You can find out more about Primary care studies in your area through the UK Clinical Trials Gateway.
The NIHR Clinical Research Network Primary Care has been enormously successful in integrating clinical research into NHS clinical service provision, and both developing and delivering a large practice changing portfolio of clinical trials.
Read our Primary Care specialty profile to find out more.
As the most integrated clinical research system in the world, the NIHR supports research studies through our funding programmes, training and supporting health researchers, and providing world-class research facilities. We also support dialogue between the life sciences industry and charities to benefit all, and facilitate the involvement of patients and the public to make research more effective.
Last year (2017/2018) the NIHR supported 523 studies on primary care. The NIHR supported these studies through our funding programmes and our research schools and units. We also support primary care research through our research infrastructure and our training and career development awards for researchers.
Obesity greatly increases the risk of long-term health consequences - including diabetes, cardiovascular disease, disability and depression - creating a huge strain on health services and costing the NHS in England an estimated £6.1 billion a year.
Guidelines recommend that GPs and primary care practitioners routinely screen and offer advice to their patients to motivate weight loss through behavioural weight loss programmes. Yet despite the high prevalence of obesity - primary care patient surveys and recordings of consultations indicate that GPs do not routinely intervene.
The BWeL trial set out to assess the effect of delivering a brief, opportunistic behavioural-change intervention within primary care services on weight loss amongst clinically obese patients. It was the first clinical trial to look at the potential impact that different opportunistic GP interventions may have on reducing obesity in primary care.
The study found that the behavioural change intervention used was not only clinically effective and short enough to be deliverable within GP appointments, but also extremely cost effective. Read more in our impact case study.
Gambling is increasing in the UK, with surveys indicating that around 59% of British adults had gambling activities in 2010, up 7% from three years earlier. Primary care presents a potential context for identifying patients with a gambling problem, who would benefit from the early intervention or specialist services. Experts say it is an area that needs more attention if primary care services are to help those in need.
In a cross sectional study funded by the NIHR School for Primary Care Research, a team of researchers at the University of Bristol explored gambling problems and gambling-related problems (anxiety, financial strain and relationship breakdowns), among 1000 patients attending general practices across 11 general practices in southwest England.
The study found that an improved understanding of the burden of, and responses to, gambling problems is required by general practices in order to address the health-related behaviour.
Read more in our news story.
GP workload has increased by 16 percent between 2007 and 2014, putting pressure on UK primary care services. GP practices have struggled to meet this challenge, and two thirds of GPs report unmanageable workloads. Difficulties accessing appointments have become a source of patient dissatisfaction. Online consultations are potentially a way to improve patient access and to reduce GPs’ workload from face-to-face consultations.
Researchers at the NIHR Collaboration for Leadership in Applied Health Research and Care West evaluated the effectiveness, acceptability and impact of implementing an online consultation system called eConsult, a platform that patients access via their GP practice website.
Across the participating practices patient use of the system was low during the pilot. Although the system did save some patients having to see their GP, the majority of e-consultations resulted in either a face-to-face consultation or a telephone call from a GP.
Read more in our CLAHRC BITE.
Psychotic disorders such as schizophrenia cause enormous disability and are very expensive for families and society. Early intervention services identify and treat people with first episode psychosis or mental states putting them at high risk of developing psychosis with the aim of improving outcomes and possibly preventing more serious disease and disability.
In the Liaison with Education and General Practices (LEGS) trial, funded by NIHR Programme Grants for Applied Research, 24 general practices were randomised to a “high-intensity” intervention which involved a specialist mental health professional providing a one hour educational session at each practice, a booster session one year later and ongoing liaison and support.
The researchers found that this tailored education session doubled the early identification and referral of people with, or at risk of, psychotic illness compared to a postal educational campaign or practice as usual. It was also the most cost-effective intervention mainly due to the potential for subsequent savings from prevention of people developing more severe illness.
Read more in our NIHR Signal article.
It is widely known that back pain can be a considerable problem for some people and remains a challenge for GPs and physiotherapists to treat.
The STarT Back Trial, funded by Arthritis Research UK, is an example of a stratified care approach according to a patient’s prognosis (low, medium or high risk). By using a targeted questionnaire tool, primary care clinicians can identify the correct course of treatment for the patient. The study compared the clinical and cost effectiveness of those participants who received the stratified care approach with those that did not.
The study recruited 1573 participants, 18 years and over who were suffering from back pain. Consultations took place at 10 general practices within West Midlands North region. Potential participants were identified via support from the NIHR Clinical Research Network.
Read more in our impact case study.
The NIHR Clinical Research Network (CRN) Primary Care Specialty supported research that will help GPs diagnose urinary tract infections in children and improve antibiotic use.
The study, funded by the NIHR Health Technology Assessment (HTA) Programme, sought to develop algorithms to accurately identify pre-school children in whom urine should be obtained and assess whether or not dipstick urinalysis provides additional diagnostic information.
After a three-year study involving more than 7,000 children, researchers have developed a technique to help GPs and nurses diagnose urinary tract infections in children. There is also hope is that this will help to better target antibiotic prescribing, so only those who are likely to benefit from antibiotics receive them.
Read more in the NIHR Journals Library.