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Prieto-Centurion V, Holm KE, Casaburi R, Porszasz J, Basu S, Bracken NE, Gallardo R, Gonzalez V, Illendula SD, Sandhaus RA, Sullivan JL, Walsh LJ, Gerald LB, Krishnan JA. A Hybrid Effectiveness/Implementation Clinical Trial of Adherence to Long-Term Oxygen Therapy for Chronic Obstructive Pulmonary Disease. Ann Am Thorac Soc 2023; 20:1561-1570. [PMID: 37683098 PMCID: PMC10632931 DOI: 10.1513/annalsats.202302-104oc] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Accepted: 09/07/2023] [Indexed: 09/10/2023] Open
Abstract
Rationale: Interventions to promote adherence to long-term oxygen therapy (LTOT) in chronic obstructive pulmonary disease (COPD) are needed. Objectives: To examine the real-world effectiveness of phone-based peer coaching on LTOT adherence and other outcomes in a pragmatic trial of patients with COPD. Methods: In a hybrid effectiveness/implementation pragmatic trial, patients were randomized to receive phone-based proactive coaching (educational materials, five phone-based peer coaching sessions over 60 d), reactive coaching (educational materials, peer coaching when requested), or usual care. Study staff members collected baseline and outcome data via phone at 30, 60, and 90 days after randomization. Adherence to LTOT over 60 days, the primary effectiveness outcome, was defined as mean LTOT use ⩾17.7 h/d. LTOT use was calculated using information about home oxygen equipment use in worksheets completed by study participants. Comparisons of adherence to LTOT between each coaching group and the usual care group using multivariable logistic regression models were prespecified as the primary analyses. Secondary effectiveness outcomes included Patient Reported Outcome Management Information System measures for physical, emotional, and social health. We assessed early implementation domains in the reach, adoption, and implementation framework. Results: In 444 participants, the proportions who were adherent to LTOT at 60 days were 74% in usual care, 84% in reactive coaching, and 70% in proactive coaching groups. Although reach, adoption by stakeholder partners, and intervention fidelity were acceptable, complete LTOT adherence data were available in only 73% of participants. Reactive coaching (adjusted odds ratio, 1.77; 97.5% confidence interval, 0.80-3.90) and proactive coaching (adjusted odds ratio, 0.70; 97.5% confidence interval, 0.34-1.46) did not improve adherence to LTOT compared with usual care. However, proactive coaching significantly reduced depressive symptoms and sleep disturbance compared with usual care and reduced depressive symptoms compared with reactive coaching. Unexpectedly, LTOT adherence was significantly lower in the proactive compared with the reactive coaching group. Conclusions: The results were inconclusive about whether a phone-based peer coaching strategy changed LTOT adherence compared with usual care. Further studies are needed to confirm the potential benefits of proactive peer coaching on secondary effectiveness outcomes and differences in LTOT adherence between proactive and reactive peer coaching. Clinical trial registered with ClinicalTrials.gov (NCT02098369).
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Affiliation(s)
| | - Kristen E. Holm
- Department of Medicine, National Jewish Health, Denver, Colorado
- Department of Community and Behavioral Health, Colorado School of Public Health, Aurora, Colorado
| | - Richard Casaburi
- Lindquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, Torrance, California
| | - Janos Porszasz
- Lindquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, Torrance, California
| | | | - Nina E. Bracken
- Breathe Chicago Center, Division of Pulmonary, Critical Care, Sleep and Allergy
- Office of Population Health Sciences, Office of the Vice Chancellor for Health Affairs, University of Illinois Chicago, Chicago, Illinois
| | - Richard Gallardo
- Alzheimer’s Therapeutic Research Institute, San Diego, California
| | - Vanessa Gonzalez
- School of Public Health, and
- American Academy of Sleep Medicine Foundation, Darien, Illinois; and
| | - Sai D. Illendula
- Breathe Chicago Center, Division of Pulmonary, Critical Care, Sleep and Allergy
- Office of Population Health Sciences, Office of the Vice Chancellor for Health Affairs, University of Illinois Chicago, Chicago, Illinois
| | | | | | | | - Lynn B. Gerald
- Breathe Chicago Center, Division of Pulmonary, Critical Care, Sleep and Allergy
- Office of Population Health Sciences, Office of the Vice Chancellor for Health Affairs, University of Illinois Chicago, Chicago, Illinois
| | - Jerry A. Krishnan
- Breathe Chicago Center, Division of Pulmonary, Critical Care, Sleep and Allergy
- Office of Population Health Sciences, Office of the Vice Chancellor for Health Affairs, University of Illinois Chicago, Chicago, Illinois
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Cimino J, Braun C. Design a Clinical Research Protocol: Influence of Real-World Setting. Healthcare (Basel) 2023; 11:2254. [PMID: 37628452 PMCID: PMC10454664 DOI: 10.3390/healthcare11162254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Revised: 08/03/2023] [Accepted: 08/09/2023] [Indexed: 08/27/2023] Open
Abstract
The design of a clinical research protocol to evaluate new therapies, devices, patient quality of life, and medical practices from scratch is probably one of the greatest challenges for the majority of novice researchers. This is especially true since a high-quality methodology is required to achieve success and effectiveness in academic and hospital research centers. This review discusses the concrete steps and necessary guidelines needed to create and structure a research protocol. Along with the methodology, some administrative challenges (ethics, regulatory and people-management barriers) and possible time-saving recommendations (standardized procedures, collaborative training, and centralization) are discussed.
