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Razzaque R, Mckenzie E. Introducing Compassionate and Relational Enquiry (CARE): A Three-Day Training for Mental Health Clinicians on Relational Ways of Working. Community Ment Health J 2024; 60:1037-1041. [PMID: 38634977 DOI: 10.1007/s10597-024-01272-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Accepted: 03/25/2024] [Indexed: 04/19/2024]
Abstract
Research shows that, in mental healthcare, empathy and active listening skills play a fundamental role in the therapeutic relationship. Despite this, clinicians receive little training in cultivating these qualities, and there is a dearth of training in therapeutic relationships and relational care in this field more generally. In response to this paucity of training, a new intensive three-day training programme has been developed called Compassionate and Relational Enquiry (CARE). The CARE training programme has recently been delivered to a number of mental health teams in different boroughs of an NHS Trust and has undergone several rounds of redevelopment. This paper outlines the CARE training programme's objectives and mode of delivery, and subsequently presents questionnaire results from recent CARE trainees regarding their experience of the nature and utility of the training. Four main themes emerged from responses to the question of the utility of the training, these were 'A shift towards more person-centred care', 'Strengthens the therapeutic relationship', 'Facilitates more collaborative care with patients and their families' and 'Development of new skills and therapeutic techniques'. The paper concludes by discussing the potential of this training to help forge a substantial shift in the culture of mental health services in a systemic way.
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Affiliation(s)
| | - Emma Mckenzie
- North East London NHS Foundation Trust, London, UK.
- Centre for Outcomes Research and Effectiveness, Research Department of Clinical, Educational and Health Psychology, University College London, London, UK.
- Research and Development Department, 1st Floor Maggie Lilley Suite Goodmayes Hospital Barley Lane, Ilford, IG3 8XJ, UK.
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Swaithes L, Campbell L, Anthierens S, Skrybant M, Schiphof D, French H, de Wit M, Blackburn S, Dziedzic K. Series: Public engagement with research. Part 4: Maximising the benefits of involving the public in research implementation. Eur J Gen Pract 2023; 29:2243037. [PMID: 37609798 PMCID: PMC10448833 DOI: 10.1080/13814788.2023.2243037] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Revised: 07/03/2023] [Accepted: 07/25/2023] [Indexed: 08/24/2023] Open
Abstract
This final article in the four-part series focuses on the often neglected yet important role of the public in implementing research in General Practice and Primary Care more broadly. Experience in implementation of findings from research with public engagement in Primary Care has highlighted how partnership working with patients and the public is important in transitioning from 'what we know' from the evidence-base to 'what we do' in practice. Factors related to Primary Care research that make public engagement important are highlighted e.g. implementing complex interventions, implementing interventions that increase health equity, implementing interventions in countries with different primary healthcare system strengths. Involvement of patients and public can enhance the development of modelling and simulation included in studies on systems modelling for improving health services. We draw on the emerging evidence base to describe public engagement in implementation and offer some guiding principles for engaging with the public in the implementation in General Practice and Primary Care in general. Illustrative case studies are included to support others wishing to offer meaningful engagement in implementing research evidence.
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Affiliation(s)
- Laura Swaithes
- Impact Accelerator Unit, Versus Arthritis Primary Care Centre, School of Medicine, Keele University, Staffordshire, United Kingdom
| | - Laura Campbell
- Impact Accelerator Unit, Versus Arthritis Primary Care Centre, School of Medicine, Keele University, Staffordshire, United Kingdom
| | - Sibyl Anthierens
- Department of Family Medicine and Population Health, University of Antwerpen, Antwerpen, Belgium
| | - Magdalena Skrybant
- National Institute of Applied Health Research Applied Research Collaboration West Midlands, Institute of Applied Health, University of Birmingham, Edgbaston, United Kingdom
| | - Dieuwke Schiphof
- Department of General Practice, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Helen French
- School of Physiotherapy, Royal College of Surgeons in Ireland University of Medicine and Health Sciences, Dublin, Ireland
| | - Maarten de Wit
- Patient Research Partner, Stichting Tools, The Netherlands
| | - Steven Blackburn
- Institute of Applied Health Research, University of Birmingham, Birmingham, United Kingdom
| | - Krysia Dziedzic
- Impact Accelerator Unit, Versus Arthritis Primary Care Centre, School of Medicine, Keele University, Staffordshire, United Kingdom
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Moss N, Bueno-Cavanillas A, Cano-Ibáñez N, Khan KS. Evidence-based medicine needs patient and public involvement to remain relevant: A proposal for a new curriculum. Semergen 2023; 49:101877. [PMID: 36434965 DOI: 10.1016/j.semerg.2022.101877] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Revised: 10/18/2022] [Accepted: 10/19/2022] [Indexed: 11/27/2022]
Abstract
INTRODUCTION Public partnerships, a route to sharing expertise, networks and resources anchored in the United Nations Sustainable Development Goals, has been championed by multiple stakeholders. OBJECTIVE To propose a new evidence-based medicine (EBM) curriculum for harnessing patient and public expertise to ensure that EBM teaching and learning can become more relevant and impactful. METHODS A curriculum development group comprising of EBM teachers, patient and public involvement representatives, clinicians, clinical epidemiologists, public health experts and educationalists, with experience of delivering and evaluating face-to-face and online EBM courses across many countries and continents, prepared a new EBM course. RESULTS A student-centred, problem-based and clinically integrated course for teaching and learning EBM was developed. In the spirit of shared decision-making, practitioners can learn to support patients, articulate their perspectives, recognise the need for their contribution and ensure community involvement when generating and applying evidence. With end users in mind, the application of research findings, delivery of care and EBM effectiveness in the workplace would carry increased priority. CONCLUSIONS Embracing patients as EBM collaborators can help deliver cognitive diversity and inspire different ways of thinking and working. Adopting the proposed approach in EBM education lays the foundations for a joint practitioner-patient partnership to ask, acquire, appraise and apply EBM in a more holistic context which will strengthen the EBM proposition.
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Affiliation(s)
- N Moss
- Katie's Team Patient and Public Involvement Advisory Group, Wolfson Institute of Population Health, Queen Mary University of London, United Kingdom; Elly Charity, East London International Women's Health Charity, United Kingdom
| | - A Bueno-Cavanillas
- Department of Preventive Medicine and Public Health; University of Granada, Granada, Spain; Centro de Investigación Biomédica en Red Epidemiología y Salud Pública (CIBERESP), Institute of Health Carlos III, Madrid, Spain; Instituto de Investigación Biosanitaria de Granada (ibs.GRANADA), Granada, Spain
| | - N Cano-Ibáñez
- Department of Preventive Medicine and Public Health; University of Granada, Granada, Spain; Centro de Investigación Biomédica en Red Epidemiología y Salud Pública (CIBERESP), Institute of Health Carlos III, Madrid, Spain; Instituto de Investigación Biosanitaria de Granada (ibs.GRANADA), Granada, Spain.
| | - K S Khan
- Department of Preventive Medicine and Public Health; University of Granada, Granada, Spain
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Vanstone M, Canfield C, Evans C, Leslie M, Levasseur MA, MacNeil M, Pahwa M, Panday J, Rowland P, Taneja S, Tripp L, You J, Abelson J. Towards conceptualizing patients as partners in health systems: a systematic review and descriptive synthesis. Health Res Policy Syst 2023; 21:12. [PMID: 36698200 PMCID: PMC9876419 DOI: 10.1186/s12961-022-00954-8] [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: 07/15/2022] [Accepted: 12/23/2022] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND With the sharp increase in the involvement of patients (including family and informal caregivers) as active participants, collaborators, advisors and decision-makers in health systems, a new role has emerged: the patient partner. The role of patient partner differs from other forms of patient engagement in its longitudinal and bidirectional nature. This systematic review describes extant work on how patient partners are conceptualized and engaged in health systems. In doing so, it furthers the understanding of the role and activities of patient partners, and best practices for future patient partnership activities. METHODS A systematic review was conducted of peer-reviewed literature published in English or French that describes patient partner roles between 2000 and 2021 in any country or sector of the health system. We used a broad search strategy to capture descriptions of longitudinal patient engagement that may not have used words such as "partner" or "advisor". RESULTS A total of 506 eligible papers were identified, representing patient partnership activities in mostly high-income countries. These studies overwhelmingly described patient partnership in health research. We identified clusters of literature about patient partnership in cancer and mental health. The literature is saturated with single-site descriptive studies of patient partnership on individual projects or initiatives. There is a lack of work synthesizing impacts, facilitating factors and outcomes of patient partnership in healthcare. CONCLUSIONS There is not yet a consolidated understanding of the role, activities or impacts of patient partners. Advancement of the literature has been stymied by a lack of consistently used terminology. The literature is ready to move beyond single-site descriptions, and synthesis of existing pockets of high-quality theoretical work will be essential to this evolution.
