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Mercadal-Orfila G, Herrera-Pérez S, Piqué N, Mateu-Amengual F, Ventayol-Bosch P, Maestre-Fullana MA, Serrano-López de Las Hazas JI, Fernández-Cortés F, Barceló-Sansó F, Rios S. Implementing Systematic Patient-Reported Measures for Chronic Conditions Through the Naveta Value-Based Telemedicine Initiative: Observational Retrospective Multicenter Study. JMIR Mhealth Uhealth 2024; 12:e56196. [PMID: 38545697 PMCID: PMC11245666 DOI: 10.2196/56196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Revised: 03/12/2024] [Accepted: 03/27/2024] [Indexed: 06/30/2024] Open
Abstract
BACKGROUND Patient-reported outcome and experience measures can play a critical role in providing patient-centered and value-based health care to a growing population of patients who are chronically ill. Value-based telemedicine platforms such as the Naveta initiative may facilitate the effective integration of these tools into health care systems. OBJECTIVE This study aims to evaluate the response rate to electronic patient-reported outcome measures (ePROMs) and electronic patient-reported experience measures (ePREMs) among patients participating in the Naveta telemedicine initiative and its correlations with sociodemographic and clinical characteristics, as well as the evolution of the response rates over time. METHODS Between January 1, 2021, and June 30, 2023, a total of 53,364 ePREMs and ePROMs for 20 chronic conditions were administered through the Naveta-Phemium platform. Descriptive statistics were used to summarize continuous and categorical variables. Differences in response rates within each sociodemographic variable were analyzed using logistic regression models, with significance assessed via chi-square and post hoc Tukey tests. Two-way ANOVA was used to examine the interaction between time interval and disease type on response rate evolution. RESULTS A total of 3372 patients with severe chronic diseases from 64 public hospitals in Spain participated in the Naveta health questionnaire project. The overall response rate to ePROMs and ePREMs during the first 2.5 years of the Naveta initiative was 46.12% (24,704/53,364), with a baseline rate of 53.33% (7198/13,496). Several sociodemographic factors correlated with lower response rates, including male gender, older age, lower education level, frequent alcohol use, being a student, and not being physically active. There were also significant variations in response rates among different types of chronic conditions (P<.001), with the highest rates being for respiratory (433/606, 71.5%), oncologic (200/319, 62.7%), digestive (2247/3601, 62.4%), and rheumatic diseases (7506/12,982, 57.82%) and the lowest being for HIV infection (7473/22,695, 32.93%). During the first 6 months of follow-up, the response rates decreased in all disease types, except in the case of the group of patients with oncologic disease, among whom the response rate increased up to 100% (6/6). Subsequently, the overall response rate approached baseline levels. CONCLUSIONS Recognizing the influence of sociodemographic factors on response rates is critical to identifying barriers to participation in telemonitoring programs and ensuring inclusiveness in patient-centered health care practices. The observed decline in response rates at follow-up may be due to survey fatigue, highlighting the need for strategies to mitigate this effect. In addition, the variation in response rates across chronic conditions emphasizes the importance of tailoring telemonitoring approaches to specific patient populations.
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Affiliation(s)
- Gabriel Mercadal-Orfila
- Pharmacy Department, Hospital Mateu Orfila, Mahó, Spain
- Department of Biochemistry and Molecular Biology, Universitat de les Illes Balears, Mallorca, Spain
| | - Salvador Herrera-Pérez
- Facultad de Ciencias de la Salud, Universidad Internacional de Valencia, Valencia, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
| | - Núria Piqué
- Microbiology Section, Department of Biology, Healthcare and Environment, Faculty of Pharmacy and Food Sciences, Universitat de Barcelona, Barcelona, Spain
- Research Institute of Nutrition and Food Safety (INSA-UB), Universitat de Barcelona, Barcelona, Spain
| | | | - Pedro Ventayol-Bosch
- Pharmacy Department, Hospital Universitari Son Espases, Palma de Mallorca, Spain
| | | | | | | | | | - Santiago Rios
- Departament de Genètica, Microbiologia i Estadística, Facultat de Biologia, Universitat de Barcelona, Barcelona, Spain
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Halas G, Baldwin A, Mackay K, Cardenas E, LaBine L, Cherrett P, Abraham L, Fogarty V, Singer A, Katz A, Kirby S. Patients' and caregivers' experiences of virtual care in a primary care setting during the COVID-19 pandemic: A patient-oriented research study. Digit Health 2024; 10:20552076241232949. [PMID: 38410792 PMCID: PMC10896066 DOI: 10.1177/20552076241232949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Accepted: 01/23/2024] [Indexed: 02/28/2024] Open
Abstract
Objective This study explored patient and caregiver expectations and experiences of virtual primary care in Manitoba, Canada. This study focused on accessibility of care, acceptability and perceptions of quality from 'users' of primary healthcare services. Due to the rapid implementation of virtual primary care during the COVID-19 pandemic in Canada, patient/public input was largely bypassed. Methods A mixed method was conducted in collaboration with Patient and Caregiver Community Advisors. Data was obtained from 696 surveys and 9 focus groups (n = 41 patients and caregivers). Results Data suggest good acceptance of virtual visits, although considered a new experience despite almost exclusive use of the telephone. Participants preferred more input for choosing the type of visit but experienced less stress, time and inconvenience by using virtual care. There were mixed opinions of quality. More complex visits were associated with incomplete consultations and serve as one exemplar of the limitations due to lack of physical presence or contact. Unique communication skills were required to convey health concerns adequately and accurately. A more transactional approach was perceived from the lack of visual cues and the awkwardness associated with pauses during the phone conversation. Virtual care may be better used for certain circumstances but should encompass patient-centred decision making for when and how. Many expressed interests in video options; technology access and user ability are additional considerations for advancing virtual care. Conclusions The experiences and recommendations from patients and caregivers provide an important contribution to decision-making and integrating and sustaining quality virtual care for patient-centered healthcare service delivery. Keywords: Virtual care experiences, primary care, patient-oriented research, mixed methods, COVID-19.
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Affiliation(s)
- Gayle Halas
- Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada
| | - Alanna Baldwin
- Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada
| | | | - Ernesto Cardenas
- Rady Faculty of Health Sciences, Dept of Family Medicine, University of Manitoba, Winnipeg, Canada
| | - Lisa LaBine
- Rady Faculty of Health Sciences, Dept of Family Medicine, University of Manitoba, Winnipeg, Canada
| | | | | | | | - Alexander Singer
- Rady Faculty of Health Sciences, Dept of Family Medicine, University of Manitoba, Winnipeg, Canada
| | - Alan Katz
- Rady Faculty of Health Sciences, Dept of Family Medicine, University of Manitoba, Winnipeg, Canada
- Rady Faculty of Health Sciences, Dept of Community Health Sciences, University of Manitoba, Winnipeg, Canada
| | - Sarah Kirby
- George and Fay Yee Centre for Healthcare Innovation, Winnipeg, Canada
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Marshall DA, Suryaprakash N, Lavallee DC, Barker KL, Mackean G, Zelinsky S, McCarron TL, Santana MJ, Moayyedi P, Bryan S. Exploring the outcomes of research engagement using the observation method in an online setting. BMJ Open 2023; 13:e073953. [PMID: 37989365 PMCID: PMC10668270 DOI: 10.1136/bmjopen-2023-073953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Accepted: 10/30/2023] [Indexed: 11/23/2023] Open
Abstract
OBJECTIVE The objective of this study was to explore the outcomes of research engagement (patient engagement, PE) in the context of qualitative research. DESIGN We observed engagement in two groups comprised of patients, clinicians and researchers tasked with conducting a qualitative preference exploration project in inflammatory bowel disease. One group was led by a patient research partner (PLG, partner led group) and the other by an academic researcher (RLG, researcher led group). A semistructured guide and a set of critical outcomes of research engagement were used as a framework to ground our analysis. SETTING The study was conducted online. PARTICIPANTS Patient research partners (n=5), researchers (n=5) and clinicians (n=4) participated in this study. MAIN OUTCOME MEASURES Transcripts of meetings, descriptive and reflective observation data of engagement during meetings and email correspondence between group members were analysed to identify the outcomes of PE. RESULTS Both projects were patient-centred, collaborative, meaningful, rigorous, adaptable, ethical, legitimate, understandable, feasible, timely and sustainable. Patient research partners (PRPs) in both groups wore dual hats as patients and researchers and influenced project decisions wearing both hats. They took on advisory and operational roles. Collaboration seemed easier in the PLG than in the RLG. The RLG PRPs spent more time than their counterparts in the PLG sharing their experience with biologics and helping their group identify a meaningful project question. A formal literature review informed the design, project materials and analysis in the RLG, while the formal review informed the project materials and analysis in the PLG. A PRP in the RLG and the PLG lead leveraged personal connections to facilitate recruitment. The outcomes of both projects were meaningful to all members of the groups. CONCLUSIONS Our findings show that engagement of PRPs in research has a positive influence on the project design and delivery in the context of qualitative research in both the patient-led and researcher-led group.