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Affiliation(s)
- Jonathan Cimino
- Clinical Research Unit, Fondation Hôpitaux Robert Schuman, 44 Rue d’Anvers, 1130 Luxembourg, Luxembourg;
- Hôpitaux Robert Schuman, 9 Rue Edward Steichen, 2540 Luxembourg, Luxembourg
| | - Claude Braun
- Clinical Research Unit, Fondation Hôpitaux Robert Schuman, 44 Rue d’Anvers, 1130 Luxembourg, Luxembourg;
- Hôpitaux Robert Schuman, 9 Rue Edward Steichen, 2540 Luxembourg, Luxembourg
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Lina I, Berges A, Ospino R, Motz K, Davis R, Anderson C, Stroud M, Rodweller C, Gelbard A, Hillel AT. A survey of patients with laryngotracheal stenosis on future clinical trial design. Clin Trials 2022; 19:194-200. [PMID: 34991364 DOI: 10.1177/17407745211065744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND/AIMS Laryngotracheal stenosis is a rare but devastating proximal airway fibrosis that restricts a patient's ability to breathe. Treatment is primarily surgical and to date, there has never been a multi-institutional, randomized, prospective, and interventional clinical trial for a medical therapy to treat laryngotracheal stenosis. Therefore, we aimed to obtain patient feedback to guide successful trial design, recruitment, retention, and for identifying potential barriers to study participation. METHODS Over 1000 members of an international laryngotracheal stenosis online support community (the Living with Idiopathic Subglottic Stenosis Facebook group) were sent two questionnaires for a proposed interventional double-blinded, randomized, placebo-controlled clinical trial. RESULTS A total of 317 and 558 participants responded to the first and second surveys, respectively. The majority of participants (77%) were willing to consider enrollment, regardless of having a 50% chance of receiving placebo versus treatment (78%). The majority (84%) of participants were willing to travel 200 miles to participate for up to six in-person visits over 50 days. Specific side effects, including anemia/thrombocytopenia (72%) or risk of infection (69.3%) had the greatest impact on clinical trial participation with other side effects (peripheral edema (53%), oral ulcers (51%), and gastrointestinal side effects (41%)) having less impact. CONCLUSION Patients with laryngotracheal stenosis possess nuanced insight into their disease and treatment options. As a group, they are extremely motivated for better therapies. Future laryngotracheal stenosis clinical trials should focus on providing excellent side effect -related education and utilizing feedback from online advocacy groups to optimize recruitment and retention.