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Affiliation(s)
- Meredith Vanstone
- grid.25073.330000 0004 1936 8227Department of Family Medicine, McMaster University, 1280 Main St W, Hamilton, ON L8S 4K1 Canada ,grid.25073.330000 0004 1936 8227Centre for Health Economics and Policy Analysis (CHEPA), McMaster University, 1280 Main St W, Hamilton, ON L8S 4K1 Canada
| | - Carolyn Canfield
- Patient Advisors Network (PAN), Toronto, ON Canada ,grid.17091.3e0000 0001 2288 9830Department of Family Practice, University of British Columbia, 5950 University Boulevard, Vancouver, BC V6T 1Z3 Canada
| | - Cara Evans
- grid.25073.330000 0004 1936 8227Health Policy PhD Program, McMaster University, 1280 Main St W, Hamilton, ON L8S 4K1 Canada
| | - Myles Leslie
- grid.22072.350000 0004 1936 7697School of Public Policy, University of Calgary, 906 8Th Avenue S.W., Calgary, AB T2P1H9 Canada
| | | | - Maggie MacNeil
- grid.25073.330000 0004 1936 8227Centre for Health Economics and Policy Analysis (CHEPA), McMaster University, 1280 Main St W, Hamilton, ON L8S 4K1 Canada
| | - Manisha Pahwa
- grid.25073.330000 0004 1936 8227Health Policy PhD Program, McMaster University, 1280 Main St W, Hamilton, ON L8S 4K1 Canada ,grid.419887.b0000 0001 0747 0732Occupational Cancer Research Centre, Cancer Care Ontario, Ontario Health, 505 University Avenue, Toronto, ON Canada
| | - Janelle Panday
- grid.25073.330000 0004 1936 8227Department of Family Medicine, McMaster University, 1280 Main St W, Hamilton, ON L8S 4K1 Canada
| | - Paula Rowland
- grid.17063.330000 0001 2157 2938Wilson Centre and Department of Occupational Science and Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, Canada 1 King’s College Circle, Toronto, ON M5S 1A8 Canada
| | - Shipra Taneja
- grid.25073.330000 0004 1936 8227Department of Family Medicine, McMaster University, 1280 Main St W, Hamilton, ON L8S 4K1 Canada
| | - Laura Tripp
- grid.25073.330000 0004 1936 8227Department of Health Research Methods, Evidence and Impact, McMaster University, 1280 Main St W, Hamilton, ON L8S 4K1 Canada
| | - Jeonghwa You
- grid.25073.330000 0004 1936 8227Health Policy PhD Program, McMaster University, 1280 Main St W, Hamilton, ON L8S 4K1 Canada
| | - Julia Abelson
- grid.25073.330000 0004 1936 8227Centre for Health Economics and Policy Analysis (CHEPA), McMaster University, 1280 Main St W, Hamilton, ON L8S 4K1 Canada ,grid.25073.330000 0004 1936 8227Department of Health Research Methods, Evidence and Impact, McMaster University, 1280 Main St W, Hamilton, ON L8S 4K1 Canada
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Bertorello D, Brichetto G, Folkvord F, Theben A, Zaratin P. A Systematic Review of Patient Engagement Experiences in Brain Disorders. Patient Relat Outcome Meas 2022; 13:259-272. [DOI: 10.2147/prom.s256396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Accepted: 11/12/2022] [Indexed: 12/14/2022] Open
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Graffigna G, Barello S. How does patient engagement work in a real-world setting? Recommendations, caveats, and challenges from a psychosocial perspective. PATIENT EDUCATION AND COUNSELING 2022; 105:3567-3573. [PMID: 36008187 DOI: 10.1016/j.pec.2022.08.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Revised: 08/12/2022] [Accepted: 08/17/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVE To propose a possible taxonomy for diverse stakeholders outside the healthcare communication field and to promote meaningful patient engagement in healthcare settings. Moreover, to support them in making more coherent policy, strategy, and practice decisions to enhance patient participation in their healthcare systems. DISCUSSION This paper is part of the pEACH Position Papers Series and provides a critical and experience-based reflection on patient engagement in different healthcare-related settings. We propose a framework that operationalises actionable patient engagement at the micro-meso-macro levels. Finally, the authors will highlight some "points of attention" that need to be addressed to support patient engagement implementation in healthcare organisations. CONCLUSION AND PRACTICE IMPLICATIONS Understanding and systematising the established meanings of patient engagement through a psychosocial lens is critical to addressing the following questions: "how can various health care organisations ensure that authentic patient engagement informs decision-making and strategies", "how can these organisations build authentic connections with their patients", and importantly, "how can patients gain valuable and reliable insights through patient engagement"? Answering these questions can enable key stakeholders to make informed decisions that ensure the quality and effectiveness of patient engagement initiatives in different healthcare settings.
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Affiliation(s)
- Guendalina Graffigna
- EngageMinds HUB - Consumer, Food & Health Engagement Research Center, Università Cattolica del Sacro Cuore, Milan and Cremona, Italy; Department of Psychology, Università Cattolica del Sacro Cuore, L.go Gemelli 1, 20123 Milan, Italy; Faculty of Agriculture, Food and Environmental Sciences, Università Cattolica del Sacro Cuore, Via Bissolati 74, 26100 Cremona, Italy
| | - Serena Barello
- EngageMinds HUB - Consumer, Food & Health Engagement Research Center, Università Cattolica del Sacro Cuore, Milan and Cremona, Italy; Department of Psychology, Università Cattolica del Sacro Cuore, L.go Gemelli 1, 20123 Milan, Italy; Faculty of Psychology, Università Cattolica del Sacro Cuore, L.go Gemelli 1, 20123 Milan, Italy.
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Bryant EA, Scott AM, Greenwood H, Thomas R. Patient and public involvement in the development of clinical practice guidelines: a scoping review. BMJ Open 2022; 12:e055428. [PMID: 36171042 PMCID: PMC9528587 DOI: 10.1136/bmjopen-2021-055428] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVES Organisations that develop clinical practice guidelines (CPGs) encourage involvement of patients and the publics in their development, however, there are no standard methodologies for doing so. To examine how CPGs report patient and public involvement (PPI), we conducted a scoping review of the evidence addressing the following four questions: (1) who are the patients and publics involved in developing the CPG?; (2) from where and how are the patients and publics recruited?; (3) at what stage in the CPG development process are the patients and publics involved? and (4) how do the patients and publics contribute their views? We also extracted data on the use of PPI reporting checklists by the included studies. DESIGN We used the methodology developed by Arksey and O'Malley and refined by the Joanna Briggs Institute. We searched PubMed, Embase, CINAHL and PsycINFO, websites of national guideline bodies from the UK, Canada, Australia and the USA, and conducted a forward citation search. No language, date or participant demographics restrictions were applied. Data were synthesised narratively. RESULTS We included 47 studies addressing 1 or more of the 4 questions. All included studies reported who the patient and publics involved (PPI members) were, and several studies reported PPI members from different groups. Patients were reported in 43/47 studies, advocates were reported in 22/47 studies, patients and advocates reported in 17/47 studies, and general public reported in 2/47 studies. Thirty-four studies reported from where the patients and publics were recruited, with patient groups being the most common (20/34). Stage of involvement was reported by 42/47 studies, most commonly at question identification (26/42) and draft review (18/42) stages. Forty-two studies reported how the patients contributed, most commonly via group meetings (18/42) or individual interviews. Ten studies cited or used a reporting checklist to report findings. CONCLUSIONS Our scoping review has revealed knowledge gaps to inform future research in several ways: replication, terminology and inclusion. First, no standard approach to PPI in CPG development could be inferred from the research. Second, inconsistent terminology to describe patients and publics reduces clarity around which patients and publics have been involved in developing CPGs. Finally, the under-representation of research describing PPI in the development of screening, as opposed to treatment, CPGs warrants further attention.
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Affiliation(s)
- Elizabeth Ann Bryant
- Human Resources, 14 University Drive, Bond University, Robina, Queensland, Australia
| | - Anna Mae Scott
- Institute for Evidence Based Healthcare, 14 University Drive, Bond University, Robina, Queensland, Australia
| | - Hannah Greenwood
- Institute for Evidence Based Healthcare, 14 University Drive, Bond University, Robina, Queensland, Australia
| | - Rae Thomas
- Institute for Evidence Based Healthcare, 14 University Drive, Bond University, Robina, Queensland, Australia
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Matsuyama M, Sachchithananthan M, Leonard R, Besser M, Nowak AK, Truran D, Vajdic CM, Zalcberg JR, Gan HK, Gedye C, Varikatt W, Koh ES, Kichenadasse G, Sim HW, Gottardo NG, Spyridopoulos D, Jeffree RL. What matters for people with brain cancer? Selecting clinical quality indicators for an Australian Brain Cancer Registry. Neurooncol Pract 2022; 9:68-78. [PMID: 35096405 PMCID: PMC8789278 DOI: 10.1093/nop/npab055] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/06/2024] Open
Abstract
BACKGROUND The goal of a clinical quality registry is to deliver immediate gains in survival and quality of life by delivering timely feedback to practitioners, thereby ensuring every patient receives the best existing treatment. We are developing an Australian Brain Cancer Registry (ABCR) to identify, describe, and measure the impact of the variation and gaps in brain cancer care from the time of diagnosis to the end of life. METHODS To determine a set of clinical quality indicators (CQIs) for the ABCR, a database and internet search were used to identify relevant guidelines, which were then assessed for quality using the AGREE II Global Rating Scale. Potential indicators were extracted from 21 clinical guidelines, ranked using a modified Delphi process completed in 2 rounds by a panel of experts and other stakeholders, and refined by a multidisciplinary Working Group. RESULTS Nineteen key quality reporting domains were chosen, specified by 57 CQIs detailing the specific inclusion and outcome characteristics to be reported. CONCLUSION The selected CQIs will form the basis for the ABCR, provide a framework for achievable data collection, and specify best practices for patients and health care providers, with a view to improving care for brain cancer patients. To our knowledge, the systematic and comprehensive approach we have taken is a world first in selecting the reporting specifications for a brain cancer clinical registry.
