Unacceptable weakness of research in the field of primary care

A Viewpoint in this week’s issue of THE LANCET addresses the state of primary-care research worldwide. Primary care includes the medical services provided by general practitioners (family physicians) and internists, with the aims of providing patients with a broad range of health care over a period of time and coordinating the care the patient receives.

David Mant from Oxford University and colleagues respond to a Lancet editorial that highlighted the unacceptable weakness of research in the field of primary care. At an international conference last year in Kingston, Canada, concerns were raised about the paucity of such research in less economically developed countries to inform the management of illnesses associated with poverty. However, even in wealthier countries, primary-care research is seen as unproductive. So is such research “a lost cause”, asked The Lancet?

Professor Mant and his co-authors agree that these shortcomings need to be taken seriously. However, they say, to give up on primary-care research is no solution. Reliable evidence is needed to underpin primary-care practice and prevent the use of inappropriate or harmful treatments. Although in several countries, primary-care research is perceived as “second class”, there are many examples of effective primary care research that influences clinical practice. Improved investment in high-quality primary-care research is needed, both to improve health care and to attract top researchers to the field. David Mant comments: “To characterise primary-care research as a “lost cause” is unhelpful. This notion implies either that the field is so weak that it cannot be resuscitated or that it is irrelevant anyway. Both are wrong.”