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Affiliation(s)
- Ioan Lina
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins Medical Institutions, Baltimore, MD, USA
| | - Alexandra Berges
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins Medical Institutions, Baltimore, MD, USA
| | - Rafael Ospino
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins Medical Institutions, Baltimore, MD, USA
| | - Kevin Motz
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins Medical Institutions, Baltimore, MD, USA
| | - Ruth Davis
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins Medical Institutions, Baltimore, MD, USA
| | - Catherine Anderson
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins Medical Institutions, Baltimore, MD, USA
| | - Mary Stroud
- Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Casey Rodweller
- Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Alexander Gelbard
- Department of Otolaryngology-Head and Neck Surgery, Vanderbilt University School of Medicine, Nashville, TN, USA
| | - Alexander T Hillel
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins Medical Institutions, Baltimore, MD, USA
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Gruß I, McCreary GM, Ivlev I, Houlihan ME, Yawn BP, Pasquale C, Clark W, Mularski RA. Developing a patient-driven chronic obstructive pulmonary disease (COPD) research agenda in the U.S. J Patient Rep Outcomes 2021; 5:126. [PMID: 34865193 PMCID: PMC8643383 DOI: 10.1186/s41687-021-00399-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Accepted: 11/15/2021] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND To document a generalizable process for developing a patient-prioritized chronic obstructive pulmonary disease (COPD) research agenda and to provide an overview of domains that were developed in response to people living with COPD and caregivers' suggestions for research. METHODS Adults with COPD and caregivers who are members of the COPD Patient-Powered Research Network (PPRN) provided suggestions for COPD-related research through a self-administered, online survey. These responses were analyzed with a content analysis approach: domains for categorizing all survey responses were created, then all responses were categorized independently by a group of researchers, then these categorizations were adjudicated, and finally a density map was created that represented the number of responses in each of the domains. RESULTS At the time of analysis, 6157 adults had fully completed the baseline survey. Survey responses were categorized across seven domains as follows: 22.5% of all responses fell into the domain family/social/community research, 20.8% of all responses fell into the domain well-being, 15% of all responses fell into the domain curative research, 14.6% of all responses fell into the domain biomedical therapies, 10.5% of all responses fell into the domain policy concerns, 6% of all responses fell into the domain holistic therapies and 10.7% of all responses fell into the domain ambiguous comments that could not be translated into concrete research topics. CONCLUSION Using qualitative open-ended survey responses from the COPD PPRN registrants, we were able to identify six key domains of research about COPD that are considered most important by patients. These domains differ in content from prior scientist-led efforts to develop priorities for COPD research, demonstrating the ongoing importance of involving patients and their caregivers in determining research priorities. The results suggest the field can more closely align research efforts to patient priorities by considering the identified domains.
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Affiliation(s)
- Inga Gruß
- Kaiser Permanente Center for Health Research, 3800 N. Interstate Ave, Portland, OR, 97227, USA.
| | | | - Ilya Ivlev
- Kaiser Permanente Center for Health Research, 3800 N. Interstate Ave, Portland, OR, 97227, USA
| | | | - Barbara P Yawn
- COPD Foundation, 3300 Ponce de Leon Blvd, Miami, FL, 33134, USA
- University of Minnesota, 6500 Delaware, Minneapolis, MN, 55449, USA
| | - Cara Pasquale
- COPD Foundation, 3300 Ponce de Leon Blvd, Miami, FL, 33134, USA
| | - William Clark
- COPD Foundation, 3300 Ponce de Leon Blvd, Miami, FL, 33134, USA
| | - Richard A Mularski
- Kaiser Permanente Center for Health Research, 3800 N. Interstate Ave, Portland, OR, 97227, USA
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Roennow A, Sauvé M, Welling J, Riggs RJ, Kennedy AT, Galetti I, Brown E, Leite C, Gonzalez A, Portales Guiraud AP, Houÿez F, Camp R, Gilbert A, Gahlemann M, Moros L, Luna Flores JL, Schmidt F, Sauter W, Finnern H. Collaboration between patient organisations and a clinical research sponsor in a rare disease condition: learnings from a community advisory board and best practice for future collaborations. BMJ Open 2020; 10:e039473. [PMID: 33328257 PMCID: PMC7745690 DOI: 10.1136/bmjopen-2020-039473] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Introduction Transparent collaborations between patient organisations (POs) and clinical research sponsors (CRS) can identify and address the unmet needs of patients and caregivers. These insights can improve clinical trial participant experience and delivery of medical innovations necessary to advance health outcomes and standards of care. We share our experiences from such a collaboration undertaken surrounding the SENSCIS® clinical trial (NCT02597933), and discuss its impact during, and legacy beyond, the trial.Summary We describe the establishment of a community advisory board (CAB): a transparent, multiyear collaboration between the scleroderma patient community and a CRS. We present shared learnings from the collaboration, which is split into three main areas: (1) the implementation and conduct of the clinical trial; (2) analysis and dissemination of the results; and (3) aspects of the collaboration not related to the trial.1. The scleroderma CAB reviewed and provided advice on trial conduct and reporting. This led to the improvement and optimisation of trial procedures; meaningful, patient-focused adaptations were made to address challenges relevant to scleroderma-associated interstitial lung disease patients.2. To ensure that results of the trial were accessible to lay audiences and patients, written lay summaries were developed by the trial sponsor with valuable input from the CAB to ensure that language and figures were understandable.3. The CAB and the CRS also collaborated to co-develop opening tools for medication blister packs and bottles. In addition, to raise disease awareness among physicians, patients and caregivers, educational materials to improve diagnosis and management of scleroderma were co-created and delivered by the CAB and CRS.Conclusions This collaboration between POs and a CRS, in a rare disease condition, led to meaningful improvements in patient safety, comfort and self-management and addressed information needs. This collaboration may serve as a template of best practice for future collaborations between POs, research sponsors and other healthcare stakeholders.