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Affiliation(s)
- Deborah A Marshall
- Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
- IMAGINE SPOR Chronic Disease Network, Hamilton, Ontario, Canada
| | - Nitya Suryaprakash
- The University of British Columbia School of Population and Public Health, Vancouver, British Columbia, Canada
| | - Danielle C Lavallee
- The University of British Columbia School of Population and Public Health, Vancouver, British Columbia, Canada
- Michael Smith Health Research, Vancouver, British Columbia, Canada
- British Columbia SPOR SUPPORT Unit, Vancouver, British Columbia, Canada
| | - Karis L Barker
- Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
| | - Gail Mackean
- Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
| | - Sandra Zelinsky
- Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
- IMAGINE SPOR Chronic Disease Network, Hamilton, Ontario, Canada
- Alberta SPOR SUPPORT Unit, Calgary, Alberta, Canada
| | - Tamara L McCarron
- Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
| | - Maria J Santana
- Alberta SPOR SUPPORT Unit, Calgary, Alberta, Canada
- Department of Paediatrics, University of Calgary and Alberta Health Services, Calgary, Alberta, Canada
| | - Paul Moayyedi
- IMAGINE SPOR Chronic Disease Network, Hamilton, Ontario, Canada
- McMaster University Faculty of Health Sciences, Hamilton, Ontario, Canada
| | - Stirling Bryan
- The University of British Columbia School of Population and Public Health, Vancouver, British Columbia, Canada
- Michael Smith Health Research, Vancouver, British Columbia, Canada
- British Columbia SPOR SUPPORT Unit, Vancouver, British Columbia, Canada
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van der Voorden M, Sipma WS, de Jong MFC, Franx A, Ahaus KCTB. The immaturity of patient engagement in value-based healthcare-A systematic review. Front Public Health 2023; 11:1144027. [PMID: 37250089 PMCID: PMC10213745 DOI: 10.3389/fpubh.2023.1144027] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Accepted: 04/10/2023] [Indexed: 05/31/2023] Open
Abstract
Introduction In recent years, Value-Based Healthcare (VBHC) has been gaining traction, particularly in hospitals. A core VBHC element is patient value, i.e., what matters most to the patient and at what cost can this be delivered. This interpretation of value implies patient engagement in patient-doctor communication. Although patient engagement in direct care in the VBHC setting is well described, patient engagement at the organizational level of improving care has hardly been studied. This systematic review maps current knowledge regarding the intensity and impact of patient engagement in VBHC initiatives. We focus on the organizational level of a continuous patient engagement model. Methods We performed a systematic review following PRISMA guidelines using five electronic databases. The search strategy yielded 1,546 records, of which 21 studies were eligible for inclusion. Search terms were VBHC and patient engagement, or similar keywords, and we included only empirical studies in hospitals or transmural settings at the organizational level. Results We found that consultation, using either questionnaires or interviews by researchers, is the most common method to involve patients in VBHC. Higher levels of patient engagement, such as advisory roles, co-design, or collaborative teams are rare. We found no examples of the highest level of patient engagement such as patients co-leading care improvement committees. Conclusion This study included 21 articles, the majority of which were observational, resulting in a limited quality of evidence. Our review shows that patient engagement at the organizational level in VBHC initiatives still relies on low engagement tools such as questionnaires and interviews. Higher-level engagement tools such as advisory roles and collaborative teams are rarely used. Higher-level engagement offers opportunities to improve healthcare and care pathways through co-design with the people being served. We urge VBHC initiatives to embrace all levels of patient engagement to ensure that patient values find their way to the heart of these initiatives.
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Affiliation(s)
- Michael van der Voorden
- Department of Obstetrics and Gynaecology, Erasmus University Medical Centre, Rotterdam, Netherlands
| | - Wim S. Sipma
- Department of Health Services Management & Organisation, Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, Netherlands
| | | | - Arie Franx
- Department of Obstetrics and Gynaecology, Erasmus University Medical Centre, Rotterdam, Netherlands
| | - Kees C. T. B. Ahaus
- Department of Health Services Management & Organisation, Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, Netherlands
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Recommendations on the use of item libraries for patient-reported outcome measurement in oncology trials: findings from an international, multidisciplinary working group. Lancet Oncol 2023; 24:e86-e95. [PMID: 36725153 DOI: 10.1016/s1470-2045(22)00654-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Revised: 10/14/2022] [Accepted: 10/18/2022] [Indexed: 02/01/2023]
Abstract
The use of item libraries for patient-reported outcome (PRO) measurement in oncology allows for the customisation of PRO assessment to measure key health-related quality of life concepts of relevance to the target population and intervention. However, no high-level recommendations exist to guide users on the design and implementation of these customised PRO measures (item lists) across different PRO measurement systems. To address this issue, a working group was set up, including international stakeholders (academic, independent, industry, health technology assessment, regulatory, and patient advocacy), with the goal of creating recommendations for the use of item libraries in oncology trials. A scoping review was carried out to identify relevant publications and highlight any gaps. Stakeholders commented on the available guidance for each research question, proposed recommendations on how to address gaps in the literature, and came to an agreement using discussion-based methods. Nine primary research questions were identified that formed the scope and structure of the recommendations on how to select items and implement item lists created from item libraries. These recommendations address methods to drive item selection, plan the structure and analysis of item lists, and facilitate their use in conjunction with other measures. The findings resulted in high-level, instrument-agnostic recommendations on the use of item-library-derived item lists in oncology trials.
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French C, Dowrick A, Fudge N, Pinnock H, Taylor SJC. What do we want to get out of this? a critical interpretive synthesis of the value of process evaluations, with a practical planning framework. BMC Med Res Methodol 2022; 22:302. [PMID: 36434520 PMCID: PMC9700891 DOI: 10.1186/s12874-022-01767-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Accepted: 10/21/2022] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Process evaluations aim to understand how complex interventions bring about outcomes by examining intervention mechanisms, implementation, and context. While much attention has been paid to the methodology of process evaluations in health research, the value of process evaluations has received less critical attention. We aimed to unpack how value is conceptualised in process evaluations by identifying and critically analysing 1) how process evaluations may create value and 2) what kind of value they may create. METHODS We systematically searched for and identified published literature on process evaluation, including guidance, opinion pieces, primary research, reviews, and discussion of methodological and practical issues. We conducted a critical interpretive synthesis and developed a practical planning framework. RESULTS We identified and included 147 literature items. From these we determined three ways in which process evaluations may create value or negative consequences: 1) through the socio-technical processes of 'doing' the process evaluation, 2) through the features/qualities of process evaluation knowledge, and 3) through using process evaluation knowledge. We identified 15 value themes. We also found that value varies according to the characteristics of individual process evaluations, and is subjective and context dependent. CONCLUSION The concept of value in process evaluations is complex and multi-faceted. Stakeholders in different contexts may have very different expectations of process evaluations and the value that can and should be obtained from them. We propose a planning framework to support an open and transparent process to plan and create value from process evaluations and negotiate trade-offs. This will support the development of joint solutions and, ultimately, generate more value from process evaluations to all.
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Affiliation(s)
- Caroline French
- grid.4868.20000 0001 2171 1133Wolfson Institute of Population Health, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, Yvonne Carter Building, 58 Turner Street, London, E1 2AB UK
| | - Anna Dowrick
- grid.4991.50000 0004 1936 8948Nuffield Department of Primary Care Health Sciences, University of Oxford, Radcliffe Primary Care Building, Radcliffe Observatory Quarter, Woodstock Road, Oxford, OX2 6GC UK
| | - Nina Fudge
- grid.4868.20000 0001 2171 1133Wolfson Institute of Population Health, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, Yvonne Carter Building, 58 Turner Street, London, E1 2AB UK
| | - Hilary Pinnock
- grid.4305.20000 0004 1936 7988Usher Institute, The University of Edinburgh, Doorway 3, Medical School, Teviot Place, Edinburgh, EH8 9AG UK
| | - Stephanie J. C. Taylor
- grid.4868.20000 0001 2171 1133Wolfson Institute of Population Health, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, Yvonne Carter Building, 58 Turner Street, London, E1 2AB UK
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Rutherford C, Boehnke JR. Introduction to the special section "Reducing research waste in (health-related) quality of life research". Qual Life Res 2022; 31:2881-2887. [PMID: 35907111 DOI: 10.1007/s11136-022-03194-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Affiliation(s)
- Claudia Rutherford
- Faculty of Medicine and Health, The University of Sydney Susan Wakil School of Nursing and Midwifery, Cancer Care Research Unit (CCRU), The University of Sydney, Sydney, Australia. .,Faculty of Science, School of Psychology, Sydney Quality of Life Office, The University of Sydney, Sydney, Australia. .,The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, Sydney, Australia.
| | - Jan R Boehnke
- School of Health Sciences, University of Dundee, Dundee, UK
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Values, principles, strategies, and frameworks underlying patient and public involvement in health technology assessment and guideline development: a scoping review. Int J Technol Assess Health Care 2022; 38:e46. [PMID: 35655444 DOI: 10.1017/s0266462322000289] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
The importance of patient and public involvement (PPI) is recognized by agencies involved in health technology assessment (HTA) and guideline development. However, a comprehensive overview of the underlying PPI principles, values, strategies, and frameworks is lacking. This scoping review aimed to summarize the available evidence on principles, values, frameworks, and strategies underpinning PPI carried out by agencies involved in HTA and guideline development. A total of twelve records were included, of which four referred to guidelines and eight to HTA. Overall, this review demonstrated a lack of consistency in the definition and application of the concepts of values and principles to PPI in the context of guideline development and HTA. There was significant overlap between values and principles, with some broad themes emerging, such as representation, transparency, relevance, equity, fairness, and reconciling different types of knowledge. Frameworks were typically based on the stages of guideline development or HTA, despite heterogeneity in how stages were labeled and described. Strategies were also mapped to the stages of guideline development and HTA and varied substantially depending on the context and setting. Both strategies and frameworks demonstrated patients and the public can be involved, albeit to a variable extent, throughout the stages of guideline development and HTA. However, frameworks often failed to explicitly link the values and principles with the HTA and guideline development stages through actionable PPI strategies. Further research is warranted to better understand the values, principles, and frameworks underpinning PPI in guideline development and HTA.
