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Ganz-Blaettler U, Liptrott SJ, Tolotti A, Cefalì M, Aeschlimann C, Vilei SB, Colombo I, Hatziandreou E, Kosmidis T, Linardou H, Pfau R, Sgourou S, Sessa C. The active involvement of patients in oncology research. Cancer Treat Rev 2024; 130:102822. [PMID: 39276429 DOI: 10.1016/j.ctrv.2024.102822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2024] [Revised: 08/30/2024] [Accepted: 08/31/2024] [Indexed: 09/17/2024]
Abstract
The aim of this review is to provide an overview of the status of patient/public involvement (PPI) in oncology research, including definitions, regulatory aspects, ongoing clinical activities in different countries, achievements and difficulties. The 10-year activities of the Swiss Group for Clinical Cancer Research (SAKK) Patient Advisory Board are described, illustrating challenges faced and solutions in daily practice. Even though clinical data are still limited, it appears PPI has great potential for development in oncology. The drive for precision medicine, activities of patient organizations, pharmaceutical industry interest, and strong support from regulatory agencies, are facilitators to integration of PPI throughout the drug development process. Despite the availability of guidance documents providing recommendations for the implementation of PPI, lack of human and structural resources, training for patients / caregivers and healthcare personnel, and lack of collaboration among stakeholders are some of the main barriers reported. More rigorous reporting of PPI in clinical studies is needed, including the methods to evaluate the impact of PPI and in the representation of patients as partner.
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Affiliation(s)
| | - Sarah Jayne Liptrott
- Oncology Institute of Southern Switzerland, EOC-IOSI, Via A. Gallino 12, CH - 6500 Bellinzona, Switzerland
| | - Angela Tolotti
- Oncology Institute of Southern Switzerland, EOC-IOSI, Via A. Gallino 12, CH - 6500 Bellinzona, Switzerland
| | - Marco Cefalì
- Oncology Institute of Southern Switzerland, EOC-IOSI, Via A. Gallino 12, CH - 6500 Bellinzona, Switzerland
| | | | | | - Ilaria Colombo
- Oncology Institute of Southern Switzerland, EOC-IOSI, Via A. Gallino 12, CH - 6500 Bellinzona, Switzerland
| | - Evi Hatziandreou
- FairLife Lung Cancer Care, 18 Napoleontos Zerva Str., 16675 Glyfada, Greece
| | - Thanos Kosmidis
- CareAcross Ltd, 1 Kings Avenue, London N21 3NA, United Kingdom
| | - Helena Linardou
- 4th Oncology Dept. & Comprehensive Clinical Trials Center, Metropolitan Hospital, Ethn. Makariou 9, Neo Faliro, Athens 18547, Greece
| | - Rosemarie Pfau
- Lymphome.ch - Patientennetz Schweiz, Weidenweg 39, 4147 Aesch, Switzerland
| | - Stavroula Sgourou
- 4th Oncology Dept. & Comprehensive Clinical Trials Center, Metropolitan Hospital, Ethn. Makariou 9, Neo Faliro, Athens 18547, Greece
| | - Cristiana Sessa
- Oncology Institute of Southern Switzerland, EOC-IOSI, Via A. Gallino 12, CH - 6500 Bellinzona, Switzerland.
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Barello S, Anderson G, Bosio C, Lane DA, Leo DG, Lobban TCA, Trevisan C, Graffigna G. Patient engagement in multimorbidity: a systematic review of patient-reported outcome measures. Front Psychol 2024; 15:1345117. [PMID: 39100568 PMCID: PMC11294995 DOI: 10.3389/fpsyg.2024.1345117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Accepted: 05/06/2024] [Indexed: 08/06/2024] Open
Abstract
Background People with multimorbidity are increasingly engaged, enabled, and empowered to take responsibility for managing their health status. The purpose of the study was to systematically review and appraise the psychometric properties of tools measuring patient engagement in adults with multimorbidity and their applicability for use within engagement programs. Methods PubMed, Scopus, Web of Science, and PsycInfo were searched from inception to 1 July 2021. Gray literature was searched using EBSCO host-database "Open dissertation". The reference lists of studies meeting the inclusion criteria were searched to identify additional eligible studies. The screening of the search results and the data extraction were performed independently by two reviewers. The methodological quality of the included studies was evaluated with the COSMIN checklist. Relevant data from all included articles were extracted and summarized in evidence synthesis tables. Results Twenty articles on eight tools were included. We included tools that measure all four dimensions of patient engagement (i.e., engagement, empowerment, activation, and participation). Their psychometric properties were analyzed separately. Most tools were developed in the last 10 years in Europe or the USA. The comparison of the estimated psychometric properties of the retrieved tools highlighted a significant lack of reliable patient engagement measures for people with multimorbidity. Available measures capture a diversity of constructs and have very limited evidence of psychometric properties that are vital for patient-reported measures, such as invariance, reliability, and responsiveness. Conclusion This review clarifies how patient engagement, as operationalized in measures purporting to capture this concept, overlaps with, and differs from other related constructs in adults with multimorbidity. The methodological quality of psychometric tools measuring patient engagement in adults with multimorbidity could be improved. Systematic review registration https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=259968, identifier CRD42021259968.
