Primary care-based evaluation of patient education for osteoarthritis of the knee

Primary healthcare research in the UK has expanded in conjunction with the wider agenda of a primary care led National Health Service (NHS). This refl ects international reconsideration of the place of primary healthcare withi n national healthcare systems. However the role and standing of research in primary care tends to be marginal and less influential than that originati ng in research establishments or medical schools pursuing biomedical invest igations. There are many reasons for this, some of which this paper attempt s to elucidate. We address the perspectives and relationships between 'stak eholder' groups in the field of primary care and highlight the ways in whic h such relationships affect research in this area. The development of a pri mary care research project concerned with osteoarthritis of the knee (the O AK project) is used as an exemplar of these stresses and we suggest ways in which the difficulties encountered may be overcome.