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The European General Practice Research Network (formerly known as EGPRW) grew out of an informal meeting held at Leusden in the Netherlands, where in October 1971, representatives from bodies engaged in academic and research activities associated with general practice met to develop international co-operation. Those interested in education went on to form the European Conference on the teaching of general practice, the European Academy of Teachers in General Practice (EURACT) and those whose interest was research initiated the EGPRW. For the first many years the EGPRW was an ill defined group of doctors, oddly unstructured, only kept together by a common interest and a mailing list. After a while National Representatives were appointed by those who happened to be present at that time, and they formed sThe European General Practice Research Workshop (EGPRN) grew out of an informal meeting held at Leusden in the Netherlands, where in October 1971, representatives from bodies engaged in academic and research activities associated with general practice met to develop international co operation. Those interested in education went on to form the European Conference on the teaching of general practice, the European Academy of Teachers in General Practice (EURACT) and those whose interest was research initiated EGPRN. During the first years, EGPRN was an ill defined group of enthusiastic GP's, only kept together by a common interest and a mailing list. After a while National Representatives were appointed by those who happened to be present at that time, and they formed some sort of a Board. Meetings were organized by the Chairman in cooperation with GPs from different countries, interested in research, National Colleges (if they existed) and the Societas Internationalis Medicinae Generalis, with expenses being met by the participants themselves. The initial meetings involved countries in Northern Europe but this was rapidly extended to Southern European countries and recently, ones in the East. Since November 1974, regular biannual meetings have taken place: by May 2005, 60 meetings had taken place.

Initially, members met to exchange ideas and views about the research problems in general practice. The true nature of the general practitioner's essential role in health care was just evolving and being understood at least by general practitioners themselves. From the beginning, the Workshop was concerned with identifying these real problems and establishing the rules and criteria for systematic enquiry in this new field. All early participants would acknowledge that the Socratic framework of constructive creative debate among peers with similar problems was the essential first step to the painstaking process of establishing a truly scientific framework for an understanding of the problems peculiar to primary care. This process was underway throughout Europe but the workshop was a unique opportunity for the consistent consideration of basic primary care problems against an international background. There was an emphasis on descriptive techniques and on ways of living with the lack of agreed criteria, definitions and labels which could be applied consistently.

 There was exploration of the way in which the "problem and action" basis for much effective general practice could be systematically explored with the limitations of traditional hypothesis testing techniques. These initial restraints led to feelings of frustration among some participants who felt that there was not enough traditional "real" research. The emphasis at meetings in the first 8 10 years was therefore on the evolution of problem solving techniques and method rather than the presentation of final results. Much of the time was spent in the systematic constructive criticism of research method almost always in the context of planned personal research studies from individual members. For example, Robin Hull, in a series of delicious and fragrantly intuitive cameos accurately transmitted the flavour of general practice as he explored it across Europe. These initial descriptive studies have been followed up by ever more rigorous and standardised studies of the Interface between Primary and Secondary Care which have involved the members of the Workshop as a whole. The European Study of Referrals from Primary to Secondary Care was based on standardised criteria, definitions and measurements of the referral process in each of the European countries and for the first time enabled a direct international comparison of the referral process in Europe. This is an example of the more general development of research activity stimulated within, and then conducted by the Workshop. Standardised criteria definitions and method are also necessary for any international comparison of the incidence and prevalence of morbidity. EGPRN also collaborated in the planning of European studies under the auspices of the EC (COMAC HSR).

A Weekly Return System for infectious and communicable diseases existed in Great Britain. A similar system was also in operation based on sentinel practices in Holland. Similar systems were then set up in Belgium and Denmark and followed by France. These earlier developments have now resulted in a centralised Eurosentinel Concerted Action on Sentinel Health Information Systems with General Practitioners funded by the EEC and managed by the Institute of Hygiene and Epidemiology in Brussels.

Over the years, much effort and thought has been given by the Workshop to what is called the denominator problem. Incidence and prevalence rates require accurate estimates of populations at risk. These are difficult to obtain in countries with health systems not involving patient registration. Important contributions have been made by the Workshop and its members though no final answer has yet been found to this problem.

Other international studies have been (and are being) carried out by smaller groups of GP researchers through the EGPRN network, e.g. the Home Visit Study, the International GP Burnout Study and the Eurobstacle Study (identifying obstacles to adherence for diabetic patients).

 

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Last Updated on Tuesday, 22 December 2009 12:42