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Affiliation(s)
- Serena Barello
- EngageMinds HUB – Consumer, Food and Health Engagement Research Center, Università Cattolica del Sacro Cuore, Milan, Italy
- Department of Psychology, Università Cattolica del Sacro Cuore, Milan, Italy
| | - Gloria Anderson
- Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Caterina Bosio
- EngageMinds HUB – Consumer, Food and Health Engagement Research Center, Università Cattolica del Sacro Cuore, Milan, Italy
| | - Deirdre A. Lane
- Liverpool Centre for Cardiovascular Science and Department of Cardiovascular and Metabolic Medicine, Faculty of Health and Life Sciences, University of Liverpool, Liverpool, United Kingdom
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Donato G. Leo
- Liverpool Centre for Cardiovascular Science and Department of Cardiovascular and Metabolic Medicine, Faculty of Health and Life Sciences, University of Liverpool, Liverpool, United Kingdom
| | | | - Caterina Trevisan
- Department of General Psychology, University of Padua, Padua, Italy
- Department of Medical Sciences, University of Ferrara, Ferrara, Italy
| | - Guendalina Graffigna
- EngageMinds HUB – Consumer, Food and Health Engagement Research Center, Università Cattolica del Sacro Cuore, Milan, Italy
- Department of Psychology, Università Cattolica del Sacro Cuore, Milan, Italy
- Faculty of Agriculture, Food and Environmental Sciences, Università Cattolica del Sacro Cuore, Cremona, Italy
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Xie X, Zhou L, Zhang X, Zou H, Lu Y, Xiao H. Evaluation of a knowledge-attitude-practice model based narrative life education program for community-dwelling older adults: a mixed-methods feasibility study. BMC Geriatr 2024; 24:547. [PMID: 38914955 PMCID: PMC11194897 DOI: 10.1186/s12877-024-05153-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2024] [Accepted: 06/17/2024] [Indexed: 06/26/2024] Open
Abstract
BACKGROUND The global aging population presents challenges that are particularly acute in China. Older Chinese adults' attitudes towards death significantly impact their quality of life. Death education is crucial for promoting positive perspectives on life and death. Narrative education offers a promising approach to facilitating death education. Integrating the Knowledge-Attitude-Practice (KAP) model into death education will enhance the feasibility and acceptability of death education programs. METHODS This mixed-methods feasibility study included a quasi-experimental trial and semi-structured interviews. Older adults in the intervention group (N = 27) received a 6-week KAP-based narrative life education program in addition to standard community health education; participants in the control group (N = 20) received only the normal community health education. In both groups, attitudes toward death and the meaning of life were assessed at baseline and immediately after the intervention. A post-intervention semi-structured interview and satisfaction survey were also conducted for the intervention group. RESULTS Forty out of 47 older adults completed the program for an 85.1% retention rate. All of the older adults in the experiment were very satisfied and satisfied with the life education program, and no adverse events were reported. Compared to the control group, participants in the intervention group had a significant decrease in the fear of death (P = 0.028), and substantial improvement in their value of life (P = 0.031), goal of life (P = 0.035), freedom of life (P = 0.003), and the total score for purpose in life (P = 0.017). The qualitative results yielded four themes: profound recognition of life and death, contradiction between thoughts and action, conflict between one's acceptance and others' avoidance, and evaluation of the life education program. CONCLUSIONS The KAP-based narrative life education program is feasible and acceptable for older Chinese community-dwelling adults. It is also potentially effective in improving attitudes toward death attitudes and the meaning of life in this cohort. TRIAL REGISTRATION This study was retrospectively registered at China Clinical Trial Registry as ChiCTR2300069551 on 2023-03-20. URL of registration: https://www.chictr.org.cn/showproj.html?proj=183176 .
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Affiliation(s)
- Xifeng Xie
- School of Nursing, Fujian Medical University, Fuzhou City, Fujian Province, China
| | - Li Zhou
- Nanjie Community Health Service Center, Fuzhou City, Fujian Province, China
| | - Xiaoling Zhang
- School of Nursing, Fujian Medical University, Fuzhou City, Fujian Province, China
| | - Huina Zou
- School of Nursing, Fujian Medical University, Fuzhou City, Fujian Province, China
| | - Yuanfeng Lu
- School of Nursing, Fujian Medical University, Fuzhou City, Fujian Province, China.
| | - Huimin Xiao
- School of Nursing, Fujian Medical University, Fuzhou City, Fujian Province, China.