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Browne J, Dorris ER. What Can We Learn From a Human-Rights Based Approach to Disability for Public and Patient Involvement in Research? FRONTIERS IN REHABILITATION SCIENCES 2022; 3:878231. [PMID: 36189077 PMCID: PMC9397757 DOI: 10.3389/fresc.2022.878231] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Accepted: 03/03/2022] [Indexed: 12/01/2022]
Abstract
Public and Patient Involvement can align both the research process and its outcomes with the values, needs and expectations of society. By fostering the design of inclusive, engaged, and sustainable practices, research and research integrity can be improved. Devolving power to involve patients and relevant publics in deliberative decision making can produce better research outcomes. Disabled people are often categorized as “Hard to Reach.” There is a varied and complex ecosystem of societal challenges of living with a disability that reinforce this. However, if researchers are to meet their obligations under the UN Convention on the Rights of Persons with Disabilities, disabled people should be included in public and patient involvement for all research in which they have a stake. In this article we argue that a better understanding of rights-based approaches and the social model of disability within the wider research community can help to remove barriers to research involvement for disabled persons. We focus on articles 3, 4, and 9 of the Convention and discuss how the principles of participation, accessibility, and equality of opportunity can be applied to research involvement, and how their adoption can facilitate truly meaningful PPI in disability research.
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Affiliation(s)
| | - Emma R. Dorris
- PPI Ignite Network at UCD, University College Dublin Research Office, University College Dublin, Dublin, Ireland
- *Correspondence: Emma R. Dorris
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Parry M, Ceroni T, Wells D, Richards DP, Toupin-April K, Ansari H, Bjørnnes AK, Burnside H, Cavallo S, Day A, Ellis A, Feldman D, Gilron I, Najam A, Zulfiqar Z, Marlin S. Patient engagement partnerships in clinical trials (PEP-CT): protocol for the systematic development and testing of patient partner and investigator decision aids. BMJ Open 2022; 12:e060267. [PMID: 35190448 PMCID: PMC8862478 DOI: 10.1136/bmjopen-2021-060267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
INTRODUCTION Building capacity to improve sex/gender knowledge and strengthen patient engagement in clinical trials requires training and support. The overall goal of this 2-year project is to refine, translate and evaluate two web-based open-access patient and investigator decision aids aimed to improve patient engagement partnerships in clinical trials. METHODS AND ANALYSIS Two decision aids were designed in Phase 1 of this programme of research and this protocol describes a subsequent sequential phased approach to refine/translate (Phase 2A) and conduct alpha/usability (Phase 2B) and beta/field (Phase 3) testing. Decision aid development is guided by the International Patient Decision Aid Standards, User-Centred Design, Ottawa Decision-Support Framework and the Ottawa Model of Research Use. We have integrated patient-oriented research methods by engaging patient partners across all phases of our programme of research. Decision aids will first be refined and then translated to French (Phase 2A). Eight iterative cycles of semistructured interviews with 40 participants (20 patient partners and 20 investigators) will be conducted to determine usability (Phase 2B). A pragmatic pre/post pilot study design will then be implemented for field/beta testing using another purposive sample of 80 English-speaking and French-speaking participants (40 patients and 40 investigators). The samples are purposive to ensure an equal representation of English-speaking and French-speaking participants and an equal representation of men and women. Since sex and/or gender differences in utilisation and effectiveness of decision aids have not been previously reported, Phase 3 outcomes will be reported for the total sample and separately for men and women. ETHICS AND DISSEMINATION Ethics approval has been granted from the University of Toronto (41109, 28 September 2021). Informed consent will be obtained from participants. Dissemination will include co-authored publications, conference presentations, educational national public forums, fact sheets/newsletters, social media sharing and videos/webinars.
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Affiliation(s)
- Monica Parry
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada
| | - Tina Ceroni
- Clinical Trials Ontario, Toronto, Ontario, Canada
| | - David Wells
- Diabetes Action Canada, Toronto, Ontario, Canada
| | | | - Karine Toupin-April
- School of Rehabilitation Sciences, University of Ottawa, Ottawa, Ontario, Canada
- Research Institute, Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada
- Institut du Savoir Montfort, Ottawa, Ontario, Canada
| | - Hafsa Ansari
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada
| | - Ann Kristin Bjørnnes
- Department of Nursing and Health Promotion, Oslo Metropolitan University, Oslo, Norway
| | - Heather Burnside
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada
| | - Sabrina Cavallo
- School of Rehabilitation, Faculty of Medicine, Université de Montréal, Montreal, Quebec, Canada
| | - Andrew Day
- Department of Community Health and Epidemiology and CERU, Queen's Unversity, Kingston, Ontario, Canada
| | - Anne Ellis
- Department of Medicine, Queen's University, Kingston, Ontario, Canada
| | - Debbie Feldman
- School of Rehabilitation, Faculty of Medicine, Université de Montréal, Montreal, Quebec, Canada
| | - Ian Gilron
- Departments of Anesthesiology and Perioperative Medicine, Biomedical and Molecular Sciences and School of Policy Studies, Queen's University, Kingston, Ontario, Canada
| | | | - Zoya Zulfiqar
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada
| | - Susan Marlin
- Clinical Trials Ontario, Toronto, Ontario, Canada
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Calvert M, King M, Mercieca-Bebber R, Aiyegbusi O, Kyte D, Slade A, Chan AW, Basch E, Bell J, Bennett A, Bhatnagar V, Blazeby J, Bottomley A, Brown J, Brundage M, Campbell L, Cappelleri JC, Draper H, Dueck AC, Ells C, Frank L, Golub RM, Griebsch I, Haywood K, Hunn A, King-Kallimanis B, Martin L, Mitchell S, Morel T, Nelson L, Norquist J, O'Connor D, Palmer M, Patrick D, Price G, Regnault A, Retzer A, Revicki D, Scott J, Stephens R, Turner G, Valakas A, Velikova G, von Hildebrand M, Walker A, Wenzel L. SPIRIT-PRO Extension explanation and elaboration: guidelines for inclusion of patient-reported outcomes in protocols of clinical trials. BMJ Open 2021; 11:e045105. [PMID: 34193486 PMCID: PMC8246371 DOI: 10.1136/bmjopen-2020-045105] [Citation(s) in RCA: 60] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Revised: 12/21/2020] [Accepted: 01/08/2021] [Indexed: 01/21/2023] Open
Abstract
Patient-reported outcomes (PROs) are used in clinical trials to provide valuable evidence on the impact of disease and treatment on patients' symptoms, function and quality of life. High-quality PRO data from trials can inform shared decision-making, regulatory and economic analyses and health policy. Recent evidence suggests the PRO content of past trial protocols was often incomplete or unclear, leading to research waste. To address this issue, international, consensus-based, PRO-specific guidelines were developed: the Standard Protocol Items: Recommendations for Interventional Trials (SPIRIT)-PRO Extension. The SPIRIT-PRO Extension is a 16-item checklist which aims to improve the content and quality of aspects of clinical trial protocols relating to PRO data collection to minimise research waste, and ultimately better inform patient-centred care. This SPIRIT-PRO explanation and elaboration (E&E) paper provides information to promote understanding and facilitate uptake of the recommended checklist items, including a comprehensive protocol template. For each SPIRIT-PRO item, we provide a detailed description, one or more examples from existing trial protocols and supporting empirical evidence of the item's importance. We recommend this paper and protocol template be used alongside the SPIRIT 2013 and SPIRIT-PRO Extension paper to optimise the transparent development and review of trial protocols with PROs.
