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Journal of Primary Health Care Journal of Primary Health Care Society
Journal of The Royal New Zealand College of General Practitioners
RESEARCH ARTICLE (Open Access)

Establishing the research priorities of a national primary care research network in New Zealand: a Delphi exercise

Sharon Leitch https://orcid.org/0000-0001-9939-8773 1 * , Jing-Ru Li 1 , Tim Stokes https://orcid.org/0000-0002-1127-1952 1
+ Author Affiliations
- Author Affiliations

1 Department of General Practice and Rural Health, University of Otago, 55 Hanover Street, Dunedin 9016, New Zealand.

* Correspondence to: sharon.leitch@otago.ac.nz

Handling Editor: Felicity Goodyear-Smith

Journal of Primary Health Care https://doi.org/10.1071/HC24046
Submitted: 3 April 2024  Accepted: 23 May 2024  Published: 13 June 2024

© 2024 The Author(s) (or their employer(s)). Published by CSIRO Publishing on behalf of The Royal New Zealand College of General Practitioners. This is an open access article distributed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND)

Abstract

Introduction

Research using routinely collected primary health care data can improve health care quality, outcomes, policy, and health equity. Aotearoa New Zealand (NZ) lacked the infrastructure to readily access these data. The Southern Primary Care Research Network (Southern PCRN) has been established to address this issue.

Aim

This study aimed to identify the research priorities of primary health care clinicians and researchers.

Methods

A modified Delphi survey method was used to identify priority general research areas and specific research questions in NZ primary health care. Participants suggested priority research areas and research questions in Round 1. These were grouped thematically and ranked by frequency. Research questions were screened by scope and feasibility. In Round 2, participants ranked the importance of the research questions.

Results

Primary health care access, health workforce, health services, mental health, and models of primary health care were identified as priority research areas. After screening, 23 research questions were included in Round 2. Consensus was reached on 20 questions. The highest-ranked questions suggested implementation and evaluation of annual checks for people with intellectual disability, and evaluating the effects of embedding allied health practitioners and social workers in primary health care teams.

Discussion

Prioritised research areas are consistent with those identified in the literature. However, the priority research questions are emerging topics. This is the first research prioritisation exercise undertaken for the Southern PCRN. Further research is planned to explore patient priorities. These findings will help the Southern PCRN to establish a research agenda in accordance with its mission of improving health equity.

Keywords: academics, clinicians, Delphi survey, general practice, health equity, New Zealand, primary care research network, primary health care, research prioritisation.

References

Simpson H. Health and disability system review. Final report. Pūrongo whakamutunga. Wellington: Health and Disability System Review; 2020.

Pigden A, Stokes T, Crengle S, et al. Developing a national primary care research network: a qualitative study of stakeholder views. J Prim Health Care 2022; 14(4): 338-44.
| Crossref | Google Scholar | PubMed |

Sullivan F, Butler C, Cupples M, et al. Primary care research networks in the United Kingdom. BMJ 2007; 334(7603): 1093-4.
| Crossref | Google Scholar | PubMed |

Green LA, Hickner J. A short history of primary care practice-based research networks: from concept to essential research laboratories. J Am Board Fam Med 2006; 19(1): 1-10.
| Crossref | Google Scholar | PubMed |

Morkem R, Shah R, Salman A, et al. CPCSSN data quality: an opportunity for enhancing Canadian primary care data. Ann Fam Med 2023; 21: 4964.
| Crossref | Google Scholar |

Leitch S. New Zealand needs a Practice Based Research Network. J Prim Health Care 2016; 8(1): 9-12.
| Crossref | Google Scholar | PubMed |

Viergever RF, Olifson S, Ghaffar A, et al. A checklist for health research priority setting: nine common themes of good practice. Health Res Policy Syst 2010; 8(1): 1-9.
| Crossref | Google Scholar | PubMed |

Yoshida S. Approaches, tools and methods used for setting priorities in health research in the 21st century. J Glob Health 2016; 6(1): 010507.
| Crossref | Google Scholar | PubMed |

Fun WH, Sararaks S, Tan EH, et al. Research funding impact and priority setting – advancing universal access and quality healthcare research in Malaysia. BMC Health Serv Res 2019; 19(1): 248.
| Crossref | Google Scholar | PubMed |

10  Nasser M, Ueffing E, Welch V, et al. An equity lens can ensure an equity-oriented approach to agenda setting and priority setting of Cochrane Reviews. J Clin Epidemiol 2013; 66(5): 511-21.
| Crossref | Google Scholar | PubMed |

11  Gradinger F, Britten N, Wyatt K, et al. Values associated with public involvement in health and social care research: a narrative review. Health Expect 2015; 18(5): 661-75.
| Crossref | Google Scholar | PubMed |

12  Forsythe LP, Ellis LE, Edmundson L, et al. Patient and stakeholder engagement in the PCORI pilot projects: description and lessons learned. J Gen Int Med 2016; 31: 13-21.
| Crossref | Google Scholar | PubMed |

13  Walter M, Lovett R, Maher B, et al. Indigenous data sovereignty in the era of big data and open data. Aust J Soc Issues 2021; 56(2): 143-56.
| Crossref | Google Scholar |

14  West K, Hudson M, Kukutai T. Data ethics and data governance from a Māori world view. Indigenous research ethics: claiming research sovereignty beyond deficit and the colonial legacy. Emerald Publishing Limited; 2020:67-81.