- Research Center for Nursing Humanity, Fujian Medical University, Fuzhou City, Fujian Province, China.
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Bertelsen N, Dewulf L, Ferrè S, Vermeulen R, Schroeder K, Gatellier L, Sargeant I, Luzuriaga D, Chapman H, Brooke N. Patient Engagement and Patient Experience Data in Regulatory Review and Health Technology Assessment: A Global Landscape Review. Ther Innov Regul Sci 2024; 58:63-78. [PMID: 37743397 PMCID: PMC10764510 DOI: 10.1007/s43441-023-00573-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 08/09/2023] [Indexed: 09/26/2023]
Abstract
BACKGROUND Working with patients through meaningful patient engagement (PE) and incorporating patient experience data (PXD) is increasingly important in medicines and medical device development. However, PE in the planning, organization, generation, and interpretation of PXD within regulatory and health technology assessment (HTA) decision-making processes remains challenging. We conducted a global review of the PE and PXD landscape to identify evolving resources by geography to support and highlight the potential of integration of PE and PXD in regulatory assessment and HTA. METHODS A review of literature/public information was conducted (August 2021-January 2023), led by a multistakeholder group comprising those with lived or professional experience of PE and PXD, to identify relevant regulatory and HTA initiatives and resources reviewed and categorized by geography and focus area. RESULTS Overall, 53 relevant initiatives/resources were identified (global, 14; North America, 11; Europe, 11; Asia, nine; UK, six; Latin America, one; Africa, one). Most focused either on PE (49%) or PXD (28%); few (11%) mentioned both PE and PXD (as largely separate activities) or demonstrated an integration of PE and PXD (11%). CONCLUSIONS Our analysis demonstrates increasing interest in PE, PXD, and guidance on their use individually in decision-making. However, more work is needed to offer guidance on maximizing the value of patient input into decisions by combining both PE and PXD into regulatory and HTA processes; the necessity of integrating PE in the design and interpretation of PXD programs should be highlighted. A co-created framework to achieve this integration is part of a future project.
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Affiliation(s)
- Neil Bertelsen
- HTAi Patient & Citizen Involvement in HTA Interest Group, Neil Bertelsen Consulting, Berlin, Germany
| | - Lode Dewulf
- Independent Expert, Les Contamines-Montjoie, France
| | | | | | | | - Laureline Gatellier
- National Cancer Center Japan, Tokyo, Japan
- NPO Japan Brain Tumor Alliance, Yokohama, Japan
| | | | | | - Hayley Chapman
- Patient Focused Medicines Development (PFMD), Brussels, Belgium.
| | - Nicholas Brooke
- Patient Focused Medicines Development (PFMD), Brussels, Belgium
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Scholz S, Berns I, Winkler C. Listen to the patients! Identifying CML patients' needs analyzing patient-generated content with AI-driven methodologies. Front Digit Health 2023; 5:1243215. [PMID: 38116100 PMCID: PMC10729659 DOI: 10.3389/fdgth.2023.1243215] [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: 06/20/2023] [Accepted: 11/20/2023] [Indexed: 12/21/2023] Open
Abstract
Background Various patient support programs exist to provide successful therapy options for patients. Pharmaceutical companies are increasingly recognizing the importance of actively supporting patients in their long-term treatment. In order to effectively assist patients, it is crucial to understand their current needs by taking a look at the patients' opinions. Objective This study focuses specifically on chronic myeloid leukemia (CML) and aims to determine if the current patient engagement offerings from pharmaceutical companies adequately address the needs of CML patients. To achieve this, the study uses content generated by CML patients to assess the patient engagement strategies of selected pharmaceutical companies, explore the relevance of medication, their products, and services, and analyze key concerns from the perspective of the patients. Methods To address the research questions, various methodologies were employed. Initially, desk research was conducted to identify relevant pharmaceutical companies and internet forums related to CML. Subsequently, content generated by patients was acquired and AI-driven techniques such as topic modeling and topic evolution analyses were used to examine this user-generated content (UGC) within the identified public forums. This involved analyzing topic models and tracking topic changes over time. Results The desk research revealed that pharmaceutical companies primarily offer information about the disease and available treatment options. The UGC analysis confirmed the significant role played by the industry in supporting CML patients. Key areas of interest for patients include the disease itself, potential treatment methods and associated side effects, dosage of active substances, and the possibility of switching therapies due to treatment failure or resistance. Stem cell transplantation was also discussed. Conclusions Overall, the pharmaceutical industry adequately addresses the needs of CML patients. However, there is room for improvement in educating patients about treatment options, drugs, and their side effects. Psychological support should not be neglected. Since CML patients frequently engage with clinical trial outcomes, there is potential for increased patient involvement in such trials. Further research in this area is recommended.