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Affiliation(s)
- Melanie Calvert
- Centre for Patient Reported Outcome Research, Institute of Applied Health Research, University of Birmingham, Birmingham, UK
- Birmingham Health Partners Centre for Regulatory Science and Innovation, University of Birmingham, Birmingham, UK
- NIHR Biomedical Research Centre, Institute of Translational Medicine, Birmingham, UK
- NIHR Surgical Reconstruction and Microbiology Research Centre, Birmingham, UK
- NIHR Applied Research Collaboration West Midlands, University of Birmingham, Birmingham, UK
| | - Madeleine King
- Faculty of Science, School of Psychology, University of Sydney, Sydney, New South Wales, Australia
| | - Rebecca Mercieca-Bebber
- Faculty of Medicine and Health, NHMRC Clinical Trials Centre, University of Sydney, Sydney, New South Wales, Australia
| | - Olalekan Aiyegbusi
- Centre for Patient Reported Outcome Research, Institute of Applied Health Research, University of Birmingham, Birmingham, UK
- NIHR Biomedical Research Centre, Institute of Translational Medicine, Birmingham, UK
| | - Derek Kyte
- Centre for Patient Reported Outcome Research, Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Anita Slade
- Centre for Patient Reported Outcome Research, Institute of Applied Health Research, University of Birmingham, Birmingham, UK
- NIHR Surgical Reconstruction and Microbiology Research Centre, Birmingham, UK
| | - An-Wen Chan
- Women's College Research Institute, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - E Basch
- University of North Carolina, Chapel Hill, North Carolina, USA
| | - Jill Bell
- Oncology Digital Health, AstraZeneca, Gaithersburg, Maryland, USA
| | - Antonia Bennett
- Cancer Outcomes Research Program, University of North Carolina, Chapel Hill, North Carolina, USA
| | | | - Jane Blazeby
- NIHR Bristol Biomedical Research Centre, University of Bristol, Bristol, UK
- Division of Surgery, Head and Neck, University Hospitals Bristol NHS Foundation Trust, Bristol, UK
| | - Andrew Bottomley
- Department of Quality of Life, European Organisation for Research and Treatment of Cancer, Brussels, Belgium
| | - Julia Brown
- Clinical Trials Research Unit, University of Leeds, Leeds, UK
| | - Michael Brundage
- Department of Oncology, Queen's University Cancer Research Institute, Kingston, Ontario, Canada
| | - Lisa Campbell
- Medicines and Healthcare Products Regulatory Agency, London, UK
| | - Joseph C Cappelleri
- Global Biometrics & Data Management-Statistics, Pfizer Inc, New York City, New York, USA
| | | | - Amylou C Dueck
- Department of Health Sciences Research, Mayo Clinic, Scottsdale, Arizona, USA
| | - Carolyn Ells
- School of Population and Global Health, McGill University, Montreal, Quebec, Canada
| | - Lori Frank
- Patient-Centered Outcomes Research Institute, Washington, DC, USA
| | | | | | - Kirstie Haywood
- Warwick Research in Nursing, University of Warwick, Warwick Medical School, Coventry, UK
| | | | | | | | | | - Thomas Morel
- Patient-Centered Outcomes Research, UCB Pharma, Brussels, Belgium
| | - Linda Nelson
- Value Evidence and Outcomes-Patient Centered Outcomes, GSK, Collegeville, Pennsylvania, USA
| | - Josephine Norquist
- Center for Observational Real-world Evidence (CORE), Patient-Centered Endpoints & Strategy, Merck & Co Inc, Kenilworth, New Jersey, USA
| | - Daniel O'Connor
- Medicines and Healthcare Products Regulatory Agency, London, UK
| | - Michael Palmer
- Cancer Research Institute, Queen's University, Kingston, Ontario, Canada
| | - Donald Patrick
- Department of Health Services, University of Washington, Seattle, Washington, USA
| | - Gary Price
- Centre for Patient Reported Outcome Research, Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | | | - Ameeta Retzer
- Centre for Patient Reported Outcome Research, Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | | | - Jane Scott
- Johnson and Johnson, Janssen Global Services LLC, High Wycombe, UK
| | | | - Grace Turner
- Centre for Patient Reported Outcome Research, Institute of Applied Health Research, University of Birmingham, Birmingham, UK
- NIHR Surgical Reconstruction and Microbiology Research Centre, Birmingham, UK
| | - Antonia Valakas
- EMD Serono Inc, Healthcare Business of Merck KGaA, Darmstadt, Germany
| | - Galina Velikova
- Leeds Institute of Medical Research at St James's, University of Leeds, Leeds, UK
| | - Maria von Hildebrand
- Centre for Patient Reported Outcome Research, Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Anita Walker
- Centre for Patient Reported Outcome Research, Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Lari Wenzel
- University of California, Irvine, California, USA
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Development of an international template to support patient submissions in Health Technology Assessments. Int J Technol Assess Health Care 2021; 37:e50. [PMID: 33789779 DOI: 10.1017/s0266462321000167] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVES To develop an international template to support patient submissions in Health Technology Assessments (HTAs). This was to be based on the experience and feedback from the implementation and use of the Scottish Medicines Consortium's (SMC) Summary Information for Patient Groups (SIP). METHODS To gather feedback on the SMC experience, web-based surveys were conducted with pharmaceutical companies and patient groups familiar with the SMC SIP. Semistructured interviews with representatives from HTA bodies were undertaken, along with patient group discussions with those less familiar with the SIP, to explore issues around the approach. These qualitative data informed the development of an international SIP template. RESULTS Survey data indicated that 82 percent (18 of 22 respondents) of pharmaceutical company representatives felt that the SIP was worthwhile; 88 percent (15/17) of patient group respondents found the SIP helpful. Both groups highlighted the need for additional support and guidance around plain language summaries. Further suggestions included provision of a glossary of terms and cost-effectiveness information. Patient group interviews supported the survey findings and led to the development of a new template. HTA bodies raised potential challenges around buy-in, timing, and bias connected to the SIP approach. CONCLUSIONS The international SIP template is another approach to support deliberative processes in HTA. Although challenges remain around writing summaries for lay audiences, along with feasibility considerations for HTA bodies, the SIP approach should support more meaningful patient involvement in HTAs.
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Parry M, Bjørnnes AK, Toupin-April K, Najam A, Wells D, Sivakumar A, Richards DP, Ceroni T, Park M, Ellis AK, Gilron I, Marlin S. Patient Engagement Partnerships in Clinical Trials: Development of Patient Partner and Investigator Decision Aids. THE PATIENT 2020; 13:745-756. [PMID: 33026639 PMCID: PMC7655585 DOI: 10.1007/s40271-020-00460-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 09/19/2020] [Indexed: 12/20/2022]
Abstract
BACKGROUND A 2017 systematic review suggested patient engagement in clinical trials has been limited, with little active engagement in trial design or data analysis, interpretation or dissemination. Additionally, there remains limited sex/gender reporting in clinical trial research. OBJECTIVES The overall goal of this project was to disseminate sex/gender knowledge and build capacity for patient engagement in clinical trials. Specific objectives were to (1) create capacity and identify opportunities for patient engagement in clinical trials and sponsor- or investigator-led activities (e.g. clinical trial design and conduct); and (2) enhance new/early investigator sex/gender knowledge and skills related to patient-oriented research (POR). METHODS We used the Canadian Institutes of Health Research Strategy for Patient-Oriented Research (SPOR) Capacity Development Framework and the SPOR Patient Engagement Framework to guide three phases of this project: (1) conduct a scoping review using methods described by the Evidence for Policy and Practice Information (EPPI) and the Coordinating Centre at the Institute of Education (Phase 1); (2) host a 1-day POR consultation workshop (Phase 2); and (3) deliver a new/early investigator POR training day (Phase 3). Six electronic databases (CINAHL, MEDLINE, EMBASE, PsychInfo, the Cochrane Library, and AMED) were searched from 1996 using keywords and Medical Subject Heading (MeSH) terms in accordance with the International Association for Public Participation (IAP2) and the search criteria in the bibliographic databases. Standard approaches were used to search the grey literature. RESULTS A total of 79 studies and over 150 websites were subject to data abstraction by team members, capturing information on sex/gender and SPOR's patient engagement guiding principles of inclusiveness, support, mutual respect, and co-building. Results were presented to 32 key stakeholders at the consultation workshop and input was sought on next steps using nominal group techniques. Based on the plethora of existing POR resources, relevant POR information from the scoping review was collated into two decision aids (patient and investigator) to determine readiness to engage with/as a patient partner in a clinical trial. The decision aids were presented at a POR training day with 88 new/early investigators, clinicians, patient partners and decision makers. The decision aids showed 'good' usability, assessed using the System Usability Scale (SUS). Attendees thought the decision aids were engaging, they increased their understanding of sex/gender, patient engagement and POR, and they would recommend them to others. POR principles and practices were integrated across all phases of the project. Patient partners (1) identified research priorities/search terms; (2) collected/analyzed data; (3) designed the patient partner decision aid; and (4) disseminated the results through presentation. CONCLUSION Our digital patient partner and investigator decision aids are the first to provide information technology to deliver sex/gender, POR knowledge, and decision support beyond the traditional decision aids used for health screening and/or treatment decisions. The decision aids have the potential to make a significant contribution to Canada's Strategy for POR and support the collaborative efforts of patients and investigators to build a sustainable, accessible and equitable health care system.
