Why and how to use mixed methods in primary health care research

Vedel, Isabelle; Kaur, Navdeep; Hong, Quan Nha; Sherif, Reem El; Khanassov, Vladimir; Godard‐Sebillotte, Claire; Sourial, Nadia; Yang, Xiaojiao; Pluye, Pierre

doi:10.1093/fampra/cmy127

Cited by 27 publications

(29 citation statements)

References 19 publications

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“…Researchers face the dilemma to study the effect of a single intervention, such as a tool or treatment plan, and to focus on one disease or condition, or a complex of interventions to optimize the effect and its generalizability, which is more difficult to analyze due to its different components. This confirms the need to use mixed methods in general practice research ( 25 ).…”

Section: Discussionsupporting

confidence: 69%

Challenges of Research on Person-Centered Care in General Practice: A Scoping Review

Burgers

Bischoff

2021

Front. Med.

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Background: Delivering person-centered care is one of the core values in general practice. Due to the complexity and multifaceted character of person-centered care, the effects of person-centered care cannot be easily underpinned with robust scientific evidence. In this scoping review we provide an overview of research on effects of person-centered care, exploring the concepts and definitions used, the type of interventions studied, the selected outcome measures, and its strengths and limitations.Methods: Systematic reviews on person-centered care compared to usual care were included from Pubmed, Embase, and PsycINFO. The search was conducted in February 2021. Data selection and charting was done by two reviewers.Results: The literature search yielded 481 articles. A total of 21 full-text articles were assessed for eligibility for inclusion. Four systematic reviews, published between 2012 and 2018, were finally included in this review. All reviews used different definitions and models and classified the interventions differently. The explicit distinction between interventions for providers and patients was made in two systematic reviews. The classification of outcomes also showed large differences, except patient satisfaction that was shared. All reviews described the results narratively. One review also pooled the results on some outcome measures. Most studies included in the reviews showed positive effects, in particular on process outcomes. Mixed results were found on patient satisfaction and clinical or health outcomes. All review authors acknowledged limitations due to lack of uniform definitions, and heterogeneity of interventions and outcomes measures.Discussion: Person-centered care is a concept that seems obvious and understandable in real life but is complex to operationalize in research. This scoping review reinforces the need to use mixed qualitative and quantitative methods in general practice research. For spreading and scaling up person-centered care, an implementation or complexity science approach could be used. Research could be personalized by defining therapeutic goals, interventions, and outcome variables based on individual preferences, goals, and values and not only on clinical and biological characteristics. Observational data and patient satisfaction surveys could be used to support quality improvement. Integrating research, education, and practice could strengthen the profession, building on the fundament of shared core values.

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Section: Discussionsupporting

confidence: 69%

Challenges of Research on Person-Centered Care in General Practice: A Scoping Review

Burgers

Bischoff

2021

Front. Med.

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“…Indeed, MM help to understand the complexity of primary care (10) that deals with a variety of settings (from clinical to community) and patients with diverse health care needs (11). Furthermore, the integration of both qualitative and quantitative methods provides new insights to improve and address the complex and multi-faceted issues of primary care (12,13). Regarding research designs, MM have matured.…”

Section: Introductionmentioning

confidence: 99%

Practical mixed methods strategies used to integrate qualitative and quantitative methods in community-based primary health care research

et al. 2019

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Background Mixed methods (MM) are common in community-based primary health care (CBPHC) research studies. Several strategies have been proposed to integrate qualitative and quantitative components in MM, but they are seldom well conceptualized and described. The purpose of the present review was to identify and describe practical MM strategies and combinations of strategies used to integrate qualitative and quantitative methods in CBPHC research. Methods A methodological review with qualitative synthesis (grouping) was performed. Records published in English in 2015 were retrieved from the Scopus bibliographic database. Eligibility criteria were: CBPHC empirical study, MM research with detailed description of qualitative and quantitative methods and their integration. Data were extracted from included studies and grouped using a conceptual framework comprised of three theoretical types of MM integration, the seven combinations of these types and nine practical strategies (three per type of integration) and multiple combinations of strategies. Results Among the 151 articles reporting CBPHC and MM studies retrieved, 54 (35.7%) met the inclusion criteria for this review. The included studies provided examples of the three theoretical types of MM integration, the seven combinations of these types as well as the nine practical strategies. Overall, 15 combinations of these strategies were observed. No emerging strategy was observed that was not predicted by the conceptual framework. Conclusions This review can provide guidance to CBPHC researchers for planning, conducting and reporting practical strategies and combinations of strategies used for integrating qualitative and quantitative methods in MM research.

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“…A mixed methods approach with a convergent design [ 13 ] was used to investigate GPs’ medicines information needs. This approach allowed the selection of methods best suited to answering the research questions.…”

Section: Methodsmentioning

confidence: 99%

“…Integration occurred by comparison of the results obtained from separate qualitative and quantitative data collection and analysis. This approach enabled triangulation of the findings and took place during interpretation and development of the discussion [ 13 ].…”

Section: Methodsmentioning

confidence: 99%

A mixed methods study on medicines information needs and challenges in New Zealand general practice

2021

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Background Medicines are central to healthcare in aging populations with chronic multi-morbidity. Their safe and effective use relies on a large and constantly increasing knowledge base. Despite the current era of unprecedented access to information, there is evidence that unmet information needs remain an issue in clinical practice. Unmet medicines information needs may contribute to sub-optimal use of medicines and patient harm. Little is known about medicines information needs in the primary care setting. The aim of this study was to investigate the nature of medicines information needs in routine general practice and understand the challenges and influences on the information-seeking behaviour of general practitioners. Methods A mixed methods study involving 18 New Zealand general practitioner participants was undertaken. Quantitative data were collected to characterize the medicines information needs arising during 642 consultations conducted by the participants. Qualitative data regarding participant views on their medicines information needs, resources used, challenges to meeting the needs and potential solutions were collected by semi-structured interview. Integration occurred by comparison of results from each method. Results Of 642 consultations, 11% (n = 73/642) featured at least one medicines information need. The needs spanned 14 different categories with dosing the most frequent (26%) followed by side effects (15%) and drug interactions (14%). Two main themes describing the nature of general practitioners’ medicines information needs were identified from the qualitative data: a ‘common core’ related to medicine dose, side effects and interactions and a ‘perplexing periphery’. Challenges in the perplexing periphery were the variation in information needs, complexity, ‘known unknowns’ and ‘unknown unknowns’. Key factors affecting general practitioners’ strategies for meeting medicines information needs were trust in a resource, presence of the patient, how the information was presented, scarcity of time, awareness of the existence of a resource, and its accessibility. Conclusions General practitioners face challenges in meeting wide-ranging medicines information needs in patients with increasingly complex care needs. Recognising the challenges and factors that influence resource use in practice can inform optimisation of medicines information support resources. Resources for general practitioners must take into account the complexity and time constraints of real-world practice. An individually responsive approach involving greater collaboration with pharmacists and specialist medicines information support services may provide a potential solution.

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Why and how to use mixed methods in primary health care research

Cited by 27 publications

References 19 publications

Challenges of Research on Person-Centered Care in General Practice: A Scoping Review

Challenges of Research on Person-Centered Care in General Practice: A Scoping Review

Practical mixed methods strategies used to integrate qualitative and quantitative methods in community-based primary health care research

A mixed methods study on medicines information needs and challenges in New Zealand general practice

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