Socioeconomic inequalities in primary care research: how can we make research more equitable?

Background Health research should reflect contexts where interventions are needed to provide evidence generalisable to practice. There is concern socioeconomically disadvantaged populations with poorer health and care outcomes are underrepresented in research, potentially exacerbating health inequalities. Evidence on the relationship between socioeconomic deprivation and general practice research involvement is limited.

Aim To explore the relationship between socioeconomic deprivation, general practice research involvement and recruitment.

Design & setting Quantitative analysis of routine data and qualitative interviews with clinical and non-clinical general practice staff in the North East and North Cumbria (NENC) area of England.

Method Analysis of general practice and NIHR Clinical Research Network data to understand associations between neighbourhood deprivation and research recruitment. Semi-structured interviews with general practitioners and practice managers explored barriers and facilitators to research involvement and patient recruitment in disadvantaged areas. Interviews were recorded, transcribed, and thematically analysed.

Results Research recruitment was lower among practices (n=358) with more deprived populations (χ²(4)=7,520.8, P<0.001), and significantly lower among ‘Deep End’ practices in areas of blanket socioeconomic disadvantage. 11 GPs and 4 practice managers were interviewed. Barriers included greater difficulty recruiting patients; resource pressures; limited financial benefit, and awareness. Supporting factors were research designed to meet needs of socioeconomically disadvantaged populations; accurately costed, remunerated and resourced; with concise, practically-focused communications.

Conclusion To support equitable general practice research participation, research should be relevant to and designed to meet needs of socioeconomically disadvantaged populations, accurately costed and remunerated. Targeting additional resource at practices in socioeconomically disadvantaged areas could incentivise equitable research participation.