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Affiliation(s)
- Misa Matsuyama
- Brain Cancer Biobanking Australia, NHMRC Clinical Trials Centre, The University of Sydney, Sydney, New South Wales, Australia
- Faculty of Medicine, The University of Queensland, Herston, Queensland, Australia
| | - Mythily Sachchithananthan
- Brain Cancer Biobanking Australia, NHMRC Clinical Trials Centre, The University of Sydney, Sydney, New South Wales, Australia
| | - Robyn Leonard
- Brain Cancer Biobanking Australia, NHMRC Clinical Trials Centre, The University of Sydney, Sydney, New South Wales, Australia
| | - Michael Besser
- Brain Cancer Biobanking Australia, NHMRC Clinical Trials Centre, The University of Sydney, Sydney, New South Wales, Australia
| | - Anna K Nowak
- Brain Cancer Biobanking Australia, NHMRC Clinical Trials Centre, The University of Sydney, Sydney, New South Wales, Australia
- Medical School, The University of Western Australia, Perth, Western Australia, Australia
- Department of Medical Oncology, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia
| | - Donna Truran
- Australian e-Health Research Centre, CSIRO, Herston, Queensland, Australia
| | - Claire M Vajdic
- Brain Cancer Biobanking Australia, NHMRC Clinical Trials Centre, The University of Sydney, Sydney, New South Wales, Australia
- Centre for Big Data Research in Health, University of New South Wales, Sydney, New South Wales, Australia
| | - John R Zalcberg
- Brain Cancer Biobanking Australia, NHMRC Clinical Trials Centre, The University of Sydney, Sydney, New South Wales, Australia
- Faculty of Medicine, Nursing and Health Sciences, School of Public Health & Preventive Medicine, Monash University, Melbourne, Victoria, Australia
- Department of Medical Oncology, Alfred Health, Melbourne, Victoria, Australia
| | - Hui K Gan
- Brain Cancer Biobanking Australia, NHMRC Clinical Trials Centre, The University of Sydney, Sydney, New South Wales, Australia
- Cancer Therapies and Biology Group, Centre of Research Excellence in Brain Tumours, Olivia Newton-John Cancer Wellness and Research Centre, Austin Hospital, Heidelberg, Melbourne, Victoria, Australia
- La Trobe University School of Cancer Medicine, Heidelberg, Melbourne, Victoria, Australia
- Department of Medicine, The University of Melbourne, Heidelberg, Melbourne, Victoria, Australia
| | - Craig Gedye
- Brain Cancer Biobanking Australia, NHMRC Clinical Trials Centre, The University of Sydney, Sydney, New South Wales, Australia
- Medical Oncology, Calvary Mater Newcastle, Waratah, New South Wales, Australia
- Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia
| | - Winny Varikatt
- Brain Cancer Biobanking Australia, NHMRC Clinical Trials Centre, The University of Sydney, Sydney, New South Wales, Australia
- Sydney Medical School West Precinct, The University of Sydney, Camperdown, New South Wales, Australia
- Tissue Pathology and Diagnostic Oncology, ICPMR, Westmead Hospital, Westmead, New South Wales, Australia
| | - Eng-Siew Koh
- Brain Cancer Biobanking Australia, NHMRC Clinical Trials Centre, The University of Sydney, Sydney, New South Wales, Australia
- Department of Radiation Oncology, Liverpool Hospital, Liverpool, New South Wales, Australia
- Ingham Institute for Applied Medical Research, Liverpool, New South Wales, Australia
- South Western Clinical School, University of New South Wales, Liverpool, New South Wales, Australia
| | - Ganessan Kichenadasse
- Department of Clinical Pharmacology, College of Medicine and Public Health, Flinders University, Bedford Park, South Australia, Australia
- Department of Medical Oncology, Flinders Centre for Innovation in Cancer, Flinders Medical Centre, Bedford Park, South Australia, Australia
| | - Hao-Wen Sim
- Brain Cancer Biobanking Australia, NHMRC Clinical Trials Centre, The University of Sydney, Sydney, New South Wales, Australia
- St Vincent’s Clinical School, University of New South Wales, Sydney, New South Wales, Australia
- Department of Medical Oncology, The Kinghorn Cancer Centre, Sydney, New South Wales, Australia
- Department of Medical Oncology, Chris O’Brien Lifehouse, Sydney, New South Wales, Australia
| | - Nicholas G Gottardo
- Brain Cancer Biobanking Australia, NHMRC Clinical Trials Centre, The University of Sydney, Sydney, New South Wales, Australia
- Telethon Kids Institute, Perth Children’s Hospital, Nedlands, Western Australia, Australia
- Centre for Child Health Research, University of Western Australia, Perth, Western Australia, Australia
- Department of Oncology, Princess Margaret Hospital, Perth, Western Australia, Australia
| | - Desma Spyridopoulos
- Brain Cancer Biobanking Australia, NHMRC Clinical Trials Centre, The University of Sydney, Sydney, New South Wales, Australia
| | - Rosalind L Jeffree
- Brain Cancer Biobanking Australia, NHMRC Clinical Trials Centre, The University of Sydney, Sydney, New South Wales, Australia
- Faculty of Medicine, The University of Queensland, Herston, Queensland, Australia
- Kenneth G. Jamieson Department of Neurosurgery, Royal Brisbane and Women’s Hospital, Herston, Queensland, Australia
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Development of an evidence-based reference framework for care coordination with a focus on the micro level of integrated care: A mixed method design study combining scoping review of reviews and nominal group technique. Health Policy 2022; 126:245-261. [DOI: 10.1016/j.healthpol.2022.01.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Revised: 01/04/2022] [Accepted: 01/06/2022] [Indexed: 11/18/2022]
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10
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Carroll P, Dervan A, Maher A, McCarthy C, Woods I, Kavanagh R, Beirne C, Harte G, O'Flynn D, Murphy P, Quinlan J, Holton A, Casey S, Moriarty F, Smith É, O'Brien FJ, Flood M. Patient and Public Involvement (PPI) in preclinical research: A scoping review protocol. HRB Open Res 2021; 4:61. [PMID: 34522837 PMCID: PMC8420886 DOI: 10.12688/hrbopenres.13303.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/23/2021] [Indexed: 11/20/2022] Open
Abstract
Introduction: Patient and public involvement (PPI) aims to improve the quality, relevance, and appropriateness of research and ensure that it meets the needs and expectations of those affected by particular conditions to the greatest possible degree. The evidence base for the positive impact of PPI on clinical research continues to grow, but the role of PPI in preclinical research (an umbrella term encompassing 'basic', 'fundamental', 'translational' or 'lab-based' research) remains limited. As funding bodies and policymakers continue to increase emphasis on the relevance of PPI to preclinical research, it is timely to map the PPI literature to support preclinical researchers involving the public, patients, or other service users in their research. Therefore, the aim of this scoping review is to explore the literature on patient and public involvement in preclinical research from any discipline. Methods: This scoping review will search the literature in Medline (PubMed), Embase, CINAHL, PsycINFO, Web of Science Core Collection, Scopus, and OpenGrey.net to explore the application of PPI in preclinical research. This review will follow the Joanna Briggs Institute (JBI) guidelines for scoping reviews. It will be reported according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). Two reviewers will independently review articles for inclusion in the final review. Data extraction will be guided by the research questions. The PPI advisory panel will then collaboratively identify themes in the extracted data. Discussion: This scoping review will provide a map of current evidence surrounding preclinical PPI, and identify the body of literature on this topic, which has not been comprehensively reviewed to date. Findings will inform ongoing work of the research team, support the work of other preclinical researchers aiming to include PPI in their own research, and identify knowledge and practice gaps. Areas for future research will be identified.
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Affiliation(s)
- Pádraig Carroll
- School of Pharmacy and Biomolecular Sciences, Royal College of Surgeons in Ireland, University of Medicine and Health Sciences, Dublin, D02 YN77, Ireland.,Tissue Engineering Research Group (TERG), Department of Anatomy and Regenerative Medicine, Royal College of Surgeons in Ireland, University of Medicine and Health Sciences, Dublin, D02 YN77, Ireland.,Advanced Materials and Bioengineering Research (AMBER) Centre, Trinity College Dublin, D02 W085 & RCSI Dublin, Dublin, D02 YN77, Ireland
| | - Adrian Dervan
- Tissue Engineering Research Group (TERG), Department of Anatomy and Regenerative Medicine, Royal College of Surgeons in Ireland, University of Medicine and Health Sciences, Dublin, D02 YN77, Ireland
| | - Anthony Maher
- School of Pharmacy and Biomolecular Sciences, Royal College of Surgeons in Ireland, University of Medicine and Health Sciences, Dublin, D02 YN77, Ireland
| | - Ciarán McCarthy
- c/o Irish Rugby Football Union (IRFU) Charitable Trust, Dublin, D04 F720, Ireland
| | - Ian Woods
- Tissue Engineering Research Group (TERG), Department of Anatomy and Regenerative Medicine, Royal College of Surgeons in Ireland, University of Medicine and Health Sciences, Dublin, D02 YN77, Ireland
| | - Rachel Kavanagh
- Advanced Materials and Bioengineering Research (AMBER) Centre, Trinity College Dublin, D02 W085 & RCSI Dublin, Dublin, D02 YN77, Ireland
| | - Cliff Beirne
- Faculty of Sports and Exercise Medicine, (RCPI & RCSI), RCSI House, 121 St Stephen's Green, Dublin 2, D02 H903, Ireland
| | - Geoff Harte
- c/o Irish Rugby Football Union (IRFU) Charitable Trust, Dublin, D04 F720, Ireland
| | - Dónal O'Flynn
- c/o Irish Rugby Football Union (IRFU) Charitable Trust, Dublin, D04 F720, Ireland
| | - Paul Murphy
- RCSI Library, Royal College of Surgeons in Ireland, University of Medicine and Health Sciences, Dublin, D02 P796, Ireland
| | - John Quinlan
- Tallaght University Hospital, Tallaght, Dublin, D24 NR04, Ireland
| | - Alice Holton
- School of Pharmacy and Biomolecular Sciences, Royal College of Surgeons in Ireland, University of Medicine and Health Sciences, Dublin, D02 YN77, Ireland
| | - Sarah Casey
- Tissue Engineering Research Group (TERG), Department of Anatomy and Regenerative Medicine, Royal College of Surgeons in Ireland, University of Medicine and Health Sciences, Dublin, D02 YN77, Ireland
| | - Frank Moriarty
- School of Pharmacy and Biomolecular Sciences, Royal College of Surgeons in Ireland, University of Medicine and Health Sciences, Dublin, D02 YN77, Ireland
| | - Éimear Smith
- National Rehabilitation Hospital, Dún Laoghaire, Dublin, Ireland
| | - Fergal J O'Brien
- Tissue Engineering Research Group (TERG), Department of Anatomy and Regenerative Medicine, Royal College of Surgeons in Ireland, University of Medicine and Health Sciences, Dublin, D02 YN77, Ireland
| | - Michelle Flood
- School of Pharmacy and Biomolecular Sciences, Royal College of Surgeons in Ireland, University of Medicine and Health Sciences, Dublin, D02 YN77, Ireland.,Tissue Engineering Research Group (TERG), Department of Anatomy and Regenerative Medicine, Royal College of Surgeons in Ireland, University of Medicine and Health Sciences, Dublin, D02 YN77, Ireland.,Advanced Materials and Bioengineering Research (AMBER) Centre, Trinity College Dublin, D02 W085 & RCSI Dublin, Dublin, D02 YN77, Ireland
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11
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Carroll P, Dervan A, Maher A, McCarthy C, Woods I, Kavanagh R, Beirne C, Harte G, O'Flynn D, Murphy P, Quinlan J, Holton A, Casey S, Moriarty F, Smith É, O'Brien FJ, Flood M. Patient and Public Involvement (PPI) in preclinical research: A scoping review protocol. HRB Open Res 2021; 4:61. [DOI: 10.12688/hrbopenres.13303.1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/17/2021] [Indexed: 11/20/2022] Open
Abstract
Introduction: Patient and public involvement (PPI) aims to improve the quality, relevance, and appropriateness of research and ensure that it meets the needs and expectations of those affected by particular conditions to the greatest possible degree. The evidence base for the positive impact of PPI on clinical research continues to grow, but the role of PPI in preclinical research (an umbrella term encompassing ‘basic’, ‘fundamental’, ‘translational’ or ‘lab-based’ research) remains limited. As funding bodies and policymakers continue to increase emphasis on the relevance of PPI to preclinical research, it is timely to map the PPI literature to support preclinical researchers involving the public, patients, or other service users in their research. Therefore, the aim of this scoping review is to explore the literature on patient and public involvement in preclinical research from any discipline. Methods: This scoping review will search the literature in Medline (PubMed), Embase, CINAHL, PsycINFO, Web of Science Core Collection, Scopus, and OpenGrey.net to explore the application of PPI in preclinical research. This review will follow the Joanna Briggs Institute (JBI) guidelines for scoping reviews. It will be reported according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). Two reviewers will independently review articles for inclusion in the final review. Data extraction will be guided by the research questions. The PPI advisory panel will then collaboratively identify themes in the extracted data. Discussion: This scoping review will provide a map of current evidence surrounding preclinical PPI, and identify the body of literature on this topic, which has not been comprehensively reviewed to date. Findings will inform ongoing work of the research team, support the work of other preclinical researchers aiming to include PPI in their own research, and identify knowledge and practice gaps. Areas for future research will be identified.
