IPCRG Visit to China: November 2019

On behalf of the IPCRG, Professor Hilary Pinnock, Professor of Primary Care Respiratory Medicine, The University of Edinburgh and Dr Catalina Panaitescu, Family Practice Physician in Bucharest, Romania, were invited to present within a sub-forum at the 4th Annual Academic Conference of Chinese Alliance for Respiratory Diseases in Primary Care (CARDPC), the IPCRG group in China. This took place in X’ian City, Shanxi Province, on 1-3 November 2019 and was hosted by Collaborative Medicine Foundation and CARDPC.

CARDPC was established in 2015 and covers 30 provinces in China including 7600 hospitals and 300,00 Community Health Centers in Primary Care.

The conference is one of the largest meetings on the clinical and scientific aspects of respiratory disease in primary care in China with nearly 2000 attendees. It brings together hospital physicians, family physicians, nurses, researchers and other personnel interested in respiratory medicine to discuss new developments. Visit www.cardpc.org for more information.

With the theme of “Standardising Diagnosis and Treatment of Respiratory Diseases at Grassroots Level”  the conference focused on the “New White Paper on Prevention and Management of Chronic Respiratory Disease In China” based on China’s current medical insurance system, essential drugs, standardised medical treatment system for respiratory diseases in primary health care institutions, and national policies for graded diagnosis and treatment. 

Catalina Panaitescu: Integrated Prevention, Control and Assessment of Chronic Airway Diseases in Primary Care

Dr Panaitescu, from the IPCRG Romanian group, RespiRO, introduced the experience of Romania in establishing a network of high-quality family medicine offices and the problem-solving framework for Romanian primary care asthma management. The management of patients with asthma should follow the structure of “SIMPLES” (Smoking | Inhaler Technique | Monitoring | Pharmacotherapy | Lifestyle | Education | Support (click here for more information) continuously strengthening patient education. Dr Panaitescu also introduced the work of RespiRO and welcomed everyone to participate in the international conference held in Dublin next year.

Hilary Pinnock: How Scientific Research Changes Clinical Practice

Professor Pinnock explained the concept of implementation research in clinical practice by asking two questions using the example of her programme of work implementing supported self-management for asthma:
1.    We need to assess ‘Is the intervention effective?’ The PRISMS meta-review which included data from 270 randomized controlled trials showed that self-management of asthma supported by clinicians can significantly improve asthma control and reduce acute attacks. 
2.    Implementation is challenging with only a third of people with asthma in the UK and several other countries having an action plan (the figure in China is not known). We therefore need to consider the second question ‘How do we implement the intervention in my setting?’  The PRISMS review concluded that effective implementation had to actively involve patients, train and motivate healthcare professionals, and encourage organisations to prioritise supported self-management. 
  
The IMP2ART programme of research aims to implement supported asthma self-management as a routine clinical strategy.

Planning Research to Improve Practice

Catalina Panaitescu and Hilary Pinnock also led a successful workshop for 40 physicians on Planning Research to Improve Practice.  Using the “Smoking Cessation” topic they exemplified the main steps of an implementation research project (importance of the research question, goal and objectives settings, barriers and facilitators, methods etc.).   Participants worked in five groups to develop research questions related to providing support for smoking cessation and to think about the design of study required to answer the question.