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Affiliation(s)
- Stefanie Scholz
- Data Science in Social Economy, SRH Wilhelm Loehe University of Applied Sciences, Fuerth, Germany
| | - Isabell Berns
- Health Economics, University of Bayreuth, Bayreuth, Germany
| | - Christian Winkler
- AI-driven User Experience Optimization, Nuremberg Institute of Technology, University of Applied Sciences, Nuremberg, Germany
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Rasul E, Hallock R, Hellmann M, Konduros J, Pembroke L, LeCleir G, Malacan J, von Mackensen S. Gene Therapy in Hemophilia: A Transformational Patient Experience. J Patient Exp 2023; 10:23743735231193573. [PMID: 37663068 PMCID: PMC10472832 DOI: 10.1177/23743735231193573] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/05/2023] Open
Abstract
Hemophilia is a bleeding disorder caused by a single absent/defective gene and characterized by a lack of functional clotting factors. People with hemophilia may experience joint damage, pain, and psychological impairments, all of which could contribute to reduced health-related quality of life (HRQoL). The current standard of care is clotting factor replacement, which is associated with regular infusions; therefore, alternative treatments such as gene therapy (GT) are in development. GT involves the delivery of a functional copy of the clotting factor 8/9 gene by a single infusion into the patient's cells, enabling them to produce their own clotting factor VIII/IX. The impact of treatment on patients' HRQoL can be assessed using hemophilia-specific patient-reported outcome (PRO) measures. Since these measures were designed before the advent of GT, there is a need for updated individualized PRO measures. Patient groups and regulatory authorities emphasize the need for increased patient engagement when considering clinical trial design. Here, we provide patients' perspective on undergoing GT and discuss how to capture the patient voice when measuring the therapy's transformative impact.
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Affiliation(s)
- Enayet Rasul
- Patient author. Have either haemophilia A or B and have undergone gene therapy treatment
| | - Ryan Hallock
- Patient author. Have either haemophilia A or B and have undergone gene therapy treatment
| | - Magnus Hellmann
- Patient author. Have either haemophilia A or B and have undergone gene therapy treatment
| | - Jay Konduros
- Patient author. Have either haemophilia A or B and have undergone gene therapy treatment
| | - Luke Pembroke
- Patient author. Have either haemophilia A or B and have undergone gene therapy treatment
| | | | | | - Sylvia von Mackensen
- Department of Medical Psychology, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
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7
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Collin-Histed T, Stoodley M, Beusterien K, Elstein D, Jaffe DH, Revel-Vilk S, Davies EH. A global neuronopathic gaucher disease registry (GARDIAN): a patient-led initiative. Orphanet J Rare Dis 2023; 18:195. [PMID: 37480076 PMCID: PMC10360308 DOI: 10.1186/s13023-023-02828-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2022] [Accepted: 07/11/2023] [Indexed: 07/23/2023] Open
Abstract
BACKGROUND Gaucher disease (GD) is a rare autosomal recessive lysosomal storage disorder. GD types 2 and 3 are known as neuronopathic Gaucher disease (nGD) because they have brain involvement that progresses over time. Implementing a systematic approach to the collection of real-world clinical and patient-relevant outcomes data in nGD presents an opportunity to fill critical knowledge gaps and ultimately help healthcare providers in the management of this patient population. This paper summarizes the development of a patient-initiated Gaucher Registry for Development Innovation and Analysis of Neuronopathic Disease (GARDIAN). METHODS The International Gaucher Alliance led the GARDIAN planning, including governance, scope, stakeholder involvement, platform, and reporting. Registry element input was determined in a series of meetings with clinical experts, patients, and caregivers, who identified key clinical variables and the draft content of nGD patient-reported outcomes (PRO) and observer-reported outcomes (ObsRO) focusing on symptoms, patient physical and emotional functioning. These were then tested in cognitive interviews with patients with nGD (> 12 years of age) and caregivers. RESULTS Core registry data elements (n = 138) were identified by seven global clinical experts from Egypt, Germany, Israel, Japan, United Kingdom (UK), and United State (US) and reviewed via online Delphi method by 14 additional clinicians with experience of nGD from six countries and three pharmaceutical representatives. The elements were consistent with those identified via interviews with 10 patients/caregivers with nGD from Japan, Sweden, UK, and US. Key domains identified were demographics, diagnostic information, health status, clinical symptomatology, laboratory testing, treatment, healthcare resource utilization, aids/home improvements, and patient/caregiver burden and quality of life, specifically physical functioning, self-care, daily and social activities, emotional impacts, support services, and caregiver-specific impacts. Nine caregivers and six patients from the US, UK, China, Mexico, Egypt, and Japan participated in the cognitive interviews that informed revisions to ensure that all items are understandable and interpreted as intended. CONCLUSIONS The comprehensive set of clinical and patient relevant outcomes data, developed collaboratively among all stakeholders, to be reported using GARDIAN will bridge the many gaps in the understanding of nGD and align with regulatory frameworks on real-world data needs.