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12
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The contribution of French patient and consumer groups to health technology assessments over a 2-year period: an observational retrospective study. Int J Technol Assess Health Care 2021; 37:e48. [PMID: 33745474 DOI: 10.1017/s0266462321000180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND In 2017, The French National Authority for Health (HAS) created an open, online, systematic contribution process to enable patient and consumer groups (PCGs) to contribute to health technology assessment (HTA) carried out to aid public authorities in reimbursement and pricing decision making. OBJECTIVES This retrospective study analyzes how French PCGs contributed to the HTA process within the HAS for the first 2 years of this new mechanism. METHODS PCG contributions received between 01 January 2017 and 31 December 2018 and the recording of deliberations leading to reports of the corresponding HTAs were included. Analysis grids were designed by the investigators with 5 rounds of refinement tests on 10 random PCG contributions and the reports. Systematic data extraction was then performed separately by two investigators. PCG answers to the open-question templates and the related final HTA report published by the HAS were analyzed. RESULTS Seventy-nine contributions from 44 PCGs were received and analyzed by the HAS for 78 out of the 592 HTAs performed for drugs or medical devices during the 2-year period. Twenty-five percent of the HTAs performed for drugs received at least one contribution. The contributions covered quality-of-life aspects, access to care, and personal and family impact. Membership and budget of the contributing PCGs varied greatly. CONCLUSIONS The experience gained in the first 2 years demonstrates the feasibility of the process and the fact that PCG contribution actually provides relevant input on the patient perspective for HTAs used for reimbursement decisions. The challenges identified on the side of PCGs were time constraints and human resources.
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Arno A, Elliott J, Wallace B, Turner T, Thomas J. The views of health guideline developers on the use of automation in health evidence synthesis. Syst Rev 2021; 10:16. [PMID: 33419479 PMCID: PMC7796617 DOI: 10.1186/s13643-020-01569-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2020] [Accepted: 12/21/2020] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND The increasingly rapid rate of evidence publication has made it difficult for evidence synthesis-systematic reviews and health guidelines-to be continually kept up to date. One proposed solution for this is the use of automation in health evidence synthesis. Guideline developers are key gatekeepers in the acceptance and use of evidence, and therefore, their opinions on the potential use of automation are crucial. METHODS The objective of this study was to analyze the attitudes of guideline developers towards the use of automation in health evidence synthesis. The Diffusion of Innovations framework was chosen as an initial analytical framework because it encapsulates some of the core issues which are thought to affect the adoption of new innovations in practice. This well-established theory posits five dimensions which affect the adoption of novel technologies: Relative Advantage, Compatibility, Complexity, Trialability, and Observability. Eighteen interviews were conducted with individuals who were currently working, or had previously worked, in guideline development. After transcription, a multiphase mixed deductive and grounded approach was used to analyze the data. First, transcripts were coded with a deductive approach using Rogers' Diffusion of Innovation as the top-level themes. Second, sub-themes within the framework were identified using a grounded approach. RESULTS Participants were consistently most concerned with the extent to which an innovation is in line with current values and practices (i.e., Compatibility in the Diffusion of Innovations framework). Participants were also concerned with Relative Advantage and Observability, which were discussed in approximately equal amounts. For the latter, participants expressed a desire for transparency in the methodology of automation software. Participants were noticeably less interested in Complexity and Trialability, which were discussed infrequently. These results were reasonably consistent across all participants. CONCLUSIONS If machine learning and other automation technologies are to be used more widely and to their full potential in systematic reviews and guideline development, it is crucial to ensure new technologies are in line with current values and practice. It will also be important to maximize the transparency of the methods of these technologies to address the concerns of guideline developers.
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Affiliation(s)
- Anneliese Arno
- EPPI-Centre, UCL Social Science Research Institute, University College London, London, UK.
| | - Julian Elliott
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Byron Wallace
- Khoury College of Computer Sciences, Northeastern University, Boston, USA
| | - Tari Turner
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - James Thomas
- EPPI-Centre, UCL Social Science Research Institute, University College London, London, UK
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14
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Healey A, van Beinum A, Hornby L, Wilson LC, Bédard S, Berrigan H, Brodrecht D, Gillrie C, Shing T, Towers J, Tilokee E, Shemie SD. Patient engagement in a Canadian consensus forum for heart donation after circulatory determination of death. Can J Anaesth 2020; 67:1738-1748. [PMID: 33025456 PMCID: PMC7716912 DOI: 10.1007/s12630-020-01808-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Revised: 05/30/2020] [Accepted: 06/07/2020] [Indexed: 11/25/2022] Open
Abstract
PURPOSE Heart donation and transplantation following circulatory determination of death has yet to be performed in Canada. A consensus forum was held to provide expert guidance to inform policy with a comprehensive patient partner strategy. This paper describes the process used to create fulsome patient partner engagement resulting in mutually beneficial policy development in this complex area. METHODS A wide-ranging process for involving patient partners in this area included pre-meeting education, in-meeting expert support, full participation and permission to step back if desired, and post-meeting debriefing. Following the meeting, a questionnaire was used to guide a debrief discussion with patient partners and steering committee members who co-authored this paper. RESULTS Five key themes arose that echoed the sentiments and contributions made by patient partners, including: 1) a strong desire to improve the system, 2) gratitude and honour, 3) expert support and process, 4) simplification of complex concepts, and 5) mutual benefit expressed by patient partners and healthcare professionals. CONCLUSION Despite the complexity of the content and the emotionally sensitive nature of discussions around deceased organ donation, a well-planned strategy to involve patient partners is important, impactful, and central to the process. This suggests a broad interprofessional audience can engage with properly prepared and supported patient partners to strengthen and focus dialogue and outputs in the development of health policy in the donation and transplant sector.
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Affiliation(s)
- Andrew Healey
- Division of Emergency Medicine, Department of Medicine, McMaster University, Hamilton, ON, Canada.
- Trillium Gift of Life Network, Toronto, ON, Canada.
| | - Amanda van Beinum
- Department of Sociology & Anthropology, Carleton University, Ottawa, ON, Canada
- Children's Hospital of Eastern Ontario Research Institute, Ottawa, ON, Canada
| | - Laura Hornby
- Children's Hospital of Eastern Ontario Research Institute, Ottawa, ON, Canada
- Canadian Blood Services, Ottawa, ON, Canada
| | | | | | | | | | | | | | | | | | - Sam D Shemie
- Canadian Blood Services, Ottawa, ON, Canada
- Critical Care, Montreal Children's Hospital, McGill University, Montreal, QC, Canada
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15
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Bryant EA, Scott AM, Thomas R. Patient and public involvement in the development of clinical practice guidelines: a scoping review protocol. BMJ Open 2020; 10:e037327. [PMID: 33020092 PMCID: PMC7537460 DOI: 10.1136/bmjopen-2020-037327] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
INTRODUCTION Clinical practice guidelines (CPGs) are intended to optimise patient care by recommending care pathways based on the best available research evidence and practice experience. Patient and public involvement (PPI) in healthcare is recommended based on the expectation that it will improve the quality and relevance of outcomes. There is no consensus on what constitutes meaningful and effective PPI in CPG. We will conduct a scoping review to identify and synthesise knowledge in four key areas: who have been the patients and public previously involved in CPG development, how were they recruited, at what stage in the CPG process were they involved and how were they involved. This knowledge will inform a general model of PPI in CPG to inform CPGs development. METHODS AND ANALYSIS We will conduct a scoping review using the Methodology for Scoping Reviews refined by the Joanna Briggs Institute. Searches will be conducted in electronic databases (PubMed, Embase, CINAHL and PsycINFO). National standards for developing CPGs from Australia, UK, Canada and the USA will also be identified. A forward and backward citation search will be conducted on the included studies and national standards. Abstracts and full-text studies will be independently screened by two researchers. Extracted data will include study details, type of clinical guideline and the four key areas, which patients and public were involved, how were they recruited, at what stage were they included and how they were involved. Data will be narratively synthesised. ETHICS AND DISSEMINATION As a scoping review, this study does not require ethics approval. We intend to disseminate the results through publication in a peer-reviewed journal and conference presentations. Furthermore, we will use the findings from our scoping review to inform future research to fill key evidence gaps identified by this review.