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Affiliation(s)
- Monica Parry
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, 155 College Street, Suite 130, Toronto, ON, M5T 1P8, Canada.
| | - Ann Kristin Bjørnnes
- Department of Nursing and Health Promotion, Oslo Metropolitan University, Oslo, Norway
| | - Karine Toupin-April
- School of Rehabilitation Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada
- Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Adhiyat Najam
- Patient Partner, Diabetes Action Canada, Toronto, ON, Canada
| | - David Wells
- Patient Partner, Diabetes Action Canada, Toronto, ON, Canada
| | - Aditi Sivakumar
- Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
| | | | - Tina Ceroni
- Patient Partner, Clinical Trials Ontario, Toronto, ON, Canada
| | - Marianne Park
- Patient Partner, Network of Women with Disabilities, Woodstock, ON, Canada
| | - Anne K Ellis
- Department of Medicine, Queen's University, Kingston, ON, Canada
| | - Ian Gilron
- Departments of Anesthesiology and Perioperative Medicine, Biomedical and Molecular Sciences and School of Policy Studies, Queen's University, Kingston, ON, Canada
| | - Susan Marlin
- Patient Partner, Diabetes Action Canada, Toronto, ON, Canada
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Janic A, Bowden S, Levy S, Stinson J, Dimaras H. Patient-reported outcome measures for retinoblastoma: a scoping review. J Patient Rep Outcomes 2020; 4:66. [PMID: 32770435 PMCID: PMC7415058 DOI: 10.1186/s41687-020-00232-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Accepted: 08/03/2020] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Retinoblastoma is a childhood retinal cancer with lifelong consequences such as vision loss and increased risk of second cancer. Patient-reported outcome measures (PROMs) are instruments that measure outcomes related to health directly reported by patients. The purpose of this study was to determine the scope, characteristics and quality of PROMs used in retinoblastoma and related fields of pediatric ophthalmology and pediatric oncology. METHODS Databases MEDLINE and Embase were searched for studies in the English language that reported on PROMs used in retinoblastoma, pediatric oncology, or pediatric ophthalmology; grey literature and studies reporting on developmental PROM phases were excluded. PROMs were grouped by the construct measured and domains assessed, and classified as condition-specific or generic. A subsequent search was then conducted in MEDLINE and Embase for studies assessing measurement properties of the identified PROMs. PROMs with associated studies were assessed for their methodologic quality using the COnsensus-based standard for the Selection of health Measurement INstruments (COSMIN) strategy. RESULTS Among 110 eligible studies uncovered by the database searches, 143 PROMs were identified: one retinoblastoma-specific, 56 ophthalmology- and 86 oncology-related. The most common construct measured was 'health-related quality of life' and the most common domain assessed was emotional well-being. Of the 143 PROMs, 100 had associated validation studies; the one retinoblastoma-specific PROM was not validated. Quality assessment revealed 34/100 PROMs received a score of sufficient quality in both subcategories of 'overall content validity'; 3/100 received a score of sufficient quality in both subcategories of 'internal structure'; 0/100 received a score of sufficient quality in all three subcategories of 'remaining measurement properties'. The Patient-Reported Outcome Measure Information System (PROMIS) Pediatric Profile-25 was the highest-scoring PROM identified, meeting COSMIN standards for 2/3 measurement property categories (and 5/7 subcategories). Eleven additional PROMs were identified which had sufficient scores in 1/3 measurement property categories (and 5/7 subcategories). CONCLUSION The study identified several PROMs from the pediatric ophthalmology and pediatric oncology literature that could be relevant to the retinoblastoma population, but many have limits to their validation. Future development of a retinoblastoma-specific PROM, performed in partnership with retinoblastoma patients to support optimal content validity, could first focus on the selection and definition of the optimal construct to measure, followed potentially by adaptation and further validation of the relevant PROMs with strong methodologic quality identified in this study.
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Affiliation(s)
- Ana Janic
- Faculty of Medicine, University of Toronto, 1 King's College Circle, Toronto, M5S 1A8, Canada
- Department of Ophthalmology & Vision Sciences, The Hospital for Sick Children, 555 University Ave, Toronto, M5G 2R3, Canada
- Child Health Evaluative Sciences Program, SickKids Research Institute, 686 Bay Street, Toronto, M5G 0A4, Canada
- Department of Anesthesia and Pain Medicine, The Hospital for Sick Children, 555 University Ave, Toronto, M5G 2R3, Canada
| | - Sylvie Bowden
- Faculty of Medicine, University of Toronto, 1 King's College Circle, Toronto, M5S 1A8, Canada
- Department of Ophthalmology & Vision Sciences, The Hospital for Sick Children, 555 University Ave, Toronto, M5G 2R3, Canada
| | - Sarah Levy
- Department of Ophthalmology & Vision Sciences, The Hospital for Sick Children, 555 University Ave, Toronto, M5G 2R3, Canada
- Child Health Evaluative Sciences Program, SickKids Research Institute, 686 Bay Street, Toronto, M5G 0A4, Canada
| | - Jennifer Stinson
- Child Health Evaluative Sciences Program, SickKids Research Institute, 686 Bay Street, Toronto, M5G 0A4, Canada
- Department of Anesthesia and Pain Medicine, The Hospital for Sick Children, 555 University Ave, Toronto, M5G 2R3, Canada
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, 155 College Street, Toronto, M5T 1P8, Canada
| | - Helen Dimaras
- Faculty of Medicine, University of Toronto, 1 King's College Circle, Toronto, M5S 1A8, Canada.
- Department of Ophthalmology & Vision Sciences, The Hospital for Sick Children, 555 University Ave, Toronto, M5G 2R3, Canada.
- Child Health Evaluative Sciences Program, SickKids Research Institute, 686 Bay Street, Toronto, M5G 0A4, Canada.
- The Centre for Global Child Health, SickKids Research Institute, 686 Bay Street, Toronto, M5G 0A4, Canada.
- Division of Clinical Public Health, University of Toronto, 150 College Street, Toronto, M5T 3M7, Canada.
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Ní Shé É, Cassidy J, Davies C, De Brún A, Donnelly S, Dorris E, Dunne N, Egan K, Foley M, Galvin M, Harkin M, Killilea M, Kroll T, Lacey V, Lambert V, McLoughlin S, Mitchell D, Murphy E, Mwendwa P, Nicholson E, O’Donnell D, O’Philbin L. Minding the gap: identifying values to enable public and patient involvement at the pre-commencement stage of research projects. RESEARCH INVOLVEMENT AND ENGAGEMENT 2020; 6:46. [PMID: 32765898 PMCID: PMC7396939 DOI: 10.1186/s40900-020-00220-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Accepted: 07/13/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND The University College Dublin (UCD) Public and Patient Invovlement (PPI) ignite program is focused on embedding PPI in health and social care related research, education and training, professional practice and administration. During a PPI knowledge sharing event challenges were noted during the pre-commencement stage of research projects. This stage includes the time before a research projects/partnership starts or when funding is being applied for. As a response, we agreed there was a need to spend time developing a values-based approach to be used from the pre-commencement of PPI projects and partnerships. Values are deeply held ideals that people consider to be important. They are vital in shaping our attitudes and motivating our choices and behaviours. METHODS Using independent facilitators, we invited a diverse group of participants to a full-day workshop in February. During the workshop, the concept of a values statement and values-based approaches was introduced. The group via a majority consensus, agreed on a core set of values and a shared understanding of them. After the workshop, a draft was shared with participants for further comment and final agreement. RESULTS The workshop had 22 people representing experts by experience, PPI charity partners, funders, academics and national PPI Ignite partners. The group via consensus identified four values of respect, openness, reciprocity and flexibility for the pre-commencement stage. A frequently reported experience of PPI partners was that some felt that the pre-commencement activities appeared at times like a performance; an act that had to be completed in order to move to the next stage rather than a genuine interest in a mutually beneficial partnership. Being open and transparent with all invovled that the funding application may not be successful was stressed. Another important feature related to 'openness' was the 'spaces' and 'places' in which meetings between partners could occur in an accessible and equitable way. The issue of 'space' is particularly critical for the involvement of seldom heard groups. The benefits of the research are often clear for academics, but for PPI partners, these are often less certain. To achieve reciprocity, academic and PPI partners need to engage in a timely, repeated and transparent dialogue to achieve beneficial outcomes for all stakeholders. Being open to new inputs and differing modes of knowledge and ideas was also stressed. For some, this will require a change in attitudes and behaviours and should result in more collective decision making. Several areas were identified using the four values. CONCLUSIONS This work via majority consensus identified four values of respect, openness, reciprocity, and flexibility for the pre-commencement stage. These values should be used to support inclusive, effective and collective PPI across all stages of involvement. We hope this work will stimulate further action in this area. In particular, we would welcome the evaluation of these values involving diverse PPI groups.
