The majority of paediatric patients in developed countries are being treated in ambulatory clinics and not in hospitals. The wide spectrum of clinical severity seen in the office differs from that seen in hospitals. Therefore, generalisation of results from hospital based studies to the unselected patient population in the primary care cannot be made. Research performed in primary care is needed, but is facing a lack of infrastructure – time, skills, funding.
These obstacles were removed following the creation of primary care research network. A research network is composed of many primary care clinics grouped together in an infrastructure of a network for the purpose of conducting research in the community. The network is the research laboratory of the primary care setting.
Key elements in a network include the participating paediatricians, the research projects, an intranet communication and an academic framework. The research projects are diverse, but there are common requirements needed for success – the projects should interest the primary care paediatricians, relate to the daily practice, and have the following – a simple design, a short duration and a reasonable budget.
In 2008, the European Academy of Paediatrics launched a paediatric-based research network – EAPRASnet (European Academy of Paediatrics Research in Ambulatory Setting network). The network has recruited primary care and general paediatricians from European and Mediterranean countries. EAPRASnet has been involved in a number of paediatricians’ surveys on topics like vaccination refusal, antibiotic treatment of respiratory infections, management of urinary tract infections and the use of electronic health records.
Data mining using the Electronic Health Records database is another form of ambulatory care research. Network participants can take part in pharmaceutical companies’ clinical trials and also initiate small scale intervention studies. Primary care clinics can additionally participate as sentinel practices for disease surveillance systems e.g. influenza.