Towards evidence-based practice via practice-based evidence: the Italian experience

Area of Science:

• Primary health care research
• Cardiovascular disease prevention
• Family medicine

Background:

• Research is crucial for general practitioners' (GPs) clinical practice and addressing unanswered population health needs.
• Accessible research results empower both GPs and participating patients, fostering a democratic approach to health information.
• Research participation offers a valuable "learning by doing" formative experience for investigators.

Purpose of the Study:

• To detail the collaborative efforts between Centro Studi e Richerche in Medicina Generale and the Mario Negri Institute.
• To showcase the production of observational and experimental research within the family medicine setting, exemplified by the Risk and Prevention Study.

Main Methods:

• The Risk and Prevention Study employed two distinct methodologies.
• An observational design was used to assess the effectiveness of intensive treatment and lifestyle advice for cardiovascular (CV) prevention.
• A randomized controlled trial design investigated the efficacy of n-3 polyunsaturated fatty acids in patients with CV risk.

Main Results:

• The Risk and Prevention trial has recruited 860 Italian GPs and over 12,500 high CV risk patients.
• Patient follow-up is planned for 5 years, with annual GP visits. The first year of follow-up is complete.
• Patient withdrawal rates were low (2.5%), and the prescribed treatments were well-tolerated.

Conclusions:

• Engaging a large number of GPs in research is achievable.
• Independent research designs that clearly address patient needs facilitate successful recruitment and participation.