Michael Parchman, MD, MPH

Walter Calmbach, MD, MPH

Marisa Rodriguez, BS

UT Health Science Center at San Antonio

South Texas Ambulatory Research Network

pbrnResource Center

STAR Net

What is a Practice-Based Research Network?

An organization of community clinicians who work together with researchers to answer meaningful questions that will improve patient care

1000 persons

800 report symptoms

327 consider seeking medical care

217 visit a physician’s office (113 visit a primary care physician’s office) PBRN Research

65 visit a complementary or alternative provider

21 visit a hospital outpatient clinic

14 receive home health care

13 visit an emergency dept

8 are hospitalized

<1 is hospitalized in an academic medical center Most Research

Results of a reanalysis of the monthly prevalence of illness in the community and the roles of various sources of health care. Green LA et al., N Engl J Med 2001, 344:2021-2024.

Why is Practice-Based Research Needed?

STARNet Leadership

Walter Calmbach, MD, Michael Parchman, MD and Marisa Rodriguez

Board of Directors

Carlos Campos, MDLeo Cigarroa, MDMitch Finnie, MDAbel Muñoz, MD

Soloman Paley, MDRamon Reyes, MD

Lloyd Van Winkle, MD

The South Texas Ambulatory Research Network (STARNet)

• MISSION:– to create and disseminate new knowledge for community

primary care physicians that will improve the health of our patients here in South Texas

• OBJECTIVES:– conduct studies and projects in the clinics and

communities of STARNet members

– link community primary care clinics to resources

– create a community of learning among STARNet members and their communities in South Texas

STAR Net

Where are PBRNs in the Research “Pipeline?”

Bench Bedside Community

Bookshelf

“T1” “T2”The Academic Health Science Center:

“If we want more evidence-based practice, we need more practice-based evidence.”

• Green LW and R. Glasgow, 2006

Examples of STARNet Studies:

• Exercise in the Elderly• Panic Disorder in Patients Presenting with Chest Pain• Patient Preference for Discussion of Family Conflict/Violence• Quality and Outcomes of Diabetes Care in Primary Care

Settings• Improving Risk Factors for Complications of Type 2 Diabetes

in Primary Care (current)• History and Physical Findings of Patients with MRSA Skin

Infections in South Texas (current)• Using interactive multimedia to promote colorectal cancer

screening (current)• Patient Safety survey (current)• Electronic primary care research network (current)• Aspirin in reducing events in the elderly (current)

PracticePractice--Based Research Networks (Based Research Networks (PBRNsPBRNs))36 new PBRN grants awarded in 200236 new PBRN grants awarded in 2002

19 PBRN grants awarded in 200019 PBRN grants awarded in 2000

Identify knowledge gap

Systematic search for adequate

answer

Generate and clarify study

question

Design StudyCollect data

Analyze and interpret results

Implement in practice

Serious input from

clinicians and office

staff

COLLABORATION IS KEY!

"I have had only positive comments from patients who are usually excited and pleased to be able to be a part of the studies. Patients don't just cooperate, they are enthusiastic participants. Many of our patients are impressed that their doctor's office is involved in medical research and that they can share in that.”

Ramon Reyes, MDHelotes, TX

"The projects are interesting and designed to be an asset to the daily practice function. The studies have never been a problem; in fact, they do, on occasion, give rise to questions from patients that lead to important doctor-patient interactions. “

Able Munoz, MDAustin, TX

"STARNet is a part of my practice where everyone wins, the patient, the practice, and the specialty of Family Practice. I believe much of the future evidence establishing the value of primary care, in general, and family practice, specifically, will grow out of office-based medical research. So being involved in STARNet is my way of helping to insure a future that includes healthy patients, healthy practices, and a healthy future for family medicine.”

Lloyd Van Winkle, MDCastroville, TX

What do I need to do to join the network?

How can I join a research project?

When is the next STARNet meeting?

Contact Information

Michael Parchman, MD, MPH

210-617-4028

parchman@uthscsa.edu