2. Overview
• Strategic context for health research
• Overview of HRB
• Primary care research in Ireland
• Examples of primary care research linked
to practice
3. Health Research Plans
• HRG Action Plan for Health
Research 2009-2013
• HRB Strategic Business Plan
2010 -2014
• National Research
Prioritisation Exercise 2012
Set the strategic direction, goals,
targets and actions to reap the health,
social and economic benefits of our
investment in health research
4. 1. Patient-oriented research
2. Population Health
3. Health Services Research
• Projects
• Applied Programmes
• Centres/networks
• Short courses/workshops
• Fellowships and Career
Awards
• Research Infrastructure
• EU/International
opportunities
5. HRB Strategy - Key Themes
• Increase high quality, interdisciplinary
health research
• Enhance research partnerships,
collaborations and networks
• Focus on translation and application of
knowledge
• Enhance use of existing health and social
data
• Increase evidence-informed policy and
practice
6. HRB Annual Income 1999-2012
60.0
50.0
40.0
30.0
20.0
10.0
0.0
1 2 3 4 5 6 7 8 9 10
Total Income (€M)
Year
Capital (€M)
Revenue (€M)
1999 2001 2003 2005 2007 2008 2009 2010 2011 2012
8. Overview of HRB grant
funding portfolio
Projects & Programmes
• Health Research Awards
• Definitive Interventions
• HRB/Medical Research Charity Group
Awards
Training/Career Development
• Cochrane Training/Cochrane
Fellowships
• PhD Fellowships for Health and Social
Care professionals (P/T and F/T)
• Structured PhD Scholars -SPHERE
• ICE Awards (post doc)
• Research Leaders (Pop Health / HSR)
• Clinician Scientists
Centres and Research Networks
• HRB Centre in Health and Diet
Research
• HRB Centre in Primary Care Research
• All Ireland Institute in Hospice and
Palliative Care – research network
• Trials Methodology Network
• Clinical Research Facilities (Dublin,
Cork, Galway)
• Clinical Trials Networks
EU/International Opportunities
• Horizon 2020
• Wellcome Trust
• US Ireland
9. Global and national context for
primary care
• Demographics – ageing population
• More people living with chronic diseases
• Shift in model from acute care to primary /
community and self care
• Shift from illness model to health and wellbeing
• Emphasis on health promotion and behaviour
change (lifestyle factors)
10. Case for primary care research
• Need for an evidence base to support practice
• Evidence to underpin clinical practice and healthcare
policy must be obtained by R&D in primary care
• Quality standards and protocols derive from research
• Need research to inform policy on staffing, organisation
or primary care
• Process of conducting research important as the
outcome
• Involvement by primary care professionals in research
leads to faster dissemination and adoption of research
evidence
11. Issues for primary care research
in Ireland*
• Lack of infrastructure
• Difficulties getting evidence implemented
• Limited capacity of the primary care community
to conduct research
• Lack of any system for provision of payments to
GPS to engage in research
• Clinical academic career structure in primary
care ‘unattractive’
* Mant Report 2006
12. HRB developments
• Increased funding for health services, clinical research
and patient research
• Practical support through the TMRN (Trials Methodology
Research Network)
• Support for population or community based studies
through the CRFs (Clinical Research Facilities)
• Support for Primary care professionals through funding
schemes, e.g. HPFs (note: few applications from GPs)
• Investment in Centre for Primary Care Research (10
years, €8 million)
• Establishment of the Irish Primary Care Research
Network
13. Themes in primary care research
• Harnessing technology to improve primary care practice
and health outcomes (e.g. access to primary care
diagnostics)
• Chronic disease management and multi-morbidity
• Role of primary care in reducing inequalities in terms of
access and health outcomes
• Safer primary care (patient safety)
• Evaluation of primary care reforms
• Mental health and primary care
• Workforce management in primary care
• Role of primary care in health promotion and behaviour
change
14. Examples of HRB funded
primary care research projects
• Framework for community involvement in decision making in primary
care (Anne MacFarlane, Limerick)
– Examined user involvement projects for quality, user experience and impact on
service
– Design a framework for the HSE to implement high quality user involvement
projects
• Developing and evaluating a complex intervention to influence quality
and quantity of anti-microbial prescribing (Andrew Murphy, Galway)
– Examining prescribing practices for urinary tract infections in Ireland and other
countries
– Evaluating interventions to reduce the amount of antibiotics prescribed
• Towards early intervention for youth mental health (Walter Cullen,
Limerick)
– Developing an intervention to address barriers to ‘early intervention’ for mental and
substance use disorders among young people
16. CPCR
• Includes RCSI, TCD, NUIG and QUB
• Focusing on
– Safer medicines (safer prescribing, medicines management)
– Safer diagnosis ( clinical decision support systems; generating and
applying clinical prediction rules)
– Evaluating intervention studies - in an elderly cohort, in a
population of poorly controlled diabetes patients
– More rational use of antibiotics
– Managing multi-morbidity
• Established the Irish Primary Care Network
17. iPCRN (Irish Primary Care
Network) www.icprn.ie
• Collaboration between the ICGP, the HRB Primary Care Research
Centre (in RCSI) and WestRen (NUIG)
• Aims to:
o Establish a national network of GP practices whose purpose is to
participate in clinical research for the benefit of their patients and
o To enhance general practice through research training and activity
• The iPCRN:
o Facilitates GP's in maintaining The Medical Council's requirements
for professional competence - particularly in in the areas of audit
and research
o Enables GP's to become more involved in planned research trial
activities in the community
o Enhances collaboration among network partners through access to
literature, resources and training materials in research methodology
o Provides General Practice with new applications/tools to audit and
manage their patient care
18. Conclusions
• Clear need for primary care research to improve service
delivery
• Key themes and questions for primary care research in
Ireland
• Need to encourage more primary care professionals
(GPs, nurses, therapists, dentists) to engage in health
services and clinical research
• Need to work in multi and interdisciplinary partnerships
for better research
• Much improved environment for primary care research -
support and infrastructure