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Affiliation(s)
- Tanya Collin-Histed
- International Gaucher Alliance (IGA), 86-90 Paul Street, London, EC2A 4NE, UK.
- International Gaucher Alliance, 86-90 Paul Street, London, EC2A 4NE, UK.
| | - Madeline Stoodley
- International Gaucher Alliance (IGA), 86-90 Paul Street, London, EC2A 4NE, UK
| | - Kathleen Beusterien
- Cerner Enviza, an Oracle Company, 51 Valley Stream Pkwy, Malvern, PA, 19355, USA
| | | | - Dena H Jaffe
- Cerner Enviza, an Oracle Company, 51 Valley Stream Pkwy, Malvern, PA, 19355, USA
| | - Shoshana Revel-Vilk
- Gaucher Unit, Shaare Zedek Medical Center, Jerusalem, Israel
- Faculty of Medicine, Hebrew University, Jerusalem, Israel
| | - Elin Haf Davies
- Aparito, 11-12 Gwenfro Technology Park, Croesnewydd Road, Wrexham, UK
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Cozad MJ, Lindley LC, Crosby K, Alshareef N, Kennedy AB, Merchant G, Evans P, Horner RD. Patient Goals for Living with Rheumatoid Arthritis: A Qualitative Study. Clin Nurs Res 2023; 32:40-48. [PMID: 35128973 DOI: 10.1177/10547738221075784] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Rheumatoid arthritis is highly individualized in terms of its flare ups and periods of remission. Each patient's unique experience requires a high level of personalization in terms of treatment making it necessary to understand what their goals for living are. This study explores patient perceptions on how the burden of RA shapes patients' goals for living and their preferences for symptom and side-effect management within the United States. Fifteen patients diagnosed with RA with varying lengths of diagnosis were interviewed. A thematic analysis was conducted to construct a conceptual framework. Emerging themes identified disease burdens as: (1) inability to perform essential needs, (2) negative feelings about disease, and (3) its influence on relationships. These burdens shaped desired goals for living which guided the symptom and side-effect priorities the patient wanted managed. Practitioners should consider patient goals and preferences in conjunction with disease progression when engaging in treatment decisions.
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Affiliation(s)
| | | | | | | | | | | | - Pam Evans
- University of South Carolina, SC, USA
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Cozad MJ, Crum M, Tyson H, Fleming PR, Stratton J, Kennedy AB, Lindley LC, Horner RD. Mobile Health Apps for Patient-Centered Care: Review of United States Rheumatoid Arthritis Apps for Engagement and Activation. JMIR Mhealth Uhealth 2022; 10:e39881. [PMID: 36469397 PMCID: PMC9764152 DOI: 10.2196/39881] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Revised: 09/30/2022] [Accepted: 10/19/2022] [Indexed: 11/07/2022] Open
Abstract
BACKGROUND Rheumatoid arthritis (RA) is a highly dynamic and individualized disease in terms of its patterns of symptomatic flare-ups and periods of remission. Patient-centered care (PCC) aligns patients' lifestyle goals with their preferences for managing symptoms and side effects through the selection of therapies appropriate for disease management. Mobile health (mHealth) apps have the potential to engage and activate patients in PCC. mHealth apps can provide features that increase disease knowledge, collect patient-generated health indicators and behavioral metrics, and highlight goals for disease management. However, little evidence-based guidance exists as to which apps contain functionality essential for supporting the delivery of PCC. OBJECTIVE The objective of this study was to evaluate the patient-centeredness of United States-based rheumatoid arthritis mobile apps in terms of patient engagement and activation. METHODS A search of mobile apps on 2 major United States app stores (Apple App Store and Google Play) was conducted from June 2020 to July 2021 to identify apps designed for use by patients with RA by adapting the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) guidelines for mobile health app screening based on the literature. Reviewers conducted a content analysis of mobile app features to evaluate their functionality for patient engagement and activation. Engagement and activation were assessed using the Mobile Application Rating Scale (MARS) and social cognitive theory, respectively. Apps were ranked by their ability to facilitate PCC care along 2 dimensions: engagement and activation. RESULTS A total of 202 mobile apps were initially identified, and 20 remained after screening. Two apps emerged with the greatest ability to facilitate PCC. Both apps were scored as having acceptable or good patient engagement according to the MARS. These 2 apps also had high patient activation according to social cognitive theory, with many features within those apps representing theoretical constructs such as knowledge, perceived self-efficacy, and expectations about outcomes that support behavioral management of RA. CONCLUSIONS We found very few mobile apps available within the United States that have functionality that both engages and activates the patient to facilitate PCC. As the prevalence of mobile apps expands, the design of mobile apps needs to integrate patients to ensure that their functionality promotes engagement and activation. More research is needed to understand how mobile app use impacts patient engagement and activation, and ultimately, treatment decisions and disease trajectory.
