Primary care practice-based research networks (PBRNs) involve practicing clinicians in asking and answering clinical and organizational questions central to primary health care. The Agency for Healthcare Research and Quality (AHRQ) developed its PBRN initiative in recognition of this work and its ability to improve the health of all Americans, and the potential of these networks to engage clinicians in quality improvement activities.
Go to the PBRN Web site.
Introduction | Frequently Asked Questions (FAQs) | More Information
PBRNs have been described as "new clinical laboratories for primary care research and dissemination."1 A PBRN is a group of 15 to several hundred primary care practices devoted principally to the care of patients. These practices are united by a shared commitment to expand the science base of clinical care through systematic inquiry to better understand the health and health care events that unfold daily in their community practice settings. Often affiliated with academic or professional organizations, these practices investigate questions of importance to clinical practice. Typically, PBRNs draw on the experience and insight of practicing clinicians to identify and frame research questions whose answers can improve the practice of primary care. By linking these questions with rigorous research methods, PBRNs produce research findings that are immediately relevant to the primary care clinician and more easily translated into everyday practice.
Increasingly, PBRNs are recognizing their potential to expand their purpose, and are supporting quality improvement activities within primary care practices and the adoption of an evidence-based culture in primary care practice. Many PBRN leaders have begun to envision their networks as places of learning, where clinicians are engaged in reflective practice inquiries, and where clinicians, their patients, and academic researchers collaborate in the search for answers that lead to the improved delivery of primary care.
Examples of types of PBRN research include studies in comparative effectiveness research:
- Treatment of common diseases and symptoms, prevention and early diagnosis.
- Organization and clinical systems.
- Continuity and coordination of care.
- Clinical decision support.
- Impact of decisions made by patients about health care and health practices for themselves, their families and their communities.
PBRNs are uniquely positioned for dissemination and implementation research.
PBRNs provide a natural laboratory for a wide variety of physician and patient studies and are a rich source of medical data. PBRNs may be the best setting for studying the process of care and the manner in which diseases are diagnosed, treatments initiated, and chronic conditions managed in a "real world" setting. PBRNs provide a resource where effectiveness can be measured2 and where the interface between patients and their community primary care physicians can be explored.3
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Frequently Asked Questions (FAQs)
What is a PBRN?
AHRQ defines a primary care practice-based research network, or PBRN, as a group of ambulatory practices devoted principally to the primary care of patients, and affiliated in their mission to investigate questions related to community-based practice and to improve the quality of primary care. This definition includes a sense of ongoing commitment to network activities and an organizational structure that transcends a single research project. PBRNs often link practicing clinicians with investigators experienced in clinical and health services research, while enhancing the research skills of the network members.
Why does AHRQ support PBRNs?
As part of the December, 1999 legislation (Public Law 106-129) reauthorizing and renaming the Agency, AHRQ was directed to use research strategies and mechanisms that link research directly with clinical practice in geographically diverse locations throughout the country, including the use of "provider-based research networks… especially (in) primary care."
To better address issues of disparities in health care quality, outcomes, cost, and access for various segments of the U.S. population, amended section 901(b)(2) authorized the Agency to implement research strategies and mechanisms that specifically include PBRNs.
How has AHRQ supported PBRNs?
Between 2000 and 2005, AHRQ funded four major competitive grant programs for PBRNs. In addition to funding opportunities, AHRQ is supporting PBRNs through a national resource center, an annual national conference, peer learning groups, an electronic PBRN research repository, and a dedicated community extranet.
In 2000, the United States had approximately 24 primary care PBRNs. AHRQ has since provided direct funding for more than 68 PBRNs through targeted grant and contract programs, and has provided technical and networking assistance for many more. In 2011, AHRQ research identified more than 130 primary care PBRNs operating across the United States with more than 67,000 clinicians in over 16,500 locations serving approximately 52.7 million patients. There is at least one member of a primary care PBRN in every State.
What is the history of AHRQ funding for PBRNs?
Select the links below for more information about AHRQ funding for PBRNs. These represent funding reserved exclusively for PBRNs. In addition, PBRNs successfully compete for grant funding from AHRQ and other Federal agencies for solicitations that are not reserved exclusively for PBRNs. For example, three PBRNs received American Recovery and Reinvestment Act (ARRA) funding in 2010 for dissemination of comparative effectiveness research findings within PBRN settings.
What additional support has AHRQ given to PBRNs?
- Annual PBRN Meeting—AHRQ hosts a 3-day conference dedicated to advancing PBRN research through presentations, workshops, and networking. For more information, visit http://pbrn.ahrq.gov.
- PBRN Resource Center—A collaborative venture of the University of Minnesota and Westat, AHRQ's national PBRN Resource Center provides technical support to primary care PBRNs. Assistance is available in PBRN research methodology (research design, analytic strategies, and organizational development), health information technology, and network organization and maintenance. Contact the Resource Center at firstname.lastname@example.org.
- Peer Learning Groups—PBRN researchers, directors, and staff participate in ongoing group discussions dedicated to advancing PBRN operations, quality improvement research, health information technology, and PBRN research methodologies.
- Electronic Repository of PBRN Research—An extensive, AHRQ-maintained database of research produced by primary care PBRNs.
- PBRN Extranet (Web portal)—A secure, AHRQ-provided Web presence where the PBRN community can share documents, collaborate on projects, and communicate ideas within and beyond their individual networks.
What are some highlights of PBRN research?
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For More Information
For more information on AHRQ's Primary Care PBRN initiative, contact:
David Meyers, MD
Center for Primary Care, Prevention, and Clinical Partnerships (CP3)
Agency for Healthcare Research and Quality
Phone: (301) 427-1500
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AHRQ Publication No. 01-P020
Current as of April 2012
1. Westfall JM, Mold JW, Fagnan LJ. Practice-based research-"Blue Highways" on the NIH roadmap. JAMA 297: 403-6. 2007.
2. Bell LM, Grundmeier R, Localio R, Zorc J, Fiks AG, Zhang X, Stephens TB, Swietlik M, Guevara JP. Electronic health record-based decision support to improve asthma care: a cluster-randomized trial. Pediatrics 2010;125: e770-e777.
3. Parchman ML, Zeber JE, Palmer RF. Participatory decision-making, patient activation, medication adherence and intermediate clinical outcomes: a STARNet study. Ann Fam Med 2010;8:410-17.
4. Nagykaldi Z, Calmbach W, DeAlleaume L, Temte J, Mold J, Ryan J. Facilitating patient self-management through telephony and web technologies in seasonal influenza. Inform Prim Care 2010;18:9-16.
5. Hickner J, Zafar A, Kuo GM, Fagnan LJ, Forjouh SN, Knox LM, Lynch JT, et al. Field test results of a new ambulatory care Medication Errors and Adverse Drug Events Reporting System (MEADERS). Ann Fam Med 2010;8:517-25.
AHRQ Practice-Based Research Networks (PBRNs). Fact Sheet, June 2001 (revised July 2011). AHRQ Publication No. 01-P020. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/research/pbrn/pbrnfact.htm