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Primary Care Research

Recommendation

Provide no less than $375 million in appropriated funds for the Agency for Healthcare Research and Quality (AHRQ) to support research vital to primary care.

Background

AHRQ is the federal agency charged with producing evidence to support clinical decision-making, reduce costs, advance patient safety, decrease medical errors and improve health care quality and access. AHRQ’s mission helps to provide the critical evidence reviews needed to answer questions on the common acute, chronic, and comorbid conditions that family physicians care for on a daily basis.  

AHRQ supports important investigation in areas which are not the focus of investigation anywhere else in the biomedical research community. Evidence-based family medicine practice requires AHRQ-supported primary care research in areas such as Practice-Based Research Networks (PBRNs), practice transformation, patient quality and safety in non-hospital settings, multi-morbidity research, as well as the delivery of mental and behavioral health services in communities by primary care practices.  Also important to successful primary care research is AHRQ’s support future primary care investigators. We believe there is a need to deliberately promote this training as a way to aid in the development of all the areas we have emphasized. AHRQ has researcher training mechanisms in place, which we believe are important, and need to be expanded. 

Primary care research includes: translating science into the active practice of medicine and caring for patients, understanding how to better organize health care to meet patient and population needs, evaluating innovations to deliver the best health care to patients, and engaging patients, communities, and practices to improve health.  AHRQ is uniquely positioned to support this sort of best practice research and to help advance its dissemination to improve primary care nationwide.

Some examples regarding the utility of AHRQ-funded grants:

“Three AHRQ grants supported the development of patient centered personal health records in 2007, 2009, and 2010, and studied whether these tools increased prevention. In our studies we found increases in important tests like colon and breast cancer screening as well as immunizations, blood pressure and cholesterol control. In addition, we were able to leave the functionality in place – permanently – for 191 doctors and now 60,000 patients. One result is that the practices are now using the AHRQ created portal as their sole patient portal and abandoned the commercial portal that did not work as well.” Alex Krist, MD, MPH, Virginia Commonwealth University


“The AHRQ-sponsored series of grants on Multiple Chronic Condition research were transformative for that field. They also sponsored regular meetings among grantees and established the Multiple Chronic Conditions Research Network, which has fostered many collaborations between researchers with shared expertise.” Elizabeth A. Bayliss, MD, MSPH, Kaiser Permanente Colorado 

How STFM Members Can Get Involved

In the event you get a chance to talk to your Members of Congress, here are some talking points that describe what comparative effectiveness research really is and why it is necessary to keep funding these programs.

  • Comparative effectiveness research identifies what works best, for whom, in what circumstances. This information is evidence-based and provides both the physician and patient information with which to make better health care decisions. 
  • In this regard, comparative effectiveness research enhances competition. With better information about their care, consumers can make better decisions and choose the treatments best for them, in the same way that Consumer Reports provides trusted information on the best cars, appliances, and other products. Informed choice is the fundamental principle of our market-based economy.
 
  • While in the Senate, Dr. Bill Frist recognized the importance of comparative effectiveness research and led the effort to authorize, through the Medicare Modernization Act of 2003, the comparative effectiveness research program at AHRQ. Funding for this new comparative effectiveness research program was first appropriated in FY 2005—spending legislation Mr. Cantor supported—and thus AHRQ’s comparative effectiveness program was launched under President George W. Bush’s administration
  • AHRQ and NIH provide funding to local universities and private research institutions to produce comparative effectiveness research. Private sector entities, such as health plans and drug and device companies, also produce this research through their own R&D efforts, but federal funding of this research ensures transparency of the results to the general public. Federal funding for research is essential to ensuring balanced, unbiased, easily accessible information.
  • Americans need federally funded comparative effectiveness research to help them make more informed choices about the care they’re buying. Eliminating federal funding for comparative effectiveness research would be a disservice to consumers who themselves say they want better information about their care.

Resources

  • Agency for Healthcare Research and Quality —AHRQ is a small federal agency with the responsibility of research to support clinical decision-making, reduce costs, advance patient safety, and improve health care quality and access.
  • Friends of AHRQ —The Friends of AHRQ is a voluntary coalition of more than 250 organizations, including the four CAFM organizations, that support AHRQ by sending joint letters to key members of Congress, make joint visits to members of Congress and their staff, and holding briefings to demonstrate the importance of AHRQ.
  • House Appropriations Committee (sets spending levels)
  • Senate Appropriations Committee (sets spending levels)

Copyright 2015 by Society of Teachers of Family Medicine