ACP releases survey results on comparative effectiveness research; hosts webinar

ACP conducted a survey on the attitudes of primary care physicians toward comparative effective research (CER), which addressed familiarity with CER, applying research findings, and the role of medical societies related to CER results.

The College is also hosting a webinar on the topic, “Comparative Effectiveness Research and Medicine: Are Primary Care Physicians Ready?” on Tuesday, March 29, from 11:30 am to 12:30 pm ET. To register, go online.

CER data can influence clinical decisions by informing patients, clinicians, and decision-makers about which interventions are most effective for each individual patient. If health care outcomes can be expected to improve, physicians and other providers will have to routinely and appropriately integrate CER findings into their practice and facilitate improved decision-making. To better understand the attitudes of primary care physicians (PCPs) toward CER and potential barriers that may impact their use, a study entitled “Measuring Physicians' Opinions of CER to Strengthen its Role in Patient-Centered Care” was funded through a Patient-Centered Outcomes Research Institute (PCORI) Eugene Washington PCORI Engagement Award (1175-ACP).

The resultant “Survey of Primary Care Societies” was conducted by ACP in collaboration with the American Academy of Family Physicians, the American Academy of Pediatrics, and the American Osteopathic Association. The survey addressed 4 central questions: (1) Are PCPs familiar with CER and what is its perceived value for educating patients? (2) What are the main factors impacting a PCP's confidence in applying CER findings to his or her practice? (3) What are the most trusted ways to make research evidence more accessible to PCPs? (4) What role should medical societies play to assist PCPs in accessing and applying CER results?

The key findings include:

1. 1. PCPs have a low level of familiarity with the term comparative effectiveness research. Although PCPs lack familiarity with CER by name, most respondents are confident they possess the abilities needed to use such research, i.e., finding, assessing, discussing with patients, and applying research findings related to treatment options.
2. 2. PCPs show strong support for CER when the concept is explained. Most PCPs agree CER can improve the physician-patient relationship, how patients make health care decisions, and the quality of patient care. Furthermore, they acknowledge CER should be used to develop clinical practice guidelines. However, 1 in 5 PCPs is skeptical about the validity of most CER or feels CER restricts one's freedom to choose treatments for patients.
3. 3. Lack of time is a major factor preventing use of CER findings. PCPs are confident in their ability to find and use CER but they do not have time to gather the necessary research. Use of CER findings to inform patients of their options is uneven with about one-third (36%) applying CER in their practice today. However, the vast majority believes CER will be important in treatment decisions in the next 2 to 3 years.
4. 4. PCPs trust information on new research findings when it is from peer-reviewed literature or from one's medical society rather than one's employer. Peer-reviewed literature, clinical information reference tools, medical societies, and systematic review articles are highly trusted sources of information on new research findings in contrast to one's employer/institution or websites of government health agencies. Regardless of age, the preferred communication medium for obtaining CER findings is print.
5. 5. Medical societies should spend more time disseminating and translating research findings for clinical decision-making. Physicians' lack of time may underlie their desire for their medical society to act as a mediator; using research findings to set guidelines/policies and helping PCPs access and apply the evidence. To assist PCPs, medical societies should offer courses or sessions for communicating effectively with patients and families as well as provide tools for incorporating research results into physician and patient decision-making.

Regardless of their specialty area, PCPs show strong support for the concept of CER. For patient-centered CER to have optimal real-world impact and truly make the patient an active participant in the decision-making process, physicians will need to integrate CER findings into their practice and facilitate improved decision-making.

These findings also highlight the need for PCORI to continue to forge relationships with medical societies that deal with PCPs and identify new ways to make research evidence more accessible to practicing PCPs. For PCORI, this is the first step toward establishing a baseline for future action that it will take with the various medical societies.