Funded Through The North Carolina Network Consortium, Chapel Hill,
Background and Objectives:
Efforts to develop “laboratories” for primary care research have largely
focused on the development of networks that recruit subjects on a project-specific basis.
to develop an alternative model—a representative cohort of adult primary care
for use in multiple projects.
In 2001, research assistants in waiting areas of a representative
sample of 16 family medicine practices in North Carolina approached all adult
a 4-week period. Follow-up has been maintained for 3 years. In 2004 and 2005,
the cohort was
refreshed by adding eight new practices. Each consenting subject was
administered a four-page selfreport
questionnaire that included items on demographics, risk factors,
health status, and quality of
Of 10,649 eligible patients approached in 2001, 6,811 (64%) completed the enrollment
questionnaire, of whom 5,575 (81.9%) consented to be included in the cohort.
Latinos, and older persons were enrolled at rates paralleling the state’s adult
population. Poor general
health, chronic illness, and risk factors for chronic disease were more prevalent
in the cohort
than in the general population. Over 3 years, cohort members were included
in multiple studies, and
77% of the original cohort remained active. The per-subject enrollment cost
varied between $27 and
$45; annual program maintenance costs were estimated at approximately $35,000.
The research cohort has these advantages over traditional practice-based
research networks: patient
focus rather than physician focus, a structure that places few demands on
practices, ability to target
racial and ethnic minorities, and a better-defined patient population. As is
true of all aspects of
research infrastructure, the cost of development and maintenance is significant.
North Carolina Health Project & Eastern North Carolina:
NCHP has invited E-Care members to join the project by assisting in the recruitment
of clinics and their patients. This partnerships was initiated in Spring of 2008.
(reprinted from Philip D. Sloane, MD, MPH; Leigh Callahan, PhD;
Leila Kahwati, MD, MPH; C. Madeline Mitchell, MURP, Development of a
Practice-based Patient Cohort for Primary Care Research,(Fam Med 2006;38(1):50-8.)