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Affiliation(s)
- Melanie J Cozad
- Health Services Research and Administration Department, College of Public Health, University of Nebraska Medical Center, Omaha, NE, United States
| | - Marissa Crum
- School of Medicine Greenville, University of South Carolina, Greenville, SC, United States
| | - Hannah Tyson
- Business and Accounting Department, Furman University, Greenville, SC, United States
| | - Perry R Fleming
- School of Medicine Greenville, University of South Carolina, Columbia, SC, United States
| | - Jeanine Stratton
- Business and Accounting Department, Furman University, Greenville, SC, United States
| | - Ann Blair Kennedy
- School of Medicine Greenville, University of South Carolina, Greenville, SC, United States
| | - Lisa C Lindley
- College of Nursing, University of Tennessee-Knoxville, Knoxville, TN, United States
| | - Ronnie D Horner
- Health Services Research and Administration Department, College of Public Health, University of Nebraska Medical Center, Omaha, NE, United States
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Cummergen K, Hannah L, Jopling L, Cameron R, Walsh C, Perez J. What outcomes matter to service users who experience persistent depression: A mixed-method narrative review and synthesis. JOURNAL OF AFFECTIVE DISORDERS REPORTS 2022. [DOI: 10.1016/j.jadr.2022.100431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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11
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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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12
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Jacob C, Bourke S, Heuss S. From testers to co-creators: the value and approaches to successful patient engagement in the development of eHealth solutions - Qualitative Expert Interviews Study. JMIR Hum Factors 2022; 9:e41481. [PMID: 36102548 PMCID: PMC9585443 DOI: 10.2196/41481] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Revised: 08/30/2022] [Accepted: 09/10/2022] [Indexed: 11/18/2022] Open
Abstract
Background Research has shown that patient engagement is most commonly done at the beginning of research or to test readily available prototypes and less commonly done in other phases such as the execution phases. Previous studies have reported that patients are usually assigned a consultative rather than a decision-making role in health service planning and evaluation. Objective This study had 2 objectives: to better understand the challenges and opportunities in the inclusion of patients in the development of eHealth technologies and ideas on how to overcome the identified gaps and to create a research-based end-to-end practical blueprint that can guide the relevant stakeholders to successfully engage patients as cocreators in all human-centered design phases rather than mere testers of preplanned prototypes. Methods Key informant interviews were conducted using in-depth semistructured interviews with 20 participants from 6 countries across Europe. This was followed by a focus group to validate the initial findings. Participants encompassed all the relevant stakeholder groups including patient experts, eHealth experts, health technology providers, clinicians, pharma executives, and health insurance experts. Results This study shows that engaging patients in eHealth development can help provide different types of value; namely, identifying unmet needs, better usability and desirability, better fit into the patient journey, better adoption and stickiness, better health outcomes, advocacy and trust, a sense of purpose, and better health equity and access. However, the participants agreed that patients are usually engaged too late in the development process, mostly assuming a sounding role in testing a ready-made prototype. The justification for these gaps in engagement is driven by some prominent barriers, notably compliance risks, patient-related factors, power dynamics, patient engagement as lip service, poor value perception, lack of resources, mistrust, and inflexibility. On the positive side, the participants also reflected on facilitators for better patient engagement; for instance, engaging through engagement partners, novel approaches such as the rise of professional patient experts, embedding patients in development teams, expectation management, and professional moderation services. Conclusions Overcoming the current gaps in patient engagement in eHealth development requires consolidated efforts from all stakeholders in a complex health care ecosystem. The shift toward more patient-driven eHealth development requires education and awareness; frameworks to monitor and evaluate the value of patient engagement; regulatory clarity and simplification; platforms to facilitate patient access and identification; patient incentivization, transparency, and trust; and a mindset shift toward value-based health care.
