Research in the community: recruiting and retaining practices

Medical investigators increasingly attempt to demonstrate the effectiveness of treatments given in routine practice settings as well as in research settings. We identified and describe several key issues in practice-based research: identifying the appropriate population; drawing the sample; recruitment of physicians and patients; maintenance of the physician-researcher relationship; and data management. Three on-going practice-based projects are described from the perspective of these key issues. Two are practice-based randomized trials, one is a larger cohort study. Common characteristics are identified which contributed to the success of the three projects: direct recruitment of clinicians by clinicians; close liaison with local medical organizations; on-going personal contact with the practices; and recognition of the value of the practicing physician's time.