Programme no. 137-OP
Quality Improvement
Data collection in general practice is not easy: experiences from a cluster randomised trial
Signe Flottorp*1, Ingeborg Granlund2, Eivind Aakhus3, Andrew D. Oxman4
1Norwegian Knowledge Centre for the Health Services,Oslo,Norway;The Institute of Health and Society,University of Oslo,Oslo,Norway, 2Norwegian Knowledge Centre for the Health Services,Oslo,Norway, 3Norwegian Knowledge Centre for the Health Services,Oslo,Norway;Research Centre for Old Age Psychiatry,Innlandet Hospital Trust,Ottestad,Norway, 4Norwegian Knowledge Centre for the Health Services,Oslo,Norway
* = Presenting author
Objectives: To describe our experiences when we collected outcome data for this implementation study.
Background: We need data from general practice to monitor and improve the quality of care, and to conduct research.

We have conducted a pragmatic cluster-randomised trial on tailored interventions to implement guidelines on elderly with depression. We randomised 80 municipalities to intervention or control group. We provided resources to all health-care professionals, but we mainly targeted our interventions at GPs. The GP practice is a core service for most elderly patients, and we measured our primary outcome at the GP level as GPs' adherence to the recommendations. With 80 municipalities, we calculated that 437 GPs should be included.

Results: Of 130 practices and 444 general practitioners in 40 municipalities, we visited 88 (68%) of the practices and 254 (57%) GPs in 38 (95%) of the municipalities. Of 900 GPs, only 77 (9%) consented to participate in an interview and 47 (5%) responded to a questionnaire, yielding a consent rate for data collection of 14%. We will present more detailed information regarding our efforts to collect data, details regarding the number and characteristics of GPs who consented to participate in data collection, and consequences regarding the strength of outcome estimates.
Material/Methods: Outreach visits were offered to all practices in the intervention group from October 2013 to March 2014. We presented recommendation and resources, including determinants of practice, a comprehensive website and a CME course for GPs. All practicing GPs in the included municipalities were eligible for the data collection, which took place June-December 2014. Invitations to participate in data collection were sent by postal services, email and phone calls to practices. We recruited and trained medical students to collect data by structured telephone interviews lasting about 1 hour. We paid the medical students for the interviews, but we were not able to pay the GPs. GPs who responded to the interviews and finished the e-learning course received CME credits.
Conclusion: We were not able to collect data from the expected number of GPs in our study.
Points for discussion: We would like to share and discuss our experiences, to get feedback, and to develop ideas on how we might develop appropriate tools and incentives to make it easier for GPs to contribute to data collection. We suggest that better data collection tools, better incentives and a research network in primary care might be helpful.