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Affiliation(s)
- Annelise Roennow
- Federation of European Scleroderma Associations aisbl, Saint-Maur, Belgium
- Sklerodermiforening, Rødovre, Denmark
| | | | - Joep Welling
- Federation of European Scleroderma Associations aisbl, Saint-Maur, Belgium
| | - Robert J Riggs
- Scleroderma Foundation, Inc, Danvers, Massachusetts, USA
| | | | - Ilaria Galetti
- Federation of European Scleroderma Associations aisbl, Saint-Maur, Belgium
- Gruppo Italiano per la Lotta alla Sclerodermia, Milan, Italy
| | | | - Catarina Leite
- Portuguese Association of Patients with Scleroderma, Monção, Portugal
| | - Alex Gonzalez
- Scleroderma Research Foundation, San Francisco, California, USA
| | | | | | - Rob Camp
- EURORDIS-Rare Diseases Europe, Barcelona, Spain
| | | | | | - Lizette Moros
- Boehringer Ingelheim International GmbH, Ingelheim am Rhein, Rheinland-Pfalz, Germany
| | - Jose Luis Luna Flores
- Boehringer Ingelheim International GmbH, Ingelheim am Rhein, Rheinland-Pfalz, Germany
| | - Friedrich Schmidt
- Boehringer Ingelheim International GmbH, Ingelheim am Rhein, Rheinland-Pfalz, Germany
| | - Wiebke Sauter
- Boehringer Ingelheim Pharma GmbH and Co KG Biberach, Biberach, Baden-Württemberg, Germany
| | - Henrik Finnern
- Boehringer Ingelheim International GmbH, Ingelheim am Rhein, Rheinland-Pfalz, Germany
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Goodlett D, Hung A, Feriozzi A, Lu H, Bekelman JE, Mullins CD. Site engagement for multi-site clinical trials. Contemp Clin Trials Commun 2020; 19:100608. [PMID: 32685765 PMCID: PMC7358177 DOI: 10.1016/j.conctc.2020.100608] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Revised: 06/15/2020] [Accepted: 06/28/2020] [Indexed: 11/26/2022] Open
Abstract
Multi-site clinical trials are essential within medical practice to help drive reliable and generalizable knowledge on advancing medical treatments. Although the success of multi-site trials is significantly dependent on local clinician and site research teams, best practices for engagement of site teams, or "site engagement," has not been extensively discussed. Site engagement centers on including sites in the planning and implementation of clinical trials to promote trial enrollment, compliance, and applicability to local contexts. Using a case example from the RadComp Trial, a longitudinal, multi-site clinical trial, novel site engagement practices are provided across three major research phases. In the Planning Phase, site engagement builds partnerships and commitment by active elicitation of information on site specific processes and feedback on trial design. In the Conducting Phase, sustained engagement encourages bi-directional communication and facilitates learning networks for enhanced site performance. In the Dissemination Phase, site and community partnerships are leveraged to create locally designed dissemination plans for broader scientific reach and impact. Site engagement practices discussed in this paper can be replicated or molded for application in other multi-site clinical trials.
