Enabling general practice research in singapore: A qualitative exploration of barriers, facilitators and solutions

BACKGROUND: The importance of primary care research in informing clinical practice and policy is well demonstrated. In the Singapore setting, the majority of research occurs in public institutions called polyclinics as opposed to the private general practice setting where approximately 80% of primary care clinical service provision takes place. There is a need to increase research in the private general practice setting to ensure that findings are relevant to this setting. This study aimed to explore the barriers, facilitators and motivations impacting on Singaporean GP’s involvement in research with a view to optimising the structure and supports offered by SPARK, a practice-based research network (PBRN). METHODS: GPs were recruited from SPARK network, research collaborators and networks of the researchers. Semi-structured interviews were conducted face to face or via zoom and audio recorded. Interviews were transcribed and then thematic analysis was conducted using a deductive and inductive approach. RESULTS: Fifteen GPs participated in the study. Four major themes (motivators, barriers, facilitators, PBRN) and 14 subthemes were identified from the interviews. Whilst there were barriers at the GP, practice, system and individual research project levels, there were strong intrinsic (altruism, alignment with personal interest) and extrinsic (better patient care, job enrichment, enhancing primary care) motivators. Important facilitators included practice support, funding, streamlining of research practices, collaboration and acknowledgement of the contribution of GPs. PBRNs could support this through providing research infrastructure underpinned by communication and relationships and the sharing of research outcomes. CONCLUSIONS: There is acknowledgement that research conducted in the Singapore general practice environment is important, but barriers such as time, financial support and lack of systemic structures exist which limit participation. PBRNs, such as SPARK, can play a role in bridging the existing gap between clinical experience and academic expertise. The findings of this study will inform future SPARK activities to build a dynamic general practice research environment in Singapore.