Kuo Grace M, Steinbauer Jeffrey R, Spann Stephen J
Southern Primary-care Urban Research Network (SPUR-Net), Baylor College of Medicine, Houston; Professor of Clinical Pharmacy, Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California at San Diego, La Jolla, Calif; Director of San Diego Pharmacist Resource and Research Network, San Diego, Calif..
SPUR-Net, Baylor College of Medicine, Houston; Professor of Family and Community Medicine, Baylor College of Medicine, Houston, and Medical Director, Baylor Clinic, Houston, Tex.
J Am Pharm Assoc (2003). 2008 Mar-Apr;48(2):163-170. doi: 10.1331/JAPhA.2008.07142.
To describe a roadmap for developing a practice-based research network (PBRN) through the experience of conducting medication safety research projects in a primary care physician PBRN.
Southern Primary-care Urban Research Network (SPUR-Net) in Houston, Tex., from 2000 to 2007.
SPUR-Net is a partnership of six health care organizations in Houston and includes 32 clinics with 313 primary care clinicians (50% family physicians, 25% general internists, and 25% pediatricians) who provide care for approximately 1 million patient encounters annually.
The pharmacist principal investigator collaborates with physicians and researchers in primary care clinics to investigate medication safety practice in SPUR-Net.
(1) A roadmap for PBRN research and (2) initiation of a research program focusing on medication safety through the PBRN.
A roadmap with 10 steps for conducting practice-based research is recommended: (1) form collaborative partnership, (2) develop research infrastructure, (3) formulate research questions, (4) design study methods, (5) obtain funding support, (6) develop study instruments, (7) implement the study, (8) manage and analyze data, (9) disseminate results, and (10) translate research into practice. Four research projects focusing on medication safety were conducted in SPUR-Net from 2002 to 2007. Medication outcomes include improved medication use, increased awareness for medication counseling, decreased medication errors, and identification of best practices for medication reconciliation.
Practice-based research conducted in primary care settings identifies, studies, and evaluates common problems encountered in busy clinic practice. With feedback from stakeholders, best practices and improved practice can be identified and "translated" back to practice. Grant funding for research projects helps sustain PBRNs. The implementation of medication safety research projects has helped primary care clinics, clinicians, and patients increase appropriate medication use and explore ways to further improve medication safety.
通过在基层医疗医生实践型研究网络中开展药物安全研究项目的经验，描述建立实践型研究网络（PBRN）的路线图。
2000年至2007年位于得克萨斯州休斯敦的南方基层医疗城市研究网络（SPUR-Net）。
SPUR-Net是休斯敦六个医疗保健组织的合作项目，包括32个诊所，有313名基层医疗临床医生（50%为家庭医生，25%为普通内科医生，25%为儿科医生），每年为约100万患者提供诊疗服务。
药剂师主要研究者与基层医疗诊所的医生和研究人员合作，调查SPUR-Net中的药物安全实践。
（1）PBRN研究的路线图；（2）通过PBRN启动一项专注于药物安全的研究项目。
推荐了一个包含10个步骤的基于实践的研究路线图：（1）建立合作关系；（2）发展研究基础设施；（3）制定研究问题；（4）设计研究方法；（5）获得资金支持；（6）开发研究工具；（7）实施研究；（8）管理和分析数据；（9）传播结果；（10）将研究转化为实践。2002年至2007年在SPUR-Net中开展了四项专注于药物安全的研究项目。药物相关结局包括用药改善、药物咨询意识增强、用药错误减少以及确定药物重整的最佳实践。
在基层医疗环境中开展的基于实践的研究可识别、研究和评估繁忙诊所实践中遇到的常见问题。通过利益相关者的反馈，可确定最佳实践并将其“转化”回实践中。研究项目的资助有助于维持PBRN。药物安全研究项目的实施有助于基层医疗诊所、临床医生和患者增加合理用药，并探索进一步提高药物安全的方法。