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Affiliation(s)
- Elizabeth Ann Bryant
- Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Queensland, Australia
| | - Anna Mae Scott
- Institute for Evidence-Based Healthcare, Bond University, Gold Coast, Queensland, Australia
| | - Rae Thomas
- Institute for Evidence-Based Healthcare, Bond University, Gold Coast, Queensland, Australia
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16
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Campbell B. Balancing the evidence for guidelines: lessons from the NICE abdominal aortic aneurysm guidance-an essay by Bruce Campbell. BMJ 2020; 370:m3480. [PMID: 32972977 DOI: 10.1136/bmj.m3480] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- Bruce Campbell
- Royal Devon and Exeter Hospital, Exeter, UK
- University of Exeter Medical School, Exeter EX2 5DW, UK
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17
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Hurtado MM, Nogueras EV, Cantero N, Gálvez L, García-Herrera JM, Morales-Asencio JM. Development of a guideline for the treatment of generalized anxiety disorder with the ADAPTE method. Int J Qual Health Care 2020; 32:356-363. [PMID: 32427320 DOI: 10.1093/intqhc/mzaa053] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2019] [Revised: 03/26/2020] [Accepted: 05/07/2020] [Indexed: 01/04/2023] Open
Abstract
OBJECTIVE The aim was to develop a clinical guideline for managing generalised anxiety disorder in Primary Health Care and Mental Health, using guideline adaptation methods. DESIGN A clinical guideline was developed, following the methods of the ADAPTE group, and implemented in a Primary Health Care District and in Mental Health Services in Spain. SETTING Regional University Hospital of Málaga and District of Primary Health Care Málaga-Guadalhorce (Spain). PARTICIPANTS The participants were family physicians, psychiatrists and clinical psychologists. The phases of the process included definition of clinical scenarios, literature search and guidelines appraisal, elaboration of recommendations, conducting focus groups with users diagnosed with generalised anxiety disorder, linking the testimonials of users with recommendations, external review and implementation by multifaceted interventions. RESULTS The final release included 49 Recommendations, of which 47 are from the 2011 NICE guidance for GAD and 2 of the 2011 NICE guideline for common mental disorder. Finally, seven recommendations needed to be adapted to the Spanish health care context, and three recommendations were excluded. CONCLUSIONS A guideline aimed to improve the quality and effectiveness of the care provided to people with generalised anxiety disorder has been released. The use of adaptation methods has simplified the use of resources and time. This guideline and the process designed for its implementation constitute a suitable collection of resources for the improvement on detection and treatment of GAD in primary health care. Adaptation methods play a key role in the knowledge translation continuum.
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Affiliation(s)
- María M Hurtado
- Mental Health Unit, Regional University Hospital, Málaga 29009, Spain.,Institute of Biomedical Research of Málaga (IBIMA), Spain
| | - Eva V Nogueras
- Mental Health Unit, Regional University Hospital, Málaga 29009, Spain.,Institute of Biomedical Research of Málaga (IBIMA), Spain
| | - Nazaret Cantero
- Mental Health Unit, Regional University Hospital, Málaga 29009, Spain
| | - Luis Gálvez
- Health District Málaga-Guadalhorce, Málaga, Spain
| | | | - José M Morales-Asencio
- Faculty of Health Sciences, University of Málaga, Málaga, Spain.,Institute of Biomedical Research of Málaga (IBIMA), Spain
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18
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Hempstead SE, Fredkin K, Hovater C, Naureckas ET. Patient and Family Participation in Clinical Guidelines Development: The Cystic Fibrosis Foundation Experience. J Particip Med 2020; 12:e17875. [PMID: 33064090 PMCID: PMC7434055 DOI: 10.2196/17875] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Revised: 04/30/2020] [Accepted: 05/06/2020] [Indexed: 01/14/2023] Open
Abstract
Patient and family participation in guideline development is neither standardized nor uniformly accepted in the guideline development community, despite the 2011 Institute of Medicine’s Guidelines We Can Trust and the Guideline International Network’s GIN-Public Toolkit recommendations. The Cystic Fibrosis Foundation has included patients and/or family members directly in guideline development since 2004. Over time, various strategies for increasing patient and family member participation have been implemented. Surveys of recent patient/family and clinical guidelines committee members have shown that inclusion of individuals with cystic fibrosis and their family members on guidelines committees has provided insight otherwise invisible to clinicians.
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Affiliation(s)
| | | | - Cade Hovater
- Community Advisor to the Cystic Fibrosis Foundation, Bethesda, MD, United States
| | - Edward T Naureckas
- Department of Pulmonary Medicine, University of Chicago, Chicago, IL, United States
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Kim C, Armstrong MJ, Berta WB, Gagliardi AR. How to identify, incorporate and report patient preferences in clinical guidelines: A scoping review. Health Expect 2020; 23:1028-1036. [PMID: 32656807 PMCID: PMC7696279 DOI: 10.1111/hex.13099] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Revised: 06/11/2020] [Accepted: 06/13/2020] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Clinical guidelines optimize care delivery and outcomes. Guidelines support patient engagement and adherence if they reflect patient preferences for treatment options, risks and benefits. Many guidelines do not address patient preferences. Developers require insight on how to develop such guidelines. OBJECTIVE To conduct a scoping review on how to identify, incorporate and report patient preferences in guidelines. SEARCH We searched MEDLINE, EMBASE, Scopus, CINAHL, OpenGrey and GreyLit from 2010 to November 2019. ELIGIBILITY We included English language studies describing patient preferences and guidelines. DATA EXTRACTION AND SYNTHESIS We reported approaches for and determinants and impacts of identifying patient preferences using summary statistics and text, and interpreted findings using a conceptual framework of patient engagement in guideline development. RESULTS Sixteen studies were included: 2 consulted patients and providers about patient engagement approaches, and 14 identified patient preferences (42.9%) or methods for doing so (71.4%). Studies employed single (57.1%) or multiple (42.9%) methods for identifying preferences. Eight (57.1%) incorporated preferences in one aspect of guideline development, while 6 (42.9%) incorporated preferences in multiple ways, most commonly to identify questions, benefits or harms, and generate recommendations. Studies did not address patient engagement in many guideline development steps. Included studies were too few to establish the best approaches for identifying or incorporating preferences. Fewer than half of the studies (7, 43.8%) explored barriers. None examined reporting preferences in guidelines. CONCLUSIONS Research is needed to establish the single or multiple approaches that result in incorporating and reporting preferences in all guideline development steps.
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Affiliation(s)
- Claire Kim
- University Health Network, Toronto, ON, Canada
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20
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Karpusheff J, Haynes C, Glen F, Leng G. Involving People with Learning Disabilities in Guideline Development. THE PATIENT 2020; 13:251-254. [PMID: 31573060 DOI: 10.1007/s40271-019-00390-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Affiliation(s)
- Justine Karpusheff
- National Institute for Health and Care Excellence, Level 1A, City Tower, Piccadilly Plaza, Manchester, M1 4BD, UK.
| | - Charlotte Haynes
- National Institute for Health and Care Excellence, Level 1A, City Tower, Piccadilly Plaza, Manchester, M1 4BD, UK
| | - Fiona Glen
- National Institute for Health and Care Excellence, Level 1A, City Tower, Piccadilly Plaza, Manchester, M1 4BD, UK
| | - Gillian Leng
- National Institute for Health and Care Excellence, Level 1A, City Tower, Piccadilly Plaza, Manchester, M1 4BD, UK
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21
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Todd S, Coupland C, Randall R. Patient and public involvement facilitators: Could they be the key to the NHS quality improvement agenda? Health Expect 2020; 23:461-472. [PMID: 32022356 PMCID: PMC7104637 DOI: 10.1111/hex.13023] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2019] [Revised: 11/26/2019] [Accepted: 12/17/2019] [Indexed: 01/31/2023] Open
Abstract
OBJECTIVE Research into patient and public involvement (PPI) has not examined in detail patient and public involvement facilitators' (PPIFs) roles and activities. This study analysed PPIFs' roles using qualitative data gathered from three different UK health-care organizations. DESIGN Thematic analysis was used to examine cross-sectional data collected using a mixed-methods approach from three organizations: a mental health trust, a community health social enterprise and an acute hospital trust. The data set comprised of 27 interviews and 48 observations. FINDINGS Patient and public involvement facilitators roles included the leadership and management of PPI interventions, developing health-care practices and influencing quality improvements (QI). They usually occupied middle-management grades but their PPIF role involved working in isolation or in small teams. They reported facilitating the development and maintenance of relationships between patients and the public, and health-care professionals and service managers. These roles sometimes required them to use conflict resolution skills and involved considerable emotional labour. Integrating information from PPI into service improvement processes was reported to be a challenge for these individuals. CONCLUSIONS Patient and public involvement facilitators capture and hold information that can be used in service improvement. However, they work with limited resources and support. Health-care organizations need to offer more practical support to PPIFs in their efforts to improve care quality, particularly by making their role integral to developing QI strategies.