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Affiliation(s)
- Éidín Ní Shé
- School of Nursing, Midwifery and Health Systems, University College Dublin, Belfield, Dublin 4, Ireland
| | | | - Carmel Davies
- School of Nursing, Midwifery and Health Systems, University College Dublin, Belfield, Dublin 4, Ireland
| | - Aoife De Brún
- School of Nursing, Midwifery and Health Systems, University College Dublin, Belfield, Dublin 4, Ireland
| | - Sarah Donnelly
- UCD School of Social Policy, Social Work and Social Justice, Dublin, Ireland
| | - Emma Dorris
- School of Medicine, University College Dublin, Dublin, Ireland
| | | | | | - Michel Foley
- PPI Ignite, Trinity College Dublin, Dublin, Ireland
| | - Mary Galvin
- Design Innovation, Maynooth University, Kildare, Ireland
| | | | - Martha Killilea
- PPI Ignite, National University of Ireland Galway, Dublin, Ireland
| | - Thilo Kroll
- School of Nursing, Midwifery and Health Systems, University College Dublin, Belfield, Dublin 4, Ireland
| | - Vanessa Lacey
- Transgender Equality Network Ireland, Dublin, Ireland
| | - Veronica Lambert
- DCU School of Nursing, Psychotherapy and Community Health, Dublin, Ireland
| | | | - Derick Mitchell
- Irish Platform for Patient Organisations, Science and Industry, Dublin, Ireland
| | - Edel Murphy
- PPI Ignite, National University of Ireland Galway, Dublin, Ireland
| | - Purity Mwendwa
- School of Nursing, Midwifery and Health Systems, University College Dublin, Belfield, Dublin 4, Ireland
| | - Emma Nicholson
- School of Nursing, Midwifery and Health Systems, University College Dublin, Belfield, Dublin 4, Ireland
| | - Deirdre O’Donnell
- School of Nursing, Midwifery and Health Systems, University College Dublin, Belfield, Dublin 4, Ireland
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Harrington RL, Hanna ML, Oehrlein EM, Camp R, Wheeler R, Cooblall C, Tesoro T, Scott AM, von Gizycki R, Nguyen F, Hareendran A, Patrick DL, Perfetto EM. Defining Patient Engagement in Research: Results of a Systematic Review and Analysis: Report of the ISPOR Patient-Centered Special Interest Group. VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2020; 23:677-688. [PMID: 32540224 DOI: 10.1016/j.jval.2020.01.019] [Citation(s) in RCA: 64] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/07/2019] [Revised: 01/17/2020] [Accepted: 01/30/2020] [Indexed: 05/13/2023]
Abstract
OBJECTIVES Lack of clarity on the definition of "patient engagement" has been highlighted as a barrier to fully implementing patient engagement in research. This study identified themes within existing definitions related to patient engagement and proposes a consensus definition of "patient engagement in research." METHODS A systematic review was conducted to identify definitions of patient engagement and related terms in published literature (2006-2018). Definitions were extracted and qualitatively analyzed to identify themes and characteristics. A multistakeholder approach, including academia, industry, and patient representation, was taken at all stages. A proposed definition is offered based on a synthesis of the findings. RESULTS Of 1821 abstracts identified and screened for eligibility, 317 were selected for full-text review. Of these, 169 articles met inclusion criteria, from which 244 distinct definitions were extracted for analysis. The most frequently defined terms were: "patient-centered" (30.5%), "patient engagement" (15.5%), and "patient participation" (13.4%). The majority of definitions were specific to the healthcare delivery setting (70.5%); 11.9% were specific to research. Among the definitions of "patient engagement," the most common themes were "active process," "patient involvement," and "patient as participant." In the research setting, the top themes were "patient as partner," "patient involvement," and "active process"; these did not appear in the top 3 themes of nonresearch definitions. CONCLUSION Distinct themes are associated with the term "patient engagement" and with engagement in the "research" setting. Based on an analysis of existing literature and review by patient, industry, and academic stakeholders, we propose a scalable consensus definition of "patient engagement in research."
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Affiliation(s)
| | - Maya L Hanna
- Boehringer Ingelheim Pharmaceuticals Inc., Ridgefield, CT USA
| | | | - Rob Camp
- Community Advisory Board Programme, EURORDIS, Barcelona, Spain
| | | | - Clarissa Cooblall
- Scientific & Health Policy Initiatives, ISPOR, Lawrenceville, NJ, USA
| | - Theresa Tesoro
- Scientific & Health Policy Initiatives, ISPOR, Lawrenceville, NJ, USA
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Taylor Buck E, Smith CM, Lane A, Keetharuth AD, Young T, Cooke J. Use of a modified World Café process to discuss and set priorities for a Community of Practice supporting implementation of ReQoL a new mental health and quality of life Patient Reported Outcome Measure (PROM). J Patient Rep Outcomes 2020; 4:38. [PMID: 32430640 PMCID: PMC7237562 DOI: 10.1186/s41687-020-00202-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Accepted: 05/01/2020] [Indexed: 11/10/2022] Open
Affiliation(s)
- Elizabeth Taylor Buck
- School of Health and Related Research (ScHARR), The University of Sheffield, Regent Court, 30 Regent St, Sheffield, S1 4DA, UK.
| | - Christine M Smith
- School of Human and Health Sciences, Centre for Applied Research in Health, University of Huddersfield, Huddersfield, UK
| | - Amanda Lane
- School of Health and Related Research (ScHARR), The University of Sheffield, Regent Court, 30 Regent St, Sheffield, S1 4DA, UK
| | - Anju Devianee Keetharuth
- School of Health and Related Research (ScHARR), The University of Sheffield, Regent Court, 30 Regent St, Sheffield, S1 4DA, UK
| | - Tracey Young
- School of Health and Related Research (ScHARR), The University of Sheffield, Regent Court, 30 Regent St, Sheffield, S1 4DA, UK
| | - Jo Cooke
- Health Sciences School, The University of Sheffield, Sheffield, UK
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18
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Martineau JT, Minyaoui A, Boivin A. Partnering with patients in healthcare research: a scoping review of ethical issues, challenges, and recommendations for practice. BMC Med Ethics 2020; 21:34. [PMID: 32393230 PMCID: PMC7216517 DOI: 10.1186/s12910-020-0460-0] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2019] [Accepted: 02/25/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Partnering with patients in healthcare research now benefits from a strong rationale and is encouraged by funding agencies and research institutions. However, this new approach raises ethical issues for patients, researchers, research professionals and administrators. The main objective of this review is to map the literature related to the ethical issues associated with patient partnership in healthcare research, as well as the recommendations to address them. Our global aim is to help researchers, patients, research institutions and research ethics boards reflecting on and dealing with these issues. METHODS We conducted a scoping review of the ethical issues and recommendations associated with partnering with patients in healthcare research. After our search strategy, 31 peer reviewed articles published between 2007 and 2017 remained and were analyzed. RESULTS We have identified 58 first-order ethical issues and challenges associated with patient partnership in research, regrouped in 18 second-order ethical themes. Most of the issues are transversal to all phases and stages of the research process and a lot of them could also apply to patient-partnership in other spheres of health, such as governance, quality improvement, and education. We suggested that ethical issues and challenges of partnered research can be related to four ethical frameworks: 1) Research ethics; 2) Research integrity; 3) Organizational ethics, and 4) Relational ethics. CONCLUSIONS We have identified numerous ethical issues associated with the recent approach of patient-partnership in research. These issues are more diverse than the issues associated with a more traditional research approach. Indeed, the current discussion on how we address ethical issues in research is anchored in the assumption that patients, as research participants, must be protected from risk. However, doing research with, and not on, the patient involves changes in the way we reflect on the ethical issues associated with this approach to research. We propose to broaden the ethical discussion on partnered research to not only rely on a research ethics framework, but to also frame it within the areas of research integrity, organizational ethics and relational ethics.
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Affiliation(s)
- Joé T Martineau
- Department of Management, HEC Montreal, 3000 chemin de la Cote-Ste-Catherine, Montreal, QC, H3T2A7, Canada.
| | | | - Antoine Boivin
- Canada Research Chair in Patient and Public Partnership, CHUM Research Center (CRCHUM) and University of Montreal, Montreal, Canada
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An international, consensus-derived Core Outcome Set for Cardiac Arrest effectiveness trials: the COSCA initiative. Curr Opin Crit Care 2020; 25:226-233. [PMID: 30925524 DOI: 10.1097/mcc.0000000000000612] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
PURPOSE OF REVIEW Accurate and relevant assessment is essential to determining the impact of ill-health and the relative benefit of healthcare. This review details the recent development of a core outcome set for cardiac arrest effectiveness trials - the COSCA initiative. RECENT FINDINGS The reported heterogeneity in outcome assessment and a lack of outcome reporting guidance were key triggers for the development of the COSCA. The historical failure of existing research to adequately capture the perspective of survivors and their family members in defining survival is described. Working collaboratively with international stakeholders - including survivors, family members and advocates - as research partners and participants ensured that a range of perspectives were considered throughout all stages of COSCA development. Three core domains and methods of assessment were recommended: survival - at 30 days or hospital discharge; neurological function assessed at 30 days or hospital discharge with the modified Rankin Scale; and health-related quality of life assessed at 90 days (as a minimum) with one of three generic measures. SUMMARY The COSCA recommendation describes a small group of outcomes that should be reported as a minimum across large, randomized clinical effectiveness trials for cardiac arrest.
