Conducting research in general practice: lessons learnt from experience.

ISSUE ADDRESSED: The increased focus on evidence-based practice and the World Health Organization (WHO) settings approach to health promotion have contributed to an increase in the importance of health promotion activity and therefore research being undertaken in the general practice setting. Primary care-based trials represent major investments in time and resources for researchers, health professionals and patients, and there are several methodological and logistical issues that need to be considered. The costs of failed trials are potentially significant and include wasted resources, opportunity costs of participants' time and discouragement of primary care professionals from co-operating with further research. DISCUSSION: This paper presents an overview of the important logistical and methodological considerations when conducting research in this setting. This paper is written for researchers new to the general practice setting. We discuss logistical challenges such as literature searching, ethical considerations, recruitment and retention of GPs, practices and patients, working with practices, and financial considerations. Methodological considerations including issues relating to patient recruitment, clustering, Hawthorne effect, ensuring conformity of intervention, avoiding contamination, and confounders are also discussed. A checklist for researchers contemplating research in this setting is supplied.