FROM HERE TO ETERNITY? EPILOGUE! DR JOHN BEST & DR ALISON CLEGG

NATIONAL HEALTH AND MEDICAL RESEARCH COUNCIL (NHMRC) Australia’s leading health and medical research agency -health advice -health ethics -health and medical research

RESEARCH-POLICY RELATIONSHIP NO RESEARCH POLICY NO POLICY NEED FOR TRANSLATION POLICY NOT UNDERPINNED BY RESEARCH IS THERE A NEED FOR RESEARCH AND POLICY? RESEARCH MONITOR POLICY UNDERPINNED BY RESEARCH RESEARCH

EVIDENCE BASED CLINICAL PRACTICE RESEARCH Evidence Based Clinical Practice Research Program (1999/2000) -identify facilitating factors and barriers to translation of research outcomes -14 projects funded for 12 months

FACILITATING FACTORS Perception of local ownership Support of senior clinicians, health professionals and patients Support of senior administration Promotional programs for guidelines

Lack of consensus on best practice - too many guidelines! Lack of skills Additional workload Fear of medico-legal issues Patient preference BARRIERS

UNANSWERED QUESTIONS Sustainability of change to policy and/or practice Generalisability/transferability of outcomes to other settings Effect of change on health outcomes

EPILOGUE STUDIES 13/14 teams funded two years after completion to examine: Sustainability of changes effected Translation of the project outcomes to other settings Health outcomes

EPILOGUE OUTCOMES Difficult to draw generic conclusions on sustainability and transferability - different nature of projects - introspective reporting Little evidence of strong links between research outcomes and policy

LESSONS LEARNED Define measurable parameters for sustainability -multiple components -specifics will differ Limited information on -generalisability/transferability -health outcomes

THE WAY FORWARD? (1) ? value of small research projects to contribute to knowledge of implementation of best practice ? larger scale study on a single clinical area where evidence and practice differ

THE WAY FORWARD? (2) Extend research endeavour to include policy makers and agents for change -alter incentives & measures of research success (from bibliometric to social benefits) -practice what we preach

RESEARCH PARADIGM Evidence Base Research Guidelines Practice No Practice More research monitor Translational A = Actual E = Expected Health Outcomes Outcome A/E = 1 Outcome A/E < 1

CONCLUSION FROM HERE (isolation and introspection) TO ETERNITY (engagement and coordination) BUT NOT interference and coercion

ACKNOWLEDGMENTS EBCPRP Investigators Dr Sue Morey More Information on