key: cord-0764614-xq7xg727
authors: Greiver, Michelle; Slade, Steve; Wong, Sabrina; Hutchison, Brian; Mutasingwa, Donatus; Pinto, Andrew; Godwin, Marshall
title: Integrating research and clinical care must include primary care
date: 2021-05-10
journal: CMAJ
DOI: 10.1503/cmaj.78754
sha: e300910d2df86ad175e75080650e129cf70df805
doc_id: 764614
cord_uid: xq7xg727

nan

We thank Dr. Lamontagne and colleagues for their timely analysis. 1 We agree that Canada can and should do more to inte grate research with clinical care. Some of the most substantial opportun ities for transformative research lie within pri mary care, the sector providing most of the care for most Canadians most of the time. By conducting clinical research in primary care, studies are more pragmatic and the findings are more generalizable to the real world.

To develop and sustain the infrastructure needed to grow clinical research in primary care, Canada should invest in primary care practicebased learning and research net works. These groups can be crit ical building blocks in constructing a panCanadian net work that integrates know ledge production, dissemination and practice improvement. For more than 25 years, primary care practicebased learning and research net works have operated in many countries to connect primary care practices and aca demic researchers. More than 15 primary care networks are currently active across Canada; they manage data collected from electronic medical records 2 and support clin ical research, ranging from randomized con trolled trials to longitudinal cohort and quali tative studies. However, funding to support network operating costs is scarce. Training opportunities, protected time for clinicianscientists involved, and support for adminis trative and analytic activities are all limited. 3 The College of Family Physicians of Can ada and its provincial colleges are fostering a culture of curiosity in Canada's primary care practices, integrating quality improve ment and research as part of care. Primary care practicebased learning and research networks are an important part of the national effort. The United Kingdom pro vides examples of worldclass primary care research, leveraging such networks and supporting them through the National Insti tute for Health Research Clinical Research Network, with substantial impact on care delivery in communities and influence on policy (www.phc.ox.ac.uk). Primary care researchers at the University of Oxford lead one of the world's largest randomized trials of communitybased COVID19 treatments (www.principletrial.org). Data from primary care practicebased learning and research networks can be used to serve commun ities, including infectious disease tracking 4 and identifying priority populations 5 for interventions, such as vaccinations.

Achieving integration between primary care delivery and research requires strategic investment, vision, and sustained relation ships between researchers, clinicians and communities. Canadians deserve no less.

Integrating research into clinical practice: challenges and solutions for Canada

Building a panCanadian primary care sen tinel surveillance network: initial development and moving forward

The current state of research capacity in US family medicine departments

The University of Toronto Family Medicine Report: caring for our diverse populations

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