Anna Holst´s reserach

Effectiveness and feasibility of primary care implementations – examples of e-health and patient instrument use

Background
The demographic development in Sweden, and the modern man’s requirements for good health and low morbidity, makes it more important than ever for primary care to use evidence-based and cost-effective methods for treatment, diagnosing, prioritization and communication. New methods are needed, the innovation field is wide. E-health and patient-reported outcomes should be scrutinized, as there are clear indications that healthcare can increase efficiency if implementing work procedures including these.

Research findings are often difficult to transfer to “real life”. “Efficacy”, the effect of a method under pure circumstances, is commonly studied. Studies focused on “effectiveness” instead illustrate generalizability and feasibility, the results become easier to transfer to “real life”.

Primary care is high-producing, and new methods for treatment are constantly launched. The methods are seldom researched using effectiveness design, and seldom in primary care context.

Method
I: Health economic analysis of the material of a RCT comparing treatment with internet mediated CBT (iCBT) with treatment as usual (TaU) at mild to moderate depression.

II: Focus-group- and individual interviews with patient from the RCT mentioned above, focusing on the patient’s experience of iCBT, analyzed using Systematic text condensation according to Malterud.

III: Health economic analysis of the material of a RCT comparing the effect of structured use of self-assessment psychological instruments with TaU at depression in primary care.

IV: Quantitative study of if MMS-referral of a skin condition, sent as a referral from a general practitioner to a dermatologist, could provide a basis for correct diagnosis and prioritization.

Relevance
Analyzing new methods from the perspectives cost-effectiveness, patient’s perspective and “effectiveness”, is crucial in order to be able to choose which methods should be prioritized for implementation in primary care.

Anna Holsts´ e-mail: anna.holst@gu.se