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Affiliation(s)
- Christine Jacob
- FHNW - University of Applied Sciences Northwestern Switzerland, Bahnhofstrasse 6, Windisch, CH
| | | | - Sabina Heuss
- FHNW - University of Applied Sciences Northwestern Switzerland, Olten, CH
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Caffery B, Petris R, Hammitt KM, Montecchi-Palmer M, Haque S, Malkowski JP, Barabino S. Patient perspectives on dry eye disease and chronic ocular surface pain: Insights from a virtual community-moderated dialogue. Eur J Ophthalmol 2022; 33:11206721221125263. [PMID: 36071618 DOI: 10.1177/11206721221125263] [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: 11/17/2022]
Abstract
PURPOSE To understand patients' perspectives on living with dry eye disease (DED), and on the unmet needs in DED and chronic ocular surface pain (COSP) management. METHODS A moderated, structured discussion with patients with ocular surface diseases and healthcare professionals (HCPs) was conducted using a virtual platform to capture patients' journey with DED, their opinion on unmet needs, and design and conduct of clinical trials in DED and COSP. RESULTS Nine participants, including four patient representatives from patient organisations, one ophthalmologist and one optometrist participated in the discussion. Patients had DED of varying severity and aetiology; three patients had Sjögren's. Over 4 weeks, 785 posts were entered on the platform. Prior to diagnosis, patients rarely associated their symptoms with DED. Convenience and symptomatic relief scored higher than treating the disease. Patients expressed the need for plain language information and dialogue with knowledgeable and sensitive HCPs. Online forums and social media were suggested as key recruitment resources, whereas convenience and safety concerns were highlighted as main barriers to enrolment. The need for the inclusion of outcome measures that have a real impact on patients' experience of their condition was highlighted. Both target product profiles were received positively by participants, highlighting the twice-daily dosing regimen and convenience of the products. Participants acknowledged the value of digital tools and suggested the need to feel valued post-trial. CONCLUSIONS This moderated dialogue provided actionable insights on the unmet needs in DED and useful inputs for consideration when designing future clinical trials for DED and COSP.
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Zvonareva O, Craveț C, Richards DP. Practices of patient engagement in drug development: a systematic scoping review. RESEARCH INVOLVEMENT AND ENGAGEMENT 2022; 8:29. [PMID: 35768857 PMCID: PMC9243835 DOI: 10.1186/s40900-022-00364-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Accepted: 06/18/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND During the past decade, patient engagement (PE) has attracted significant attention in the field of drug development. Readiness to accept the central importance of patients' knowledge and contributions has become evident. This study aimed to synthesize evidence on the current state of PE in drug development: what is actually being done and how. METHODS A systematic scoping review was conducted based on a PRISMA-informed protocol. Search was performed in PubMed, EMBASE and Web of Science, covering the period between 2011 and 2021. For analysis of extracted data, we developed a framework for analyzing PE in Drug Development. The Framework distinguishes a number of different PE types that take place at different stages of drug development and are characterized by the different degrees of power patients have in the process. It allowed us to assess depth and intensity of PE initiatives included in this review. RESULTS Most included PE initiatives took place at the stage of designing studies (40 in total). At this stage drug development goals are already set, but the mode of reaching them has not yet been fully determined. PE initiatives on the finetuning details stage followed (16 in total). The finetuning details stage covers the last parts of the drug development trajectory, when only relatively minor issues are still open for patients' contributions. The least numerous were PE initiatives on the stage of setting up R&D program (13 in total). This stage refers to the early steps in drug development where PE has the potential to make the most impact on shaping the subsequent process. In terms of intensity of engagement, most PE initiatives included in this review align with consultation and involvement types, 26 and 30 initiatives, respectively. Partnership was less frequent in the published accounts of PE (13 initiatives). CONCLUSIONS This review delineated a contemporary landscape of PE in drug development. Although attention to PE in drug development is relatively recent, a wide range of PE practices has already been initiated. The results indicate the necessity of distinguishing between different types of PE in order to understand consequences of choices regarding depth and intensity of PE.
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Affiliation(s)
- Olga Zvonareva
- Department of Health, Ethics and Society, Maastricht University, Minderbroedersberg 4-6, 6211 LK, Maastricht, The Netherlands.