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Affiliation(s)
- Dana Goodlett
- Department of Radiation Oncology, Perelman School of Medicine, University of Pennsylvania, 3400 Civic Center Blvd, Philadelphia, PA, 19104, USA
| | - Anna Hung
- Center for Informing Health Decisions, Duke Clinical Research Institute, Duke University, 200 Morris Street, Durham, NC, 27701, USA
| | - Ashley Feriozzi
- Department of Radiation Oncology, Perelman School of Medicine, University of Pennsylvania, 3400 Civic Center Blvd, Philadelphia, PA, 19104, USA
| | - Hien Lu
- Department of Radiation Oncology, Perelman School of Medicine, University of Pennsylvania, 3400 Civic Center Blvd, Philadelphia, PA, 19104, USA
| | - Justin E. Bekelman
- Department of Radiation Oncology, Perelman School of Medicine, University of Pennsylvania, 3400 Civic Center Blvd, Philadelphia, PA, 19104, USA
| | - C. Daniel Mullins
- Department of Pharmaceutical Health Services Research, University of Maryland School of Pharmacy, 220 Arch Street, Baltimore, MD, 21201, USA
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Patient Experience in Home Respiratory Therapies: Where We Are and Where to Go. J Clin Med 2019; 8:jcm8040555. [PMID: 31022916 PMCID: PMC6518292 DOI: 10.3390/jcm8040555] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2019] [Revised: 04/22/2019] [Accepted: 04/23/2019] [Indexed: 12/16/2022] Open
Abstract
The increasing number of patients receiving home respiratory therapy (HRT) is imposing a major impact on routine clinical care and healthcare system sustainability. The current challenge is to continue to guarantee access to HRT while maintaining the quality of care. The patient experience is a cornerstone of high-quality healthcare and an emergent area of clinical research. This review approaches the assessment of the patient experience in the context of HRT while highlighting the European contribution to this body of knowledge. This review demonstrates that research in this area is still limited, with no example of a prescription model that incorporates the patient experience as an outcome and no specific patient-reported experience measures (PREMs) available. This work also shows that Europe is leading the research on HRT provision. The development of a specific PREM and the integration of PREMs into the assessment of prescription models should be clinical research priorities in the next several years.
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Characteristics at the time of oxygen initiation associated with its adherence: Findings from the COPD Long-term Oxygen Treatment Trial. Respir Med 2019; 149:52-58. [PMID: 30803886 DOI: 10.1016/j.rmed.2019.02.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Revised: 01/22/2019] [Accepted: 02/02/2019] [Indexed: 02/04/2023]
Abstract
RATIONALE Characteristics associated with adherence to long-term oxygen therapy (LTOT) in COPD remain unclear. OBJECTIVES To identify patient characteristics at the time of oxygen initiation associated with its adherence. METHODS We conducted a secondary analysis of data from 359 COPD participants assigned to oxygen in the Long-term Oxygen Treatment Trial. Participants were prescribed continuous (n = 214) or intermittent (n = 145) oxygen based on desaturation patterns at study entry. At the time of initial prescription, participants rated their perceived readiness, confidence, and importance to use oxygen on a 0-10 scale (0 = not at all, 10 = very much). During follow-up, they self-reported average hours per day of use (adherence). Adherence was averaged over short-term (0-30 days), medium-term (months 9-12), and long-term (month 13 to last follow-up) intervals. Multivariable logistic regression models explored characteristics associated with high adherence (≥16 h/day [continuous] or ≥8 h/day [intermittent]) during each time interval. RESULTS Participant readiness, confidence, and importance at the time of oxygen initiation were associated with high short- and medium-term adherence. For each unit increase in baseline readiness, the odds of high short-term adherence increased by 21% (odds ratio [OR] 1.21, 95% confidence interval [CI] 1.05-1.40) and 94% (OR 1.94, 95% CI 1.45-2.59) in the continuous and intermittent groups, respectively. In both groups, high adherence in the medium-term was associated with high adherence in the long-term (continuous, OR 12.49, 95% CI 4.90-31.79; intermittent, OR 38.08, 95% CI 6.96-208.20). CONCLUSIONS Readiness, confidence, and importance to use LTOT at initiation, and early high adherence, are significantly associated with long-term oxygen adherence.