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20
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Liabo K, Boddy K, Bortoli S, Irvine J, Boult H, Fredlund M, Joseph N, Bjornstad G, Morris C. Public involvement in health research: what does 'good' look like in practice? RESEARCH INVOLVEMENT AND ENGAGEMENT 2020; 6:11. [PMID: 32266085 PMCID: PMC7110674 DOI: 10.1186/s40900-020-0183-x] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/09/2019] [Accepted: 02/17/2020] [Indexed: 05/06/2023]
Abstract
PLAIN ENGLISH SUMMARY Background Patient and public involvement means researchers working with members of the public, patients or carers to jointly plan and carry out research.Aim This article is written by members of three involvement groups, and the university employees that they work with. We wanted to jointly reflect on what enables our collaborative work, and what the challenges are for everyone involved.What we did and how we did it We wanted to establish what the literature defines as 'good' public involvement and compare this with processes and practices in our involvement groups. We therefore carried out a literature review and each group met separately to discuss what characterises good involvement, and what the challenges are. From these discussions we developed a set of descriptions about each group. We compared the literature review findings with what came out of the discussions within the involvement groups.Findings Some of the involvement principles from the literature were similar to the priorities of the involvement groups. In addition, the groups identified characteristics of 'good' involvement practice that were not reported in the literature: passion and enthusiasm, informal and welcoming meeting spaces, and opportunities to share lived experiences. In this article we present examples of how principles for good involvement are practiced in these groups, and difficulties we have experienced. ABSTRACT Background Patient and public involvement is important for producing relevant and accessible health research. Evidence of impact from involvement is growing, but there is also a need for research on how to create conditions for meaningful collaborations between researchers and public advisers.Objective We report on a co-produced self-reflective evaluation of involvement practices in three UK research programmes.Methods A structured review identified research-based principles for 'good' public involvement in research. In parallel, members of three involvement groups co-developed statements on how the groups work, and enablers and challenges to collaborative research. The author team analysed these statements using the findings from the review.Results We identified 11 international articles reporting research-based principles for involvement published between 2013 and 2017. We identified five 'values' and seven 'practice principles' for 'good' involvement. There was convergence between these principles and the priorities of the involvement groups. But the groups also identified additional good involvement practice that were not reported by the literature: passion, enthusiasm, informal and welcoming meeting spaces, and opportunities to share lived experiences. We present examples of how principles for good involvement are practiced in these groups, and highlight principles that have been challenging to implement.Conclusions Ongoing appraisal of public involvement is crucial. We present a process for self-evaluation, illuminate what 'good' means to researchers and public advisers involved in research, and identify areas for improvement. We conclude that provision of resources that enable support to public advisers in turn enable universities and research teams to implement other principles of good involvement.
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Affiliation(s)
- Kristin Liabo
- NIHR Applied Research Collaboration South West Peninsula, University of Exeter Medical School, St Luke’s Campus, Exeter, EX1 2LU UK
| | - Kate Boddy
- NIHR Applied Research Collaboration South West Peninsula, University of Exeter Medical School, St Luke’s Campus, Exeter, EX1 2LU UK
| | - Silvia Bortoli
- Living Systems Institute, University of Exeter College of Life and Environmental Sciences, Stocker Road, Exeter, EX4 4QD UK
- Peninsula Childhood Disability Research Unit (PenCRU), University of Exeter Medical School, St Luke’s Campus, Exeter, EX1 2LU UK
| | - Jenny Irvine
- NIHR Collaboration for Leadership in Applied Health Research and Care (CLAHRC) North West Coast, Lancaster University, Lancaster, UK
| | - Heather Boult
- Peninsula Public Involvement Group, NIHR Applied Research Collaboration South West Peninsula, University of Exeter Medical School, St Luke’s Campus, Exeter, EX1 2LU UK
| | - Mary Fredlund
- PenCRU Family Faculty, Peninsula Childhood Disability Research Unit, University of Exeter Medical School, St Luke’s Campus, Exeter, EX1 2LU UK
| | - Neil Joseph
- Public Adviser Forum, NIHR Applied Research Collaboration North West Coast, Lancaster University, Lancaster, LA1 4YX UK
| | - Gretchen Bjornstad
- Peninsula Childhood Disability Research Unit (PenCRU), University of Exeter Medical School, St Luke’s Campus, Exeter, EX1 2LU UK
| | - Christopher Morris
- Peninsula Childhood Disability Research Unit (PenCRU), University of Exeter Medical School, St Luke’s Campus, Exeter, EX1 2LU UK
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Klopstock T, Escolar ML, Marshall RD, Perez-Dueñas B, Tuller S, Videnovic A, Greblikas F. The FOsmetpantotenate Replacement Therapy (FORT) randomized, double-blind, Placebo-controlled pivotal trial: Study design and development methodology of a novel primary efficacy outcome in patients with pantothenate kinase-associated neurodegeneration. Clin Trials 2019; 16:410-418. [PMID: 31055958 PMCID: PMC6661719 DOI: 10.1177/1740774519845673] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
BACKGROUND/AIMS Pantothenate kinase-associated neurodegeneration is a rare neurodegenerative disease with a variable clinical phenotype. Fosmetpantotenate is in clinical development as a replacement therapy that targets the underlying cause of pantothenate kinase-associated neurodegeneration. The FOsmetpantotenate Replacement Therapy pivotal trial-an ongoing phase 3, randomized, double-blind, placebo-controlled, multicenter trial-examines the efficacy and safety of fosmetpantotenate in patients with pantothenate kinase-associated neurodegeneration aged 6-65 years. The FOsmetpantotenate Replacement Therapy trial required the development and validation of a novel patient-reported outcome measure specifically relevant to pantothenate kinase-associated neurodegeneration. The Pantothenate Kinase-Associated Neurodegeneration-Activities of Daily Living scale was developed to assess activities of daily living related to motor functioning in patients with pantothenate kinase-associated neurodegeneration to evaluate clinically meaningful change as the primary efficacy endpoint in clinical trials. This article describes the design of the FOsmetpantotenate Replacement Therapy pivotal trial and the development of the Pantothenate Kinase-Associated Neurodegeneration-Activities of Daily Living scale. METHODS A systematic, iterative process consistent with the US Food and Drug Administration guidance and advice from the Committee for Medicinal Products for Human Use at the European Medicines Agency was used to evaluate and adapt or remove scale items of an existing widely used instrument for movement disorders to be pantothenate kinase-associated neurodegeneration-specific, and to create new items. Modification of scale items was based on input from international experts, patient advocacy leaders, and primary caregivers. A clinimetric study of the Pantothenate Kinase-Associated Neurodegeneration-Activities of Daily Living scale conducted in patients with pantothenate kinase-associated neurodegeneration or their caregivers (N = 40 at first assessment; N = 39 at second assessment) demonstrated high content and construct validity and excellent test-retest reliability over an approximately 2-week period. The Pantothenate Kinase-Associated Neurodegeneration-Activities of Daily Living scale was developed to be broadly useful within clinical and research settings in the examination of patient response to pantothenate kinase-associated neurodegeneration therapies. RESULTS Approximately 82 patients will be enrolled in the ongoing FOsmetpantotenate Replacement Therapy pivotal trial. Change from baseline in Pantothenate Kinase-Associated Neurodegeneration-Activities of Daily Living score over the 24-week double-blind period is the primary efficacy endpoint for the FOsmetpantotenate Replacement Therapy trial. Treatment effect will be evaluated using a mixed model for repeated measures analysis to assess data from all visits simultaneously. CONCLUSION The development and implementation of the Pantothenate Kinase-Associated Neurodegeneration-Activities of Daily Living scale in the FOsmetpantotenate Replacement Therapy trial illustrates the feasibility and potential patient benefit of putting into practice the current regulatory guidance on the use of patient-reported outcomes in clinical trials. These processes can be broadly applied to clinical trial methodology that requires newly created or revised patient-reported outcome measures to evaluate outcome change as a primary efficacy endpoint. The goal of such measures in patients with pantothenate kinase-associated neurodegeneration is to facilitate development of disease-modifying therapeutics in multiple drug development programs.
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Affiliation(s)
- Thomas Klopstock
- Department of Neurology,
Friedrich-Baur-Institute, Ludwig-Maximilians-University of Munich, Munich,
Germany
- German Center for Neurodegenerative
Diseases (DZNE), Munich, Germany
- Munich Cluster for Systems Neurology
(SyNergy), Munich, Germany
| | - Maria L Escolar
- Department of Pediatrics, School of
Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | | | - Belen Perez-Dueñas
- Department of Child Neurology, Hospital
Universitari Vall d’Hebron, Barcelona, Spain
| | - Sarah Tuller
- Formerly of Research & Development,
Retrophin, Inc., San Diego, CA, USA
| | - Aleksandar Videnovic
- Department of Neurology, Massachusetts
General Hospital and Harvard Medical School, Boston, MA, USA
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Archer J, Stevenson L, Coulter A, Breen AM. Connecting patient experience, leadership, and the importance of involvement, information, and empathy in the care process. Healthc Manage Forum 2018; 31:252-255. [PMID: 30223676 DOI: 10.1177/0840470418783463] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
To improve health outcomes, restore trust, and create a safe and healing environment for patients, the health system needs to shift from being disease, system, and provider focused to being patient centred. Drawing from a patient story, this article focuses on three aspects of the care process that have a significant impact on patient experience: involvement in care, information about treatment and care, and empathy and respect. It will also provide recommendations for leaders in how to become more patient centred and aligned to the LEADS competency framework.