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Affiliation(s)
- Sarah Todd
- Centre for Professional Work & SocietySchool of Business & EconomicsLoughborough UniversityLoughboroughUK
| | - Christine Coupland
- Centre for Professional Work & SocietySchool of Business & EconomicsLoughborough UniversityLoughboroughUK
| | - Raymond Randall
- Centre for Professional Work & SocietySchool of Business & EconomicsLoughborough UniversityLoughboroughUK
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El-Harakeh A, Lotfi T, Ahmad A, Morsi RZ, Fadlallah R, Bou-Karroum L, Akl EA. The implementation of prioritization exercises in the development and update of health practice guidelines: A scoping review. PLoS One 2020; 15:e0229249. [PMID: 32196520 PMCID: PMC7083273 DOI: 10.1371/journal.pone.0229249] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2019] [Accepted: 02/02/2020] [Indexed: 02/07/2023] Open
Abstract
Background The development of trustworthy guidelines requires substantial investment of resources and time. This highlights the need to prioritize topics for guideline development and update. Objective To systematically identify and describe prioritization exercises that have been conducted for the purpose of the de novo development, update or adaptation of health practice guidelines. Methods We searched Medline and CINAHL electronic databases from inception to July 2019, supplemented by hand-searching Google Scholar and the reference lists of relevant studies. We included studies describing prioritization exercises that have been conducted during the de novo development, update or adaptation of guidelines addressing clinical, public health or health systems topics. Two reviewers worked independently and in duplicate to complete study selection and data extraction. We consolidated findings in a semi-quantitative and narrative way. Results Out of 33,339 identified citations, twelve studies met the eligibility criteria. All included studies focused on prioritizing topics; none on questions or outcomes. While three exercises focused on updating guidelines, nine were on de novo development. All included studies addressed clinical topics. We adopted a framework that categorizes prioritization into 11 steps clustered in three phases (pre-prioritization, prioritization and post-prioritization). Four studies covered more than half of the 11 prioritization steps across the three phases. The most frequently reported steps for generating initial list of topics were stakeholders’ input (n = 8) and literature review (n = 7). The application of criteria to determine research priorities was used in eight studies. We used and updated a common framework of 22 prioritization criteria, clustered in 6 domains. The most frequently reported criteria related to the health burden of disease (n = 9) and potential impact of the intervention on health outcomes (n = 5). All the studies involved health care providers in the prioritization exercises. Only one study involved patients. There was a variation in the number and type of the prioritization exercises’ outputs. Conclusions This review included 12 prioritization exercises that addressed different aspects of priority setting for guideline development and update that can guide the work of researchers, funders, and other stakeholders seeking to prioritize guideline topics.
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Affiliation(s)
- Amena El-Harakeh
- Center for Systematic Reviews on Health Policy and Systems Research (SPARK), American University of Beirut, Beirut, Lebanon
- Clinical Research Institute (CRI), American University of Beirut Medical Center, Beirut, Lebanon
| | - Tamara Lotfi
- Global Evidence Synthesis Initiative (GESI) Secretariat, American University of Beirut, Beirut, Lebanon
- Faculty of Medicine, American University of Beirut, Beirut, Lebanon
| | - Ali Ahmad
- Faculty of Medicine, American University of Beirut, Beirut, Lebanon
| | - Rami Z. Morsi
- Faculty of Medicine, American University of Beirut, Beirut, Lebanon
| | - Racha Fadlallah
- Center for Systematic Reviews on Health Policy and Systems Research (SPARK), American University of Beirut, Beirut, Lebanon
- Department of Health Management and Policy, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - Lama Bou-Karroum
- Center for Systematic Reviews on Health Policy and Systems Research (SPARK), American University of Beirut, Beirut, Lebanon
- Department of Health Management and Policy, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - Elie A. Akl
- Center for Systematic Reviews on Health Policy and Systems Research (SPARK), American University of Beirut, Beirut, Lebanon
- Clinical Research Institute (CRI), American University of Beirut Medical Center, Beirut, Lebanon
- Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon
- Department of Health Research Methods, Evidence, and Impact (HEI), McMaster University, Hamilton, Canada
- * E-mail:
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Khodyakov D, Grant S, Denger B, Kinnett K, Martin A, Peay H, Coulter I. Practical Considerations in Using Online Modified-Delphi Approaches to Engage Patients and Other Stakeholders in Clinical Practice Guideline Development. THE PATIENT 2020; 13:11-21. [PMID: 31544219 PMCID: PMC6957573 DOI: 10.1007/s40271-019-00389-4] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Patients and caregivers are increasingly recognized as key stakeholders in developing clinical practice guidelines (CPGs). Online engagement approaches offer the promise of a rigorous, scalable, and convenient engagement method. This paper illustrates how an online modified-Delphi approach could be used to engage patients, caregivers, and other stakeholder in CPG development. It provides practical guidance for conducting online modified-Delphi panels that covers (1) joint development of the engagement approach with relevant stakeholders, (2) adaptation of methods used by experts in guideline development, (3) pilot testing, (4) participant recruitment, (5) determining panel size and composition, (6) building participant capacity, (7) facilitation of two-way interaction, (8) continuous engagement and retention of participants, (9) rigorous data analysis, (10) evaluation of engagement activities, and (11) result dissemination. The paper is based on a recently completed study about engaging individuals with Duchenne muscular dystrophy (DMD) and their caregivers in determining the patient-centeredness of DMD care guidelines.
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Affiliation(s)
- Dmitry Khodyakov
- RAND Health Care, RAND Corporation, 1776 Main Street, PO Box 2138, Santa Monica, CA USA
| | - Sean Grant
- RAND Health Care, RAND Corporation, 1776 Main Street, PO Box 2138, Santa Monica, CA USA
- Indiana University, Richard M. Fairbanks School of Public Health, Indianapolis, IN USA
| | - Brian Denger
- Parent Project Muscular Dystrophy, Hackensack, NJ USA
| | - Kathi Kinnett
- Parent Project Muscular Dystrophy, Hackensack, NJ USA
| | - Ann Martin
- Parent Project Muscular Dystrophy, Hackensack, NJ USA
| | - Holly Peay
- RTI International, Research Triangle Park, NC USA
| | - Ian Coulter
- RAND Health Care, RAND Corporation, 1776 Main Street, PO Box 2138, Santa Monica, CA USA
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Huls SPI, Whichello CL, van Exel J, Uyl-de Groot CA, de Bekker-Grob EW. What Is Next for Patient Preferences in Health Technology Assessment? A Systematic Review of the Challenges. VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2019; 22:1318-1328. [PMID: 31708070 DOI: 10.1016/j.jval.2019.04.1930] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/18/2018] [Revised: 04/25/2019] [Accepted: 04/26/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND Integrating patient preferences in Health Technology Assessment (HTA) is argued to improve uptake, adherence, and patient satisfaction. However, how to elicit and incorporate these preferences in HTA in a systematic and scientifically valid manner is subject to debate. OBJECTIVE This article provides a systematic review of the challenges to integrating patient preferences in HTA that have been raised in the literature about patient preferences in HTA. METHODS A systematic review of articles published between 2013 and 2017 addressing challenges to the integration of patient preferences in HTA was conducted in 7 databases. All issues with respect to the integration of patient preferences in HTA were extracted and divided into 5 categories: conceptual, normative, procedural, methodological, and practical issues. The issues were ranked according to how often they were mentioned. RESULTS Of 2147 retrieved articles, 67 were included in the analysis. Thirty-seven unique research issues were identified. In the majority of the articles, methodological issues were posed (82%), followed by procedural (73%), normative (51%), practical (24%), and conceptual (9%) issues. Frequently posed methodological issues concerned preference heterogeneity and choice of method. Common procedural issues concerned how to evaluate the impact of preference studies and their degree of being evidence based. CONCLUSIONS This article provides an overview of issues with respect to the integration of patient preferences in HTA procedures. Most issues were of a methodological or procedural nature; yet, the large number of different issues points to the overall importance of further researching the different aspects concerned with patient preferences in HTA. Through its ranking of how many articles mention particular issues, this article proposes an implicit research agenda.
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Affiliation(s)
- Samare P I Huls
- Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, The Netherlands; Erasmus Choice Modelling Centre, Erasmus University Rotterdam, Rotterdam, The Netherlands.
| | - Chiara L Whichello
- Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, The Netherlands; Erasmus Choice Modelling Centre, Erasmus University Rotterdam, Rotterdam, The Netherlands
| | - Job van Exel
- Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, The Netherlands; Erasmus School of Economics, Erasmus University Rotterdam, Rotterdam, The Netherlands
| | - Carin A Uyl-de Groot
- Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, The Netherlands; Institute for Medical Technology Assessment, Erasmus University Rotterdam, Rotterdam, The Netherlands
| | - Esther W de Bekker-Grob
- Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, The Netherlands; Erasmus Choice Modelling Centre, Erasmus University Rotterdam, Rotterdam, The Netherlands
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Colombani F, Sibé M, Kret M, Quintard B, Ravaud A, Saillour-Glénisson F. EPOCK study protocol: a mixed-methods research program evaluating cancer care coordination nursing occupations in France as a complex intervention. BMC Health Serv Res 2019; 19:483. [PMID: 31299966 PMCID: PMC6626323 DOI: 10.1186/s12913-019-4307-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2019] [Accepted: 06/28/2019] [Indexed: 12/20/2022] Open
Abstract
Background Facing the increasing cancer incidence and cancer survivorship, many national strategic cancer plans have identified cancer care coordination as a priority for health service improvement. However, the high variability of practices, the diversity of definitions and underlying concepts increases the existing difficulty to standardise, replicate, transpose and assess care coordination within the French health system context. The EPOCK national study aims at evaluating practices and the working context of hospital-based cancer care coordination nurses, based on a previously designed reference framework for care coordination within the French health system context. Methods EPOCK is based on a comprehensive evaluation of nursing professions in cancer care coordination, considered as a complex intervention. Phase 1 (theoretical phase) will define and design a theoretical reference framework for care coordination in France through an international literature review, aiming to identify relevant models and all components of the expected framework and a structured consensus method, the Nominal group technique, aiming to select and prioritise the most relevant components already found in the literature review with regard to the French healthcare system; phase 2 (Operational phase) will consist in an in-depth analysis of practices, contexts, perceptions and attitudes related to care coordination occupations by nurses in oncology and all stakeholders (related professionals, patients and their caregivers) through a multicentric cross-sectional mixed-method evaluative study. The observed practices and contexts will be finally compared with the theoretical reference framework using both inductive and deductive approaches. Discussion This study will result in an evaluation framework identifying key models and key elements relative to cancer care coordination interventions that can be used to guide management of cancer care coordination nursing occupations within the French healthcare system. EPOCK would also assist in public decision-making to identify optimal targets, skills profiles and scope of actions for cancer coordination professions. Finally, EPOCK will describe typology of nurse practices in cancer care coordination and thus obtain precise preliminary information essential for drafting a medico-economic evaluation study of these new nursing professions’ impact. Trial registration Clinicaltrial.gov registration: NCT03350776, 11/22/2017.