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Talebizadeh Z, Shah A. Building a Bridge Between Genetics and Outcomes Research: Application in Autism (The AutGO Study). PATIENT-PATIENT CENTERED OUTCOMES RESEARCH 2019; 11:451-462. [PMID: 29508356 PMCID: PMC6019410 DOI: 10.1007/s40271-018-0302-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
BACKGROUND Concerns over the need to improve translational aspects of genetics research studies and engaging community members in the research process have been noted in the literature and raised by patient advocates. In addition to the work done by patient advocacy groups, organizations such as the Patient-Centered Outcomes Research Institute advocate for a change in the culture of research from being researcher-driven to becoming more patient-driven. OBJECTIVE Our project, Autism Genetics and Outcomes (AutGO), consists of two phases. The goal for phase I was to initiate a general discussion around the main topic (i.e., linking genetics and outcomes research). We used the Patient-Centered Outcomes Research Institute engagement approach to: (aim 1) develop a partnership with a wide range of stakeholders to assess their perspective on developing projects that use both genetics and outcomes research data/principles; (aim 2) identify barriers, facilitators, and needs to promote engagement in patient-centered genetics research; and (aim 3) distill and describe actions that may facilitate utilization of patient/parent perspectives in designing genetics research studies. METHODS In phase I, we formed a community advisory board composed of 33 participants, including outcomes and genetics researchers, clinicians, healthcare providers, patients/family members, and community/industry representatives, and convened six sessions over the 12-month period. We structured the sessions as a combination of online PowerPoint presentations, surveys, and in-person group discussions. During the sessions, we discussed topics pertaining to linking genetics and outcomes research and reviewed relevant materials, including patient stories, research projects, and existing resources. RESULTS Two sets of surveys, project evaluations (k = 2) and session evaluations (k = 6), were distributed among participants. Feedback was analyzed using content analysis strategies to identify the themes and subthemes. Herein, we describe: the established partnership (aim 1), the identified barriers, facilitators, and needs (aim 2), as well as the lessons learned and suggested recommendations for the research community (aim 3). Following phase I participants' recommendation, in phase II, we will focus on a specific disease (i.e., autism); this projected plan is briefly outlined to highlight the overarching goal of the project and its potential significance. We also discuss the study limitations, challenges for conducting this type of multidisciplinary work, as well as potential ways to address them. CONCLUSIONS The AutGO project has created a unique collaborative forum to facilitate the much needed dialogue between genetics and outcomes researchers, which may contribute to finding ways to improve the translational aspects of genetics research studies.
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Affiliation(s)
- Zohreh Talebizadeh
- Children's Mercy Hospital, 2401 Gillham Road, Kansas City, MO, 64108, USA. .,University of Missouri-Kansas City School of Medicine, Kansas City, MO, USA.
| | - Ayten Shah
- Children's Mercy Hospital, 2401 Gillham Road, Kansas City, MO, 64108, USA
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Harrison JD, Anderson WG, Fagan M, Robinson E, Schnipper J, Symczak G, Hanson C, Carnie MB, Banta J, Chen S, Duong J, Wong C, Auerbach AD. Patient and Family Advisory Councils (PFACs): Identifying Challenges and Solutions to Support Engagement in Research. THE PATIENT 2018; 11:413-423. [PMID: 29392529 PMCID: PMC11034744 DOI: 10.1007/s40271-018-0298-4] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVE The aim was to describe barriers to patient and family advisory council (PFAC) member engagement in research and strategies to support engagement in this context. METHODS We formed a study team comprising patient advisors, researchers, physicians, and nurses. We then undertook a qualitative study using focus groups and interviews. We invited PFAC members, PFAC leaders, hospital leaders, and researchers from nine academic medical centers that are part of a hospital medicine research network to participate. All participants were asked a standard set of questions exploring the study question. We used content analysis to analyze data. RESULTS Eighty PFAC members and other stakeholders (45 patient/caregiver members of PFACs, 12 PFAC leaders, 12 hospital leaders, 11 researchers) participated in eight focus and 19 individual interviews. We identified ten barriers to PFAC member engagement in research. Codes were organized into three categories: (1) individual PFAC member reluctance; (2) lack of skills and training; and (3) problems connecting with the right person at the right time. We identified ten strategies to support engagement. These were organized into four categories: (1) creating an environment where the PFAC members are making a genuine and unique contribution; (2) building community between PFAC members and researchers; (3) best practice activities for researchers to facilitate engagement; and (4) tools and training. CONCLUSION Barriers to engaging PFAC members in research include patients' negative perceptions of research and researchers' lack of training. Building community between PFAC members and researchers is a foundation for partnerships. There are shared training opportunities for PFAC members and researchers to build skills about research and research engagement.
