Funded Through The North Carolina Network Consortium, Chapel Hill,
Although the vast majority of health care is rendered in
primary care practices, most research is carried out in
subspecialty settings, largely in tertiary care centers.
To help alleviate this disparity between research and
practice settings, it has been increasingly recommended
that “various types of practice laboratories, or centers of
excellence” in primary care research be established.
To date, efforts to develop a primary care research
infrastructure have largely focused on establishing
practice-based research networks (PBRNs)—groups
of practices that affiliate to carry out practice-relevant
The growth of PBRNs has served a valuable role
in promoting and carrying out primary care research.
However, PBRNs have several limitations. Membership
has largely been solicited through personal networks,
leading to selection bias and underrepresentation
of racial and ethnic minorities in PBRN-sponsored
studies. Further, because PBRNs are physician and
practice centered, their research has tended to focus
more on physicians and physician services (eg, office
function, quality of care, and health services research)
than on patients and health behavior. Finally, PBRNs
have tended to be costly, inefficient, and demanding of
participating practitioners, factors that have become
particularly problematic in the increasingly stressful
primary care environment.
This (project) describes the development of a different
type of primary care research laboratory—a cohort of
adult patients recruited from a representative sample
of primary care offices and maintained for use on mul-
tiple projects. The cohort, the North Carolina Health
Project (NCHP) research cohort, was developed by
faculty of the University of North Carolina (UNC),
in collaboration with the North Carolina Academy
of Family Physicians, for the purpose of facilitating
research on chronic disease and related health care
problems commonly addressed in primary care settings.
As such, it may represent a new model of primary care
research infrastructure development—different from,
and complementary to, traditional PBRNs.
(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.)