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Affiliation(s)
- Jana Archer
- 1 Vancouver Island Health Authority, Royal Jubilee Hospital, Victoria, British Columbia, Canada
| | - Lynn Stevenson
- 2 Health Services, British Columbia Ministry of Health, Victoria, British Columbia, Canada.,Author is now retired
| | - Angela Coulter
- 3 Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
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Haywood KL, Mars TS, Potter R, Patel S, Matharu M, Underwood M. Assessing the impact of headaches and the outcomes of treatment: A systematic review of patient-reported outcome measures (PROMs). Cephalalgia 2018; 38:1374-1386. [PMID: 28920448 PMCID: PMC6024352 DOI: 10.1177/0333102417731348] [Citation(s) in RCA: 48] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2017] [Revised: 05/25/2017] [Accepted: 06/12/2017] [Indexed: 01/03/2023]
Abstract
Aims To critically appraise, compare and synthesise the quality and acceptability of multi-item patient reported outcome measures for adults with chronic or episodic headache. Methods Systematic literature searches of major databases (1980-2016) to identify published evidence of PROM measurement and practical properties. Data on study quality (COSMIN), measurement and practical properties per measure were extracted and assessed against accepted standards to inform an evidence synthesis. Results From 10,903 reviewed abstracts, 103 articles were assessed in full; 46 provided evidence for 23 PROMs: Eleven specific to the health-related impact of migraine (n = 5) or headache (n = 6); six assessed migraine-specific treatment response/satisfaction; six were generic measures. Evidence for measurement validity and score interpretation was strongest for two measures of impact, Migraine-Specific Quality of Life Questionnaire (MSQ v2.1) and Headache Impact Test 6-item (HIT-6), and one of treatment response, the Patient Perception of Migraine Questionnaire (PPMQ-R). Evidence of reliability was limited, but acceptable for the HIT-6. Responsiveness was rarely evaluated. Evidence for the remaining measures was limited. Patient involvement was limited and poorly reported. Conclusion While evidence is limited, three measures have acceptable evidence of reliability and validity: HIT-6, MSQ v2.1 and PPMQ-R. Only the HIT-6 has acceptable evidence supporting its completion by all "headache" populations.
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Affiliation(s)
- Kirstie L Haywood
- Warwick Research in Nursing, Department
of Health Sciences, Warwick Medical School, The
University
of Warwick, Gibbet Hill, Coventry, UK
- On behalf of the CHESS team; Warwick
Clinical Trials Unit, Warwick Medical School, The
University
of Warwick, Gibbet Hill, Coventry, UK
| | - Tom S Mars
- On behalf of the CHESS team; Warwick
Clinical Trials Unit, Warwick Medical School, The
University
of Warwick, Gibbet Hill, Coventry, UK
- Warwick Clinical Trials Unit, Warwick
Medical School, The
University
of Warwick, Gibbet Hill, Coventry, UK
| | - Rachel Potter
- On behalf of the CHESS team; Warwick
Clinical Trials Unit, Warwick Medical School, The
University
of Warwick, Gibbet Hill, Coventry, UK
- Warwick Clinical Trials Unit, Warwick
Medical School, The
University
of Warwick, Gibbet Hill, Coventry, UK
| | - Shilpa Patel
- On behalf of the CHESS team; Warwick
Clinical Trials Unit, Warwick Medical School, The
University
of Warwick, Gibbet Hill, Coventry, UK
- Warwick Clinical Trials Unit, Warwick
Medical School, The
University
of Warwick, Gibbet Hill, Coventry, UK
| | - Manjit Matharu
- On behalf of the CHESS team; Warwick
Clinical Trials Unit, Warwick Medical School, The
University
of Warwick, Gibbet Hill, Coventry, UK
- Headache Group, UCL Institute of
Neurology, Queen Square, London, UK
| | - Martin Underwood
- On behalf of the CHESS team; Warwick
Clinical Trials Unit, Warwick Medical School, The
University
of Warwick, Gibbet Hill, Coventry, UK
- Warwick Clinical Trials Unit, Warwick
Medical School, The
University
of Warwick, Gibbet Hill, Coventry, UK
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Manafo E, Petermann L, Mason-Lai P, Vandall-Walker V. Patient engagement in Canada: a scoping review of the 'how' and 'what' of patient engagement in health research. Health Res Policy Syst 2018; 16:5. [PMID: 29415734 PMCID: PMC5804082 DOI: 10.1186/s12961-018-0282-4] [Citation(s) in RCA: 217] [Impact Index Per Article: 36.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2017] [Accepted: 01/10/2018] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Over the last 10 years, patient engagement in health research has emerged as the next evolution in healthcare research. However, limited evidence about the clear role and scope of patient engagement in health research and a lack of evidence about its impact have influenced the uptake, implementation and ongoing evolution of patient engagement. The present study aims to conduct a scoping review to identify methods for and outcomes of patient engagement in health research. METHODS An adaptation of the scoping review methodology originally described by Arksey and O'Malley and updated by Levac, Colquhoun and O'Brien was applied. Sources from a formal database search and relevant documents from a grey literature search were compiled into data extraction tables. Articles were synthesised into key themes according to the (1) methods and (2) outcomes of patient engagement in health research. RESULTS The total yield for the scoping review was 55 records from across Canada, the United Kingdom and the United States. While evidence about the methods used to engage patients in health research is increasing, stronger evidence of specific patient and healthcare system outcomes is required. This necessitates further mobilisation of research that explores outcomes and that validates specific tools to evaluate engagement. Additionally, theoretical frameworks that can better inform and sustain patient engagement across the lifecycle of health research are lacking. CONCLUSION Further increasing the volume and reach of evidence about patient engagement in health research will support the paradigmatic shift needed to normalise the patient's role in research beyond 'subject' or 'participant', so as to ultimately improve patient health outcomes and better address healthcare reform in Canada.
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Affiliation(s)
- Elizabeth Manafo
- Patient Engagement Platform, Alberta SPOR SUPPORT Unit, Faculty of Health Disciplines, Athabasca University, 1 University Drive, Athabasca, Alberta T9S 3A3 Canada
| | - Lisa Petermann
- Patient Engagement Platform, Alberta SPOR SUPPORT Unit, Faculty of Health Disciplines, Athabasca University, 1 University Drive, Athabasca, Alberta T9S 3A3 Canada
| | - Ping Mason-Lai
- Patient Engagement Platform, Alberta SPOR SUPPORT Unit, Faculty of Health Disciplines, Athabasca University, 1 University Drive, Athabasca, Alberta T9S 3A Canada
| | - Virgnia Vandall-Walker
- Patient Engagement Platform, Alberta SPOR SUPPORT Unit, Faculty of Health Disciplines, Athabasca University, 1 University Drive, Athabasca, Alberta T9S 3A Canada
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Graffigna G. Is a Transdisciplinary Theory of Engagement in Organized Settings Possible? A Concept Analysis of the Literature on Employee Engagement, Consumer Engagement and Patient Engagement. Front Psychol 2017; 8:872. [PMID: 28729843 PMCID: PMC5499260 DOI: 10.3389/fpsyg.2017.00872] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2017] [Accepted: 05/12/2017] [Indexed: 11/29/2022] Open
Abstract
Organizations are experiencing increased competition, disruptive innovation, and continuous changes in their social and economic context. Furthermore, the decrease of resources (economic and human) in such a demanding context make it imperative for organizations to find new models and strategies to make their service delivery more sustainable at the economic, environmental and psychological levels. In such a complex scenario the concept of engagement of the individuals involved in organized settings (either as service providers or as final receivers) is a promising lever for innovation. However, despite the number of studies on the matter, the debate on engagement is still very fragmented because the corpus of literature addressing the different areas of engagement is divided and diverse in its nature. In this paper, we discuss the results of a conceptual analysis of the literature conducted in order to investigate overlapping features and areas of divergence among three different areas of investigation and application of the engagement phenomenon in organized settings: the domains of employee engagement, consumer engagement, and patient engagement. These are deliberately selected as prototypical of the phenomenon of engagement along the "inside/outside" of organizational settings. The analysis consisted in a qualitative conceptual survey? Of the scholarly literature indexed with the key terms "employee engagement," "consumer engagement," and "patient engagement." We performed a key-word based survey? Of the literature in the Scopus database. A total of 163 articles were selected and analyzed. The analysis cast light on the following areas of conceptual overlap among employee, consumer and patient engagement: (1) engagement is different from empowerment and activation; (2) engagement is a multi-componential psychological experience; (3) engagement is a self-transformative experience; (4) engagement develops within a relational context; (5) engagement is a systemic phenomenon. These findings, although preliminary and in need of further investigation, suggest the feasibility of promoting a transdisciplinary reflection on the phenomenon of engagement in organized settings.
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