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Affiliation(s)
- James D Harrison
- Division of Hospital Medicine, University of California San Francisco, 533 Parnassus Avenue, San Francisco, CA, 94143, USA.
| | - Wendy G Anderson
- Division of Hospital Medicine, University of California San Francisco, 533 Parnassus Avenue, San Francisco, CA, 94143, USA
| | - Maureen Fagan
- Center for Patients and Families, Brigham and Women's Hospital, Boston, MA, USA
| | - Edmondo Robinson
- Department of Medicine, Christiana Care Health System, Wilmington, DE, USA
| | - Jeffrey Schnipper
- Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA
| | - Gina Symczak
- Intensive Care Unit Patient and Family Advisory Council, University of California San Francisco, San Francisco, CA, USA
| | - Catherine Hanson
- University of Michigan Local Patient and Stakeholder Council, Ann Arbor, MI, USA
| | - Martha B Carnie
- Center for Patients and Families, Brigham and Women's Hospital, Boston, MA, USA
| | - Jim Banta
- Intensive Care Unit Patient and Family Advisory Council, University of California San Francisco, San Francisco, CA, USA
| | - Sherry Chen
- Division of Hospital Medicine, University of California San Francisco, 533 Parnassus Avenue, San Francisco, CA, 94143, USA
| | - Jonathan Duong
- Division of Hospital Medicine, University of California San Francisco, 533 Parnassus Avenue, San Francisco, CA, 94143, USA
| | - Celene Wong
- Center for Patients and Families, Brigham and Women's Hospital, Boston, MA, USA
| | - Andrew D Auerbach
- Division of Hospital Medicine, University of California San Francisco, 533 Parnassus Avenue, San Francisco, CA, 94143, USA
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11
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Morain SR, Whicher DM, Kass NE, Faden RR. Deliberative Engagement Methods for Patient-Centered Outcomes Research. PATIENT-PATIENT CENTERED OUTCOMES RESEARCH 2018; 10:545-552. [PMID: 28374286 DOI: 10.1007/s40271-017-0238-8] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
There is growing emphasis on eliciting and incorporating stakeholder perspectives into health research and public policy development. The deliberative engagement session (DES) method provides one approach to elicit informed preferences from patients and other stakeholders on policy issues. DES involves day-long interaction with participants, including short plenary presentations followed by small group discussion. While interest in DES methods is expanding, practical guidance for researchers on this method remains limited. In this paper, we describe the DES method and its contemporary relevance for health policy research, illustrate how to conduct a DES using an example of a recent patient-centered outcomes research (PCOR) study with which we were involved, and discuss strengths and challenges of using this approach. DES methods generate rich data, reduce the risk of eliciting uniformed preferences or non-attitudes, and increase the likelihood of eliciting informed, reflective preferences. However, they are resource-intensive, and thus generally require trading away a larger, more representative sample. Despite these limitations, the DES method, when carefully designed, is well-suited for engaging stakeholders in research on complex health policy issues.
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Affiliation(s)
- Stephanie R Morain
- Center for Medical Ethics and Health Policy, Baylor College of Medicine, One Baylor Plaza, Suite 310D, Houston, TX, 77030, USA.
| | - Danielle M Whicher
- Patient Centered Outcomes Research Institute, 1919 M Street, NW, Suite 250, Washington, DC, 20036, USA
| | - Nancy E Kass
- Johns Hopkins Berman Institute of Bioethics and Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, 1809 Ashland Ave, Baltimore, MD, 21205, USA
| | - Ruth R Faden
- Johns Hopkins Berman Institute of Bioethics, 1809 Ashland Ave, Baltimore, MD, 21205, USA
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Abstract
Patients are increasingly recognised as the true customers of healthcare. By providing insights and perspectives, patients can help the wider healthcare community better understand their needs and ultimately enhance the value of healthcare solutions being developed. In the development of new medicines, for example, meaningful patient engagement can enable the pharmaceutical industry, healthcare providers and other stakeholders to achieve more meaningful health outcomes. While both the pharmaceutical industry and regulators have achieved some progress in incorporating patient perspectives into their activities, the lack of standardised best practices and metrics has made it challenging to achieve consistency and measure success in patient engagement. Practical guidance for patient engagement can facilitate better interactions between patients or patient groups and other collaborators, e.g. industry, regulators and other healthcare stakeholders. Accordingly, UCB has developed an internal model for Patient Group Engagement incorporating four key principles, based on shared ambition, transparency, accountability and respect, essential for effective collaborations.
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