R&P: the multiple meaning of a research project in general practice

Rischio e Prevenzione (Risk and Prevention) is a research project that is becoming the paradigm of the Italian research on General Practice. It started from a survey showing that treatment and control of cardiovascular risk is still far from optimal even in very high-risk patients. A group of general practitioners, coordinated by Istituto Mario Negri, wrote the protocol of the study with various proposals: Creating a research network. Building research infrastructure with good research capacity. Building a 'therapeutic alliance' with the patient while presenting the research, not only obtaining their signature for a 'bureaucratic' informed consent. Having the 'Collaborative Group' as the 'sponsor' of a research even if the funds are coming from Pharmaceutical Industry. It is a randomised controlled trial (RCT) carried out in primary care with the normal patient of our daily work, so transferability is very possible. The way to enroll the patients and the request to specify the reason for not joining the project of the outcome study are a kind of participatory research. The outcome study can become a model for implementing new strategy on cardiovascular risk. A specific questionnaire will enquire the different point of view of the patient and of the general practitioner/researcher. The result of this project will help us understand the phenomenon of the poor compliance of the high-risk patients. First results during enrollment allow some optimism.