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FROM HERE TO ETERNITY? EPILOGUE! DR JOHN BEST & DR ALISON CLEGG. NATIONAL HEALTH AND MEDICAL RESEARCH COUNCIL (NHMRC). Australia’s leading health and medical research agency. health advice health ethics health and medical research. POLICY UNDERPINNED BY RESEARCH. MONITOR.

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slide2

NATIONAL HEALTH AND MEDICAL RESEARCH COUNCIL (NHMRC)

Australia’s leading health and

medicalresearch agency

  • health advice
  • health ethics
  • health and medical research
slide3

POLICY UNDERPINNED BY RESEARCH

MONITOR

NEED FOR TRANSLATION

RESEARCH

IS THERE A NEED FOR RESEARCH AND POLICY?

POLICY NOT UNDERPINNED BY RESEARCH

RESEARCH-POLICY RELATIONSHIP

NO POLICY

POLICY

RESEARCH

NO RESEARCH

slide4

EVIDENCE BASED CLINICAL PRACTICE RESEARCH

  • Evidence Based Clinical Practice Research Program (1999/2000)
      • identify facilitating factors and barriers to translation of research outcomes
      • 14 projects funded for 12 months
slide5

FACILITATING FACTORS

  • Perception of local ownership
  • Support of senior clinicians, health professionals and patients
  • Support of senior administration
  • Promotional programs for guidelines
barriers
BARRIERS
  • Lack of consensus on best practice - too many guidelines!
  • Lack of skills
  • Additional workload
  • Fear of medico-legal issues
  • Patient preference
slide7

UNANSWERED QUESTIONS

  • Sustainability of change to policy and/or practice
  • Generalisability/transferability of outcomes to other settings
  • Effect of change on health outcomes
slide8

EPILOGUE STUDIES

  • 13/14 teams funded two years after completion to examine:
    • Sustainability of changes effected
    • Translation of the project outcomes to other settings
    • Health outcomes
epilogue outcomes
EPILOGUE OUTCOMES
  • Difficult to draw generic conclusions on sustainability and transferability
      • different nature of projects
      • introspective reporting
  • Little evidence of strong links between research outcomes and policy
lessons learned
LESSONS LEARNED
  • Define measurable parameters for sustainability
      • multiple components
      • specifics will differ
  • Limited information on
      • generalisability/transferability
      • health outcomes
the way forward 1
THE WAY FORWARD? (1)
  • ? value of small research projects to contribute to knowledge of implementation of best practice
  • ? larger scale study on a single clinical area where evidence and practice differ
the way forward 2
THE WAY FORWARD? (2)
  • Extend research endeavour to include policy makers and agents for change
      • alter incentives & measures of research success (from bibliometric to social benefits)
      • practice what we preach
slide13

Health

Outcomes

monitor

Outcome

A/E = 1

Practice

Outcome

No Practice

A/E < 1

More research

A = Actual

E = Expected

RESEARCH PARADIGM

Translational

Evidence

Base

Research

Guidelines

conclusion
CONCLUSION

FROM HERE

(isolation and introspection)

TO ETERNITY

(engagement and coordination)

BUT NOT

interference and coercion

acknowledgments
ACKNOWLEDGMENTS

EBCPRP Investigators

Dr Sue Morey

More Information on

www.nhmrc.gov.au