Building a bridge from the swamp to the ivory tower: Conducting randomised controlled trials in general practice

Abstract

BACKGROUND: Primary care research is underfunded. Few randomised controlled trials (RCTs) are conducted in a primary care setting. However, it is important that clinical practice be informed by adequate primary care evidence so general practitioners (GPs) have tools and guidelines applicable to the patients they see. OBJECTIVE: The aim of this article is to describe and reflect on the experience of conducting five RCTs between 2003 and 2017 in a general practice setting with minimal funding, in North Queensland. DISCUSSION: Enabling factors include using grassroots research questions and engaging practice nurses. Barriers include ethics applications and insufficient funding. Recommendations to reduce study costs include compensating practice nurses rather than GP time. The findings are designed to encourage grassroots GPs to consider participating in pragmatic, feasible projects. The success of the projects was underpinned by the fact that they were established by a group of GPs who had interesting questions that were relevant to their clinical practice and not answered by current evidence.