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Affiliation(s)
- F Colombani
- Centre de Coordination en Cancérologie (3C), CHU de Bordeaux (Bordeaux University Hospital), Groupe hospitalier Saint-André, 1 rue Jean Burguet, F-33000, Bordeaux, France. .,Economie et Management des Organisations de Santé (EMOS), INSERM, ISPED, Centre INSERM U1219-Bordeaux Population Health, F-33000, Bordeaux, France.
| | - M Sibé
- Economie et Management des Organisations de Santé (EMOS), INSERM, ISPED, Centre INSERM U1219-Bordeaux Population Health, F-33000, Bordeaux, France.,ISPED (Bordeaux School of Public Health), Centre INSERM U1219-Bordeaux Population Health, Université de Bordeaux, F-33000, Bordeaux, France
| | - M Kret
- Service d'Information médicale, Unité de soutien méthodologique à la recherche clinique (USMR), CHU de Bordeaux, Pôle de Santé publique, F-33000, Bordeaux, France
| | - B Quintard
- Faculté de Psychologie, Laboratoire EA 4136 Handicap, Activité, Cognition, Santé, Université de Bordeaux, F-33000, Bordeaux, France
| | - A Ravaud
- Centre de Coordination en Cancérologie (3C), CHU de Bordeaux (Bordeaux University Hospital), Groupe hospitalier Saint-André, 1 rue Jean Burguet, F-33000, Bordeaux, France.,Pôle de cancérologie, Service d'Oncologie Médicale, CHU de Bordeaux, F-33000, Bordeaux, France
| | - F Saillour-Glénisson
- Economie et Management des Organisations de Santé (EMOS), INSERM, ISPED, Centre INSERM U1219-Bordeaux Population Health, F-33000, Bordeaux, France.,ISPED (Bordeaux School of Public Health), Centre INSERM U1219-Bordeaux Population Health, Université de Bordeaux, F-33000, Bordeaux, France.,Pôle de santé publique, Service d'Information Médicale, Unité Méthodes d'Evaluation en Santé, CHU de Bordeaux, F-33000, Bordeaux, France
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de Wit M, Cooper C, Tugwell P, Bere N, Kirwan J, Conaghan PG, Roberts C, Aujoulat I, Al-Daghri N, Araujo de Carvalho I, Barker M, Bedlington N, Brandi ML, Bruyère O, Burlet N, Halbout P, Hiligsmann M, Jiwa F, Kanis JA, Laslop A, Lawrence W, Pinto D, Prieto Yerro C, Rabenda V, Rizzoli R, Scholte-Voshaar M, Vlaskovska M, Reginster JY. Practical guidance for engaging patients in health research, treatment guidelines and regulatory processes: results of an expert group meeting organized by the World Health Organization (WHO) and the European Society for Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (ESCEO). Aging Clin Exp Res 2019; 31:905-915. [PMID: 30993659 PMCID: PMC6589151 DOI: 10.1007/s40520-019-01193-8] [Citation(s) in RCA: 46] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2019] [Accepted: 04/03/2019] [Indexed: 12/27/2022]
Abstract
There is increasing emphasis on patient-centred research to support the development, approval and reimbursement of health interventions that best meet patients' needs. However, there is currently little guidance on how meaningful patient engagement may be achieved. An expert working group, representing a wide range of stakeholders and disciplines, was convened by the European Society for Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (ESCEO) and the World Health Organization (WHO). Through a structured, collaborative process the group generated practical guidance to facilitate optimal patient engagement in clinical development and regulatory decisions. Patient engagement is a relational process. The principles outlined in this report were based on lessons learned through applied experience and on an extensive dialogue among the expert participants. This practice guidance forms a starting point from which tailoring of the approach to suit different chronic diseases may be undertaken.
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Affiliation(s)
- Maarten de Wit
- Department of Medical Humanities, Amsterdam University Medical Centre, Amsterdam, The Netherlands
| | - Cyrus Cooper
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, UK
- NIHR Musculoskeletal Biomedical Research Unit, University of Oxford, Oxford, UK
- WHO Collaborating Centre for Public Health Aspects of Musculoskeletal Health and Aging, Liège, Belgium
| | - Peter Tugwell
- Department of Medicine, University of Ottawa, Ottawa, Canada
| | - Nathalie Bere
- Public Engagement Department, European Medicines Agency, 30 Churchill Place, Canary Wharf, London, E14 5EU, UK
| | - John Kirwan
- Emeritus Professor of Rheumatic Diseases, University of Bristol, Bristol, UK
| | - Philip G Conaghan
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK
- NIHR Leeds Biomedical Research Centre, Leeds, UK
| | - Charlotte Roberts
- International Consortium for Health Outcomes Measurement, Hamilton House, 4 Mabledon Place, Bloomsbury, London, WC1H 9BB, UK
| | - Isabelle Aujoulat
- Université Catholique de Louvain, Institute of Health & Society, Brussels, Belgium
| | - Nasser Al-Daghri
- Chair for Biomarkers of Chronic Diseases, Biochemistry Department, College of Science, King Saud University, Riyadh, Kingdom of Saudi Arabia
| | - Islene Araujo de Carvalho
- Department of Ageing and Life Course, World Health Organization, 20 Avenue Appia, 1211, Geneva 27, Switzerland
| | - Mary Barker
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, UK
| | - Nicola Bedlington
- European Patients' Forum, Chaussée d'Etterbeek 180, Etterbeek, 1040, Brussels, Belgium
| | - Maria Luisa Brandi
- Department of Surgery and Translational Medicine, University of Florence, Florence, Italy
- Fondazione F.I.R.M.O., Florence, Italy
| | - Olivier Bruyère
- WHO Collaborating Centre for Public Health Aspects of Musculoskeletal Health and Aging, Liège, Belgium
- Department of Public Health, Epidemiology and Health Economics, University of Liège, CHU Sart Tilman B23, 4000, Liège, Belgium
| | - Nansa Burlet
- WHO Collaborating Centre for Public Health Aspects of Musculoskeletal Health and Aging, Liège, Belgium
| | - Philippe Halbout
- International Osteoporosis Foundation, 9 Rue Juste-Olivier, 1260, Nyon, Switzerland
| | - Mickaël Hiligsmann
- Department of Health Services Research, CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands
| | | | - John A Kanis
- Mary McKillop Health Institute, Australian Catholic University, Melbourne, Australia
- Centre for Metabolic Bone Diseases, University of Sheffield Medical School, Sheffield, UK
| | - Andrea Laslop
- Scientific Office, Federal Office for Safety in Health Care, Austrian Agency for Health and Food Safety, Vienna, Austria
| | - Wendy Lawrence
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, UK
- NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Daniel Pinto
- Department of Physical Therapy, College of Health Sciences, Marquette University, Milwaukee, USA
- Center for Healthcare Studies, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Concepción Prieto Yerro
- Spanish Agency for Drugs and Medical Devices, Calle Campezo 1, Building 8, 28022, Madrid, Spain
| | - Véronique Rabenda
- Department of Public Health, Epidemiology and Health Economics, University of Liège, CHU Sart Tilman B23, 4000, Liège, Belgium
| | - René Rizzoli
- WHO Collaborating Centre for Public Health Aspects of Musculoskeletal Health and Aging, Liège, Belgium
- Division of Bone Diseases, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - Marieke Scholte-Voshaar
- Department of Psychology, Health and Technology, University of Twente, Enschede, The Netherlands
| | - Mila Vlaskovska
- Medical Faculty, Department of Pharmacology, Medical University Sofia, 2, Zdrave Str, 1431, Sofia, Bulgaria
| | - Jean-Yves Reginster
- WHO Collaborating Centre for Public Health Aspects of Musculoskeletal Health and Aging, Liège, Belgium.
- Chair for Biomarkers of Chronic Diseases, Biochemistry Department, College of Science, King Saud University, Riyadh, Kingdom of Saudi Arabia.
- Department of Public Health, Epidemiology and Health Economics, University of Liège, CHU Sart Tilman B23, 4000, Liège, Belgium.
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Abstract
PURPOSE OF REVIEW Genomic tests offer increased opportunity for diagnosis, but their outputs are often uncertain and complex; results may need to be revised and/or may not be relevant until some future time. We discuss the challenges that this presents for consent and autonomy. RECENT FINDINGS Popular discourse around genomic testing tends to be strongly deterministic and optimistic, yet many findings from genomic tests are uncertain or unclear. Clinical conversations need to anticipate and potentially challenge unrealistic expectations of what a genomic test can deliver in order to enhance autonomy and ensure that consent to genomic testing is valid. SUMMARY We conclude that 'fully informed' consent is often not possible in the context of genomic testing, but that an open-ended approach is appropriate. We consider that such broad consent can only work if located within systems or organisations that are trustworthy and that have measures in place to ensure that such open-ended agreements are not abused. We suggest that a relational concept of autonomy has benefits in encouraging focus on the networks and relationships that allow decision making to flourish.
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Affiliation(s)
- Rachel Horton
- Clinical Ethics and Law at Southampton (CELS), Faculty of Medicine, University of Southampton, Centre for Cancer Immunology, Southampton General Hospital, Southampton, SO16 6YD UK
- Wessex Clinical Genetics Service, Princess Anne Hospital, Southampton, SO16 5YA UK
| | - Anneke Lucassen
- Clinical Ethics and Law at Southampton (CELS), Faculty of Medicine, University of Southampton, Centre for Cancer Immunology, Southampton General Hospital, Southampton, SO16 6YD UK
- Wessex Clinical Genetics Service, Princess Anne Hospital, Southampton, SO16 5YA UK
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Critical Appraisal of International Clinical Practice Guidelines in Kidney Transplantation Using the Appraisal of Guidelines for Research and Education II Tool: A Systematic Review. Transplantation 2019; 102:1419-1439. [PMID: 30124634 DOI: 10.1097/tp.0000000000002255] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND Although clinical practice guidelines (CPGs) are used for the development of local protocols in kidney transplantation (Ktx), the quality of their methodology is variable. This systematic review aimed to critically appraise international CPGs in all aspects of Ktx using the Appraisal of Guidelines for Research and Evaluation II tool. METHODS Clinical Practice Guidelines in Ktx and donation published between 2010 and 2017 were identified from MEDLINE, Embase, National Guideline Clearinghouse, National Health Service and National Institute for Health and Care Excellence Evidence Searches, and the websites of transplant societies. Using Appraisal of Guidelines for Research and Evaluation II, 3 appraisers assessed the quality of CPGs. Interrater reliability was measured using the intraclass correlation coefficient (ICC). RESULTS Searches identified 3168 records, and 115 CPGs were included. The highest scoring Appraisal of Guidelines for Research and Evaluation II domain was "scope and purpose" (80%; range, 30%-100%), followed by "clarity of presentation" (77%; range, 43%-98%), "editorial independence" (52%; range, 0%-94%), "rigor of development" (47%; range 6%-97%) and "stakeholder involvement" (41%; range, 11%-85%). The poorest scoring domain was "applicability" (31%; range, 3%-74%). Most CPGs were recommended for future use either with (63%) or without (18%) modifications. A small number (14%) were not recommended for future use or reviewers (5%) did not agree on recommending the CPG. The overall mean CPG quality score was 4 of 7 (range, 2-7). The mean ICC of 0.74 indicated substantial agreement between reviewers. CONCLUSIONS The quality of international CPGs in Ktx was variable, and most CPGs lacked key aspects of methodological robustness and transparency. Improvements in methodology, patient involvement, and strategies for implementation are required.