15  Grill C. Involving stakeholders in research priority setting: a scoping review. Res Involv Engagem 2021; 7(1): 75.
| Crossref | Google Scholar | PubMed |

16  Choi BC, Maza RA, Mujica OJ, et al. The Pan American Health Organization-adapted Hanlon method for prioritization of health programs. Pan Am J Public Health 2019; 43:.
| Google Scholar |

17  Nasa P, Jain R, Juneja D. Delphi methodology in healthcare research: how to decide its appropriateness. World J Methodol 2021; 11(4): 116.
| Crossref | Google Scholar | PubMed |

18  Diamond IR, Grant RC, Feldman BM, et al. Defining consensus: a systematic review recommends methodologic criteria for reporting of Delphi studies. J Clin Epidemiol 2014; 67(4): 401-9.
| Crossref | Google Scholar | PubMed |

19  Qualtrics. Qualtrics. 2005. Available at https://www.qualtrics.com [accessed March 2023].

20  Deane HC, Wilson CL, Babl FE, et al. PREDICT prioritisation study: establishing the research priorities of paediatric emergency medicine physicians in Australia and New Zealand. Emerg Med J 2018; 35(1): 39-45.
| Crossref | Google Scholar | PubMed |

21  Heal C, Roberts G. General practice research priority setting in Australia: informing a research agenda to deliver best patient care. Aust J Gen Pract 2019; 48(11): 789-95.
| Crossref | Google Scholar | PubMed |

22  Abrams R, Blake S. UK general practice service delivery research priorities: an adapted James Lind Alliance approach. Br J Gen Pract 2024; 74(738): e9.
| Crossref | Google Scholar | PubMed |

23  Morris RL, Stocks SJ, Alam R, et al. Identifying primary care patient safety research priorities in the UK: a James Lind Alliance Priority Setting Partnership. BMJ Open 2018; 8(2): e020870.
| Crossref | Google Scholar | PubMed |

24  Goodyear-Smith F, Bazemore A, Coffman M, et al. Primary Care research priorities in low-and middle-income countries. Ann Fam Med 2019; 17(1): 31-5.
| Crossref | Google Scholar | PubMed |

25  Groenewegen P, Hansen J, Fahy N, et al. Priority setting and cross-country learning: the relevance of TO-REACH for primary care. Prim Health Care Res Dev 2022; 23: e40.
| Crossref | Google Scholar | PubMed |

26  Crampton P, Bagg W, Bristowe Z, et al. National cross-sectional study of the sociodemographic characteristics of Aotearoa New Zealand’s regulated health workforce pre-registration students: a mirror on society? BMJ Open 2023; 13(3): e065380.
| Crossref | Google Scholar | PubMed |

27  McAllister T, Kidman J, Rowley O, et al. Why isn’t my professor Mäori. Mai J 2019; 8(2): 235-49.
| Google Scholar |

28  Sheridan N, Love T, Kenealy T, et al. Is there equity of patient health outcomes across models of general practice in Aotearoa New Zealand? A national cross-sectional study. Int J Equity Health 2023; 22(1): 79.
| Crossref | Google Scholar | PubMed |

29  Jeffreys M, Ellison-Loschmann L, Irurzun-Lopez M, et al. Financial barriers to primary health care in Aotearoa New Zealand. Fam Pract 2023; cmad096.
| Crossref | Google Scholar | PubMed |

30  Ministry of Health. Annual Data Explorer 2022/23: New Zealand Health Survey [Data File]. 2023. Available at https://minhealthnz.shinyapps.io/nz-health-survey-2022-23-annual-data-explorer/ [accessed February 2024].

31  Silwal P, Lopez MI, Pledger M, et al. Association between enrolment with a Primary Health Care provider and amenable mortality: a national population-based analysis in Aotearoa New Zealand. PLoS One 2023; 18(2): e0281163.
| Crossref | Google Scholar | PubMed |

32  Rees GH. The evolution of New Zealand’s health workforce policy and planning system: a study of workforce governance and health reform. Hum Resour Health 2019; 17(1): 51.
| Crossref | Google Scholar | PubMed |

33  O’Neill B, Aversa V, Rouleau K, et al. Identifying top 10 primary care research priorities from international stakeholders using a modified Delphi method. PLoS One 2018; 13(10): e0206096.
| Crossref | Google Scholar | PubMed |

34  Te Whatu Ora – Health New Zealand. Health Workforce Plan 2023-24. Wellington: Te Whatu Ora – Health New Zealand; 2023.