| | - Constanța Craveț
- Department of Health, Ethics and Society, Maastricht University, Minderbroedersberg 4-6, 6211 LK, Maastricht, The Netherlands
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Karim S, Craig BM, Groothuis-Oudshoorn CGM. Exploring the importance of controlling heteroskedasticity and heterogeneity in health valuation: a case study on Dutch EQ-5D-5L. Health Qual Life Outcomes 2022; 20:85. [PMID: 35614472 PMCID: PMC9131619 DOI: 10.1186/s12955-022-01989-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Accepted: 05/06/2022] [Indexed: 11/12/2022] Open
Abstract
Background Respondents in a health valuation study may have different sources of error (i.e., heteroskedasticity), tastes (differences in the relative effects of each attribute level), and scales (differences in the absolute effects of all attributes). Although prior studies have compared values by preference-elicitation tasks (e.g., paired comparison [PC] and best–worst scaling case 2 [BWS]), no study has yet controlled for heteroskedasticity and heterogeneity (taste and scale) simultaneously in health valuation. Methods Preferences on EQ-5D-5L profiles were elicited from a random sample of 380 adults from the general population of the Netherlands, using 24 PC and 25 BWS case 2 tasks. To control for heteroskedasticity and heterogeneity (taste and scale) simultaneously, we estimated Dutch EQ-5D-5L values using conditional, heteroskedastic, and scale-adjusted latent class (SALC) logit models by maximum likelihood. Results After controlling for heteroskedasticity, the PC and BWS values were highly correlated (Pearson's correlation: 0.9167, CI: 0.9109–0.9222) and largely agreed (Lin's concordance: 0.7658, CI: 0.7542–0.7769) on a pits scale. In terms of preference heterogeneity, some respondents (mostly young men) failed to account for any of the EQ-5D-5L attributes (i.e., garbage class), and others had a lower scale (59%; p-value: 0.123). Overall, the SALC model produced a consistent Dutch EQ-5D-5L value set on a pits scale, like the original study (Pearson's correlation:0.7295; Lin's concordance: 0.6904). Conclusions This paper shows the merits of simultaneously controlling for heteroskedasticity and heterogeneity in health valuation. In this case, the SALC model dispensed with a garbage class automatically and adjusted the scale for those who failed the PC dominant task. Future analysis may include more behavioral variables to better control heteroskedasticity and heterogeneity in health valuation. Highlights The Dutch EQ-5D-5L values based on paired comparison [PC] and best-worst scaling [BWS] responses were highly correlated and largely agreed after controlling for heteroskedasticity. Controlling for taste and scale heterogeneity simultaneously enhanced the Dutch EQ-5D-5Lvalues by automatically dispensing with a garbage class and adjusting the scale for those who failed the dominant task. After controlling for heteroskedasticity and heterogeneity, this study produced Dutch EQ-5D-5L values on a pits scale moderately concordant with the original values.
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Affiliation(s)
- Suzana Karim
- University of South Florida, 4202 E Fowler Ave, Tampa, FL, 33620, USA.
| | - Benjamin M Craig
- University of South Florida, 4202 E Fowler Ave, Tampa, FL, 33620, USA
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Gnanasakthy A, Norcross L, DeMuro Romano C, Carson RT. A Review of Patient-Reported Outcome Labeling of FDA-Approved New Drugs (2016-2020): Counts, Categories, and Comprehensibility. VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2022; 25:647-655. [PMID: 35365309 DOI: 10.1016/j.jval.2021.10.006] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Revised: 09/30/2021] [Accepted: 10/14/2021] [Indexed: 06/14/2023]
Abstract
OBJECTIVES A review of new drug approvals (NDAs) by the US Food and Drug Administration (FDA) for 2006 to 2015 showed that approximately 20% of new drugs had labeling based on patient-reported outcomes (PROs). The purpose of this study was to review labeling text based on PRO endpoints for NDAs from 2016 to 2020, with a special focus on the comprehensibility of such statements when included. METHODS We reviewed drug approval reports on the Drugs@FDA web page of the FDA website to determine the number of NDAs from 2016 to 2020. For all identified NDAs, drug approval package and product labels were reviewed. NDAs from 2016 to 2020 were grouped by disease category as per International Classification of Diseases 10th Revision. Data were summarized for diseases that traditionally rely on PROs for evaluating treatment benefit (PRO dependent) and for diseases that traditionally do not rely on PROs (non-PRO dependent). Results were compared with NDAs from 2006 to 2010. RESULTS NDAs amounting to 228 were identified from 2016 to 2020, 26.3% of which had labeling statements based on PRO endpoints. From 2006 to 2015 and from 2016 to 2020, PRO labeling statements were included in 46.5% (46 of 99) and 50.0% (47 of 94), respectively, of NDAs for PRO-dependent new molecular entities and in 6.0% (12 of 199) and 9.7% (13 of 199), respectively, of NDAs for non-PRO-dependent new molecular entities. Comprehensibility of labeling statements based on PRO endpoints was judged to be complex in 56.7% of product labels. CONCLUSIONS The increase in labeling text based on PRO endpoints in product labels is encouraging. However, there is room for improvement on the comprehensibility of labeling statements based on PRO endpoints.
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Affiliation(s)
| | | | - Carla DeMuro Romano
- RTI Health Solutions, Research Triangle Park, NC, USA; AbbVie, HEOR