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Grant S, Hazlewood GS, Peay HL, Lucas A, Coulter I, Fink A, Khodyakov D. Practical Considerations for Using Online Methods to Engage Patients in Guideline Development. PATIENT-PATIENT CENTERED OUTCOMES RESEARCH 2018; 11:155-166. [PMID: 29030831 DOI: 10.1007/s40271-017-0280-6] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Clinical practice guidelines (CPGs) have been widely used in healthcare policy, practice, and for suggesting future research. As patients increasingly become involved in CPG development to produce patient-centered recommendations, more research is needed on methods to engage patients, particularly methods allowing for scalable engagement of large, diverse, and geographically distributed groups of patients. In this article, we discuss practical considerations for using online methods to engage patients in CPG development. To inform this discussion, we conducted a rapid, systematic review of literature on patient involvement in CPG development and used qualitative evidence synthesis techniques to make inferences about potential advantages and challenges of using online methods to engage patients in this context. We identified 79 articles containing information about involving patients in CPG development. Potential advantages include the ability of online methods to facilitate greater openness and honesty by patients, as well as to reflect the diversity of patient views, which in turn further improve the utility of CPGs. Potential challenges of using online methods may include the extra skill, time, and certain types of resources that may be needed for patient engagement, as well as the difficulty engaging specific patient populations. However, these challenges are mitigated by growing calls for patient engagement as normative for CPG development in addition to patients' increasing familiarity with online technologies. These practical considerations should be examined empirically as guideline development groups further explore the appropriateness of using online methods to engage patients across different stages of CPG development.
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Affiliation(s)
- Sean Grant
- Behavioral and Policy Sciences Department, RAND Corporation, 1776 Main Street, PO Box 2138, Santa Monica, CA, 90407-2138, USA.
| | - Glen S Hazlewood
- Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Holly L Peay
- RTI International, Research Triangle Park, NC, USA
| | - Ann Lucas
- Parent Project Muscular Dystrophy, Hackensack, NJ, USA
| | - Ian Coulter
- Economics, Sociology, and Statistics Department, RAND Corporation, Santa Monica, CA, USA
| | - Arlene Fink
- David Geffen School of Medicine, University of California-Los Angeles, Los Angeles, CA, USA
| | - Dmitry Khodyakov
- Behavioral and Policy Sciences Department, RAND Corporation, 1776 Main Street, PO Box 2138, Santa Monica, CA, 90407-2138, USA
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Putting Patients at the Centre of Healthcare: Progress and Challenges for Health Technology Assessments. PATIENT-PATIENT CENTERED OUTCOMES RESEARCH 2018; 11:581-589. [DOI: 10.1007/s40271-018-0325-5] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Lee DH, Yoo S, Shin E, Cho Y. Nonshaved Ear Surgery: Effect of Hair on Surgical Site Infection of the Middle Ear/Mastoid Surgery and Patients' Preference for the Hair Removal. J Audiol Otol 2018; 22:160-166. [PMID: 29890817 PMCID: PMC6103491 DOI: 10.7874/jao.2018.00101] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2018] [Accepted: 03/29/2018] [Indexed: 11/22/2022] Open
Abstract
Background and Objectives This study aimed 1) to compare the rates of surgical site infection (SSI) between two groups with and without preoperative hair shaving, 2) to compare the bacterial colonization just before the skin incision between them, and 3) to evaluate people’s preference for the hair shaving. Subjects and Methods The retrospective study enrolled cases in which middle ear and mastoid surgery was performed with as well as without hair removal. Main measurement outcomes were the SSI rate within 3 months following the surgery, bacterial culture results obtained from the incision area just before the skin incision, and questionnaire to evaluate the preference for hair shaving from patients with chronic suppurative otitis media but without experience with the ear surgery. Results This study did not show any difference in the rates of SSI and bacterial colonization between two groups with and without preoperative hair shaving. Most patients without experience with the ear surgery chose the nonshaved ear surgery, even though the questionnaire presented a comment as follow; “Your hair will always grow back as the growth speed of about 1.25 cm per month.” Conclusions There is no evidence showing that preoperative shaving of the surgical site is helpful for the SSI than no hair removal. Nonshaved middle ear and mastoid surgery via postauricular approach appears to be preferable. Contrary to doctors’ popular belief, the hair shaving can cause psychological discomfort, especially for women. Now is the time to keep the balance between the professional’s perspective and the patients’ preferences.
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Affiliation(s)
- Dong-Hee Lee
- Department of Otolaryngology-Head and Neck Surgery, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Soonil Yoo
- Department of Otolaryngology-Head and Neck Surgery, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Eunhye Shin
- Department of Otolaryngology-Head and Neck Surgery, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Yesun Cho
- Department of Otolaryngology-Head and Neck Surgery, College of Medicine, The Catholic University of Korea, Seoul, Korea
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Souliotis K, Peppou LE, Agapidaki E, Tzavara C, Debiais D, Hasurdjiev S, Sarkozy F. Health democracy in Europe: Cancer patient organization participation in health policy. Health Expect 2018; 21:474-484. [PMID: 29094422 PMCID: PMC5867319 DOI: 10.1111/hex.12638] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/30/2017] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND Patient organization participation in health policy decision making is an understudied area of inquiry. A handful of qualitative studies have suggested that the growing number of patient organizations in Europe and their increasing involvement in policy issues do not result in high political effectiveness. However, existing research is largely country-specific. OBJECTIVE To examine the degree and impact of cancer patient organization (CPO) participation in health policy decision making in EU-28 and to identify their correlates. METHODS A total of 1266 members of CPOs participated in this study, recruited from a diversity of sources. CPO participation in health policy was assessed with the Health Democracy Index, a previously developed instrument measuring the degree and impact of patient organization participation in various realms of health policy. Additional questions collected information about participants' and the CPO's characteristics. Data were gleaned in the form of an online self-reported instrument. RESULTS The highest degree of CPO participation was observed with respect to hospital boards, reforms in health policy and ethics committees for clinical trials. On the contrary, the lowest was discerned with regard to panels in other important health-related organizations and in the Ministry of Health. The reverse pattern of results was observed concerning the Impact subscale. As regards the correlates of CPO participation, legislation bore the strongest association with the Degree subscale, while organizational factors emerged as the most important variables with regard to the Impact subscale. CONCLUSIONS Research findings indicate that a high degree of CPO participation does not necessarily ensure a high impact. Efforts to promote high and effective CPO participation should be geared towards the establishment of a health-care law based on patient rights as well as to the formation of coalitions among CPOs and the provision of training to its members.
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Affiliation(s)
- Kyriakos Souliotis
- Faculty of Social and Political SciencesUniversity of PeloponneseCorinthGreece
| | | | - Eirini Agapidaki
- Faculty of Social and Political SciencesUniversity of PeloponneseCorinthGreece
| | - Chara Tzavara
- Department of Hygiene, Epidemiology and Medical StatisticsCentre for Health Services ResearchMedical SchoolNational & Kapodistrian University of AthensAthensGreece
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PATIENT AND PUBLIC INVOLVEMENT IN EARLY AWARENESS AND ALERT ACTIVITIES: AN EXAMPLE FROM THE UNITED KINGDOM. Int J Technol Assess Health Care 2018; 34:10-17. [DOI: 10.1017/s0266462317004421] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Objectives: The aim of this study is to report on the experiences, benefits, and challenges of patient and public involvement and engagement (PPIE) from a publicly funded early awareness and alert (EAA) system in the United Kingdom.Methods: Using email, telephone, a Web site portal, Twitter and focus groups, patients and the public were involved and engaged in the recognized stages of an EAA system: identification, filtration, prioritization, early assessment, and dissemination.Results: Approaches for PPIE were successfully integrated into all aspects of the National Institute for Health Research Horizon Scanning Research and Intelligence Centre's EAA system. Input into identification activities was not as beneficial as involvement in prioritization and early assessment. Patients gave useful insight into the Centre's Web site and engaging patients using Twitter has enabled the Centre to disseminate outputs to a wider audience.Conclusions: EAA systems should consider involving and engaging with patients and the public in identification, prioritization, and assessment of emerging health technologies where practicable. Further research is required to examine the value and impact of PPIE in EAA activities and in the early development of health technologies.
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Munthali AC, Swartz L, Mannan H, MacLachlan M, Chilimampunga C, Makupe C. “This one will delay us”: barriers to accessing health care services among persons with disabilities in Malawi. Disabil Rehabil 2017; 41:683-690. [DOI: 10.1080/09638288.2017.1404148] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
| | - Leslie Swartz
- Department of Psychology, Alan J Flisher Centre for Public Mental Health, Stellenbosch University, Stellenbosch, South Africa
| | - Hasheem Mannan
- School of Nursing, Midwifery and Health, University College Dublin, Dublin, Ireland
| | - Malcolm MacLachlan
- Maynooth ALL (Assisting Living & Learning) Institute and Department of Psychology, Maynooth University, Ireland
- Centre for Rehabilitation Studies, Stellenbosch University, Tygerberg, South Africa
- Olomouc University Social Health Institute, Palacky University, Olomouc, Czech Republic
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