35  McNaughton SM, Flood B, Morgan CJ, et al. Existing models of interprofessional collaborative practice in primary healthcare: a scoping review. J Interprof Care 2021; 35(6): 940-52.
| Crossref | Google Scholar | PubMed |

36  de Lusignan S, van Weel C. The use of routinely collected computer data for research in primary care: opportunities and challenges. Fam Pract 2006; 23(2): 253-63.
| Crossref | Google Scholar | PubMed |

37  Tierney WM, McDonald CJ. Practice databases and their uses in clinical research. Stat Med 1991; 10(4): 541-57.
| Crossref | Google Scholar | PubMed |

38  Sutcliffe K, Ball J, Clark TC, et al. Rapid and unequal decline in adolescent mental health and well-being 2012–2019: findings from New Zealand cross-sectional surveys. Aust NZ J Psychiatry 2023; 57(2): 264-82.
| Crossref | Google Scholar | PubMed |

39  Wilson A, Nicolson M. Mental health in Aotearoa: Results from the 2018 mental health monitor and the 2018/19 New Zealand Health Survey. Wellington: Te Hiringa Hauora/Health Promotion Agency; 2020.

40  Lockett H, Lai J, Tuason C, et al. Primary healthcare utilisation among adults with mood and anxiety disorders: an analysis of the New Zealand Health Survey. J Prim Health Care 2018; 10(1): 68-75.
| Crossref | Google Scholar | PubMed |

41  Richmond-Rakerd LS, D’Souza S, Milne BJ, et al. Longitudinal associations of mental disorders with physical diseases and mortality among 2.3 million New Zealand citizens. JAMA Netw Open 2021; 4(1): e2033448.
| Crossref | Google Scholar | PubMed |

42  Tselebis A, Pachi A. Primary mental health care in a new era. Healthcare 2022; 10: 2025.
| Crossref | Google Scholar |

43  Kulshrestha V, Shahid SM. Barriers and drivers in mental health services in New Zealand: current status and future direction. Glob Health Promot 2022; 29(4): 17579759221099312.
| Crossref | Google Scholar | PubMed |

44  O’Hara J, McCarthy J, Bouras N. Intellectual disability and ill health – A review of the evidence. Adv Ment Health Intellect Disabil 2011; 5(6): 58-60.
| Crossref | Google Scholar |

45  Liao P, Vajdic C, Trollor J, et al. Prevalence and incidence of physical health conditions in people with intellectual disability – a systematic review. PLoS One 2021; 16(8): e0256294.
| Crossref | Google Scholar | PubMed |

46  Shea B, Bailie J, Dykgraaf SH, et al. Access to general practice for people with intellectual disability in Australia: a systematic scoping review. BMC Prim Care 2022; 23(1): 306.
| Crossref | Google Scholar | PubMed |

47  Robertson J, Hatton C, Emerson E, et al. The impact of health checks for people with intellectual disabilities: an updated systematic review of evidence. Res Dev Disabil 2014; 35(10): 2450-62.
| Crossref | Google Scholar | PubMed |

48  McCarthy J, Duff M. Services for adults with intellectual disability in Aotearoa New Zealand. BJPsych Int 2019; 16(3): 71-3.
| Crossref | Google Scholar | PubMed |

49  Health Mo. Annual update of key results 2018/19: New Zealand health survey. Wellington: Ministry of Health; 2019.

50  Tomlin AM, Woods DJ, Reid JJ, et al. Trends in prescription medicine use by older people in New Zealand 2010–2015: a national population-based study. N Z Med J 2020; 133(1513): 61-72.
| Google Scholar | PubMed |

51  Raghunandan R, Marra CA, Tordoff J, et al. Examining non-medical prescribing trends in New Zealand: 2016–2020. BMC Health Serv Res 2021; 21(1): 418.
| Crossref | Google Scholar | PubMed |

52  Maixner W, Fillingim RB, Williams DA, et al. Overlapping chronic pain conditions: implications for diagnosis and classification. J Pain 2016; 17(9): T93-107.
| Crossref | Google Scholar | PubMed |

53  Huttunen MH, Paananen M, Miettunen J, et al. Multidisciplinary management of persistent pain in primary care—A systematic review. Eur J Pain 2024; 1-15.
| Crossref | Google Scholar | PubMed |

54  Saint-Pierre C, Herskovic V, Sepúlveda M. Multidisciplinary collaboration in primary care: a systematic review. Fam Pract 2017; 35(2): 132-41.
| Crossref | Google Scholar | PubMed |

55  Wranik WD, Price S, Haydt SM, et al. Implications of interprofessional primary care team characteristics for health services and patient health outcomes: a systematic review with narrative synthesis. Health Policy 2019; 123(6): 550-63.
| Crossref | Google Scholar | PubMed |

56  Davidson AR, Kelly J, Ball L, et al. What do patients experience? Interprofessional collaborative practice for chronic conditions in primary care: an integrative review. BMC Prim Care 2022; 23(1): 1-12.
| Crossref | Google Scholar |

57  Couturier Y, Lanoue S, Karam M, et al. Social workers coordination in primary healthcare for patients with complex needs: a scoping review. Int J Care Coord 2023; 26(1): 5-25.
| Crossref | Google Scholar |