detection and management of risks related to hypertension3 or hyperlipidaemia are highly variable.4 The impact of secondary prevention, including the administration of secondary prophylactic drugs to patients surviving a myocardial infarction, is reduced by similar disparities.5–7 Much of this variation is not attributable to either patient or resource factors. There are mounting expectations to deliver high quality primary care from governments impatient for results. Legitimate challenges to improve the quality of care8 must be informed by research that can offer clinicians and managers effective and efficient means to enhance service delivery.9 Implementation research (the scientific study of methods to promote the uptake of research findings, and hence to reduce inappropriate care) aims to inform policy decisions about how best to use resources to improve the uptake of research findings by testing approaches to change professional and organizational behaviour. What is known?