GRACE WP9-10 Result 1 st season CARDIFF Number of patients included: 75/75 Number of participating GPs:24 (8) Strong points: Weak points:

GRACE WP9-10 Result 1st season CARDIFF

Number of patients included: 75/75

Number of participating GPs:24 (8)

Strong points:

Weak points:

GRACE WP9-10 Plan to improve recruitment

1. Recruitment capacity: 8 more GPs

2. Changes in strategy:

NICE Guidance

3. Other actions:

Combat Medical Consumerism

GRACE WP9-10 Result 1st season Network Southampton

Number of patients included: 106

Number of participating GPs: 7 & 4 nurses

Strong points:• Two extremely committed practices

• No logistical problems

Weak points:• Delay with recruiting first patient – Early December

• Not able to find other practices to participate


1. Recruitment capacity:Increased recruitment capacity by recruiting additional practices and securing

funds for a locum

2. Changes in strategy:• set up a minor illness clinic in one practice with a nurse allocating sessions for

GRACE recruitment

• Secured funds and recruited an additional practice that will have a locum who will only recruit for GRACE

3. Other actions:Installed electronic notice board to alert patients to the GRACE study

Enlisted the help of PIs to try to find more practices to help

GRACE WP9-10 Result 1st season Network Utrecht

Number of patients included: 94 Pt & 96 Ctl

Number of participating GPs: 22

Strong points:• Saskia

• The lab is visiting the patients to sample

Weak points:• GPs don’t have enough time

• Late start


1. Recruitment capacity:We cloned Saskia.

2. Changes in strategy:Both GRACE physicians will cover two group practices.

Recruitment is centralized in a neighbourhood close by an X-ray facility.

3. Other actions:Only motivated GPs are allowed to participate.

GRACE WP9-10 Result 1st season Network [BARCELONA]



Strong points:

Knowledge: they know the inclusion criteria

Motivation: most of the GP’s are committed

Weak points:

Introducing data

Finding controls


1. Recruitment capacity:We will try to select new GPs inside the same centers.

2. Changes in strategy:Research Nurse: to help to find controls

and introduce data.

3. Other actions:Meetings with GP’s every month

GRACE WP9-10 Result 1st season Network of Mataró

Number subjects included: 95 patents + 95 controls (190)


Strong points:

• Diary, samples, x-ray >98% and spirometry in >90%

• Transport, lab procedures and storage, entering data to GOS with no problems

• Help GPs to complete all data (CRF)

Weak points:

• GP workload

• Difficulties in the second visit (reach 90%)

• Difficulties in the acceptance of the clinical trial (wp-10)


1. Recruitment capacity:

• Increase nº GPs/practices

• Start 2nd season in 15th September

2. Changes in strategy:

• A nurse in each practice will help GPs to recruit cases and controls and to fill in the CRF

3. Other actions:

• More periodic GP contacts/visits

• Organization of clinical sessions on this topic (LRTI, resistance against antibiotics, etc.) with GPs

GRACE WP9-10 Result 1st season Network [Rotenburg]

Number of patients included: 192, 96 patients, 96 controls


Strong points:

4 hard working GPs

Weak points:

Too much work for the GPs

No additional time besides the routine in the practice

Different procedere between patients:

younger ones (not willing to participate) -

elder ones (need much time for information).

Extensive problems to find controls,

no possibility for slide shows, no electronic boards in surgeries.


1. Recruitment capacity: 15, 4 in Rotenburg, 11 spread out in the district up to 40 km

2. Changes in strategy: no, because no capacity of the staff.

3. Other actions from the first day:

Assistance of the GPs

Finding controls, taking samples, doing the follow up and the lung function

Entering all the data onto GOS

Patient information leaflets,posters in waiting room

Arranging regular visits and contacts by phone with the GPs and their assistants

Training of nurses and assistants in the practices and by phone

Contacts at any time by phone

Invitation to informing events, small presents

Detailed instructions for working in terms of a flow chart

Regular transfer of GRACE Cases, News, German Newsletter and results to the G

GPs

Special German problems

GPs

• Do not like to trouble patients with the swabs. • Different structure to other countries concerning the practices:• Only private surgeries with one or two GPs -• But they do not work always together over the day.• First of all – the GPs are interested in taking care for their patients,

afterwards they may have time for recruiting• To convince the GPs to participate in WP 10• Only our pharmacist is allowed by the competent authority to hand

out the study medication

GRACE WP9-10 Result 1st season Network Antwerp



Strong points: – Selection of GPs most successful in WP8 et al.

