|Full day of presentations at Family Medicine Resident’s Forum
Family medicine residents had a chance to show off their research skills on March 8 during a forum at the Fluvarium. The day’s events included 12 presentations two from faculty members and a keynote speech by Dr. Marshall Godwin.
At the Discipline of Family Medicine Resident’s Forum the Chairman’s Award was presented by Dr. Bob Miller to Dr. Joystna Ziradhar for her presentation on A Review of Cervical Screening in a Rural Practice Population.
Dr. Godwin, formerly a member of Memorial’s Discipline of Medicine, is now research director at the Department of Family Medicine at Queen’s University, Kingston. His group published a paper in the British Medical Journal in January of this year on a Randomised equivalence trial comparing three month and six month follow up of patients with hypertension by family practitioners.
Dr. Godwin outlined the 11-year process it took from having the idea for the study to getting it published. “We first thought about comparing patients with controlled hypertension who were followed up at three months, six months and 12 months to see if the follow-up period made a difference. In September 1995 we submitted a proposal to what was then the Medical Research Council (MRC) they tore our proposal apart!”
Not to be deterred, the group of family doctors went back to the drawing board. First they did a survey of local family physicians who agreed to sign up for the study if it were funded. They modified the breadth of the study to compare only three and six-month follow-up, added an economist and a biostatician to the research team, and submitted their revised proposal to the MRC.
Dr. Bill Eaton presented the Research Director’s Award to Drs. John and Susan Campbell for their study on a comparison of Intravenous Meperidine, with Ketorolac and Fentanyl with Ketorolac for Management of Acute Renal Colic in the Emergency Department.
Once again the proposal was turned down, but this time the MRC offered some practical advice about methodology and planned analysis. Another reworking of the proposal and it was finally funded in June 1997 for $260,000 about $100,000 less than needed for the full four years. The next step was to obtain ethics approval and then hire a project managed and research assistant. Fifty physicians participated over four years and only one dropped out. With a little creativity, further funding was found and eventually the first patient was seen in 1998. Six hundred patients later, the last follow-up was in 2002 and a year later the BMJ article was published.
The study’s conclusion was that follow-up of patients with treated essential hypertension every six months is equivalent to follow up every three months. Dr. Godwin said patient satisfaction and adherence to treatment are the same for these follow up intervals, but that as about 20 per cent of patients' hypertension was out of control at any time during the study in both groups, the frequency of follow up may not the most important factor in the control of patients' hypertension by family practitioners.