– Recruitment of 1 pt/ctr / week from October 1 onwards

– Regular contact (feedback, reward, …) with team

Weak points:– Dependence on a few GPs


1. Recruitment capacity: - 1 GP (underperforming and no longer motivated)

+ 7 GPs (2 new practices of motivated GPs)

+ 10 GPs? (decision pending for 3 other practices)

2. Changes in strategy:In some practices we tried to identify 1 key person (e.g. GP in training) for GRACE

3. Other actions:• Patient information: posters for the waiting room

laminated leaflets for the waiting room• GP support: regular practice visits (training, new material, …)

e-mail gender and age band of controls to be recruited

enter data onto GOS for some• GP motivation e-mail once a week with feedback, …

give small present once a monthe-mail GRACE News

GRACE WP9-10 Result 1st season Network LODZ-POLAND



Strong points:high GP motivation, good logistic organisation, support from network,

patients want to participate in the project,

Weak points:complicated SOP, lack of X-ray and lab results, complicated patient

diary,


1. Recruitment capacity:we plan to select two new GPs, to motivate GPs with no or low inclusion rate

2. Changes in strategy:meeting with GPs just before starting date and individual meetings in case of reported problems

3. Other actions:meeting with GPs, leafletes for patients and posters in waiting rooms, newsletter about all three Polish networks, continuous support from NNF and administrative staff

GRACE WP9-10 Result 1st season Network [Milan network]

Number of patients included: 26 (4 controls)

Number of participating GPs: 12 (5/12 GPs have

recruited so far)

Weak points:Lowest recruitment rate

Low n° controls

Late approval for WP10 (will start 2nd season)

Strong points:

?


1. Recruitment capacity:Selection for new GPs underway

2. Changes in strategy:Additional research physicians will be present in GP practices to help recruit controls

3. Other actions:Posters + newspaper coverage have been placed in waiting rooms

Frequency of meetings with GPs has been intensified (dispel worries over WP10)

GRACE WP9-10 Result 1st season Network Sweden

Number of patients included: 29 and 25controls

Number of participating GPs: 6 Health centres (40 GPs)

Strong points:

None

Weak points:

Late, bad start.

Organisation

Computor systems, political “unrest”


1. Recruitment capacity:organizational changes

2. Changes in strategy:research physicians twice a week/two sites

specific GRACE-hour at each Health centre for patients with LRTI

3. Other actions:nurse information/GRACE-hours

posters in waiting room

GRACE WP9-10 Result 1st season Network Ghent

Number of patients included: 52Number of participating GPs: 32Strong points:- Great efforts to find new GPs to participate- New practices in a region without university: no research “fatigue”- New practices with trainees who can help with inclusions

Weak points:- Group practices (appointment system, foreigners, lack of time, no

financial boost, anti-antibiotic behavior) - Doubts about the inclusion criteria- GPs found the protocol very heavy- New GPs: barrier to include patients- Problem to find control patients within the same period


1. Recruitment capacity:- 8 GPs recruited at least 1 patient- At least 2 group practices (8 GPs) will give it a second try if they get more support- Contact with 15 interested new GPs

- Solo practices or GPs with an GP in trainee- Other region (Roeselare: less foreigners, less anti-antibiotic thoughts)

2. Changes in strategy:- More support:

- Spending time in a practice to help including patients and to recruit control patients- Visiting the GPs more frequently (so that they don’t forget the GRACE-study)

- Better encouragement of patients to see their GP for the second visit- Exercising to enroll a patient with new GPs and bad recruiters (to lower the barrier)- Check-in point for control patients- Organizing a course of spirometry- Stimulating GPs to include in WP9 if WP10 is not possible

3. Other actions:- Incentives for the GPs (a gift with Santa, new year,…)

Documents

GRACE WP9-10 Result 1 st season CARDIFF Number of patients included: 75/75 Number of participating GPs:24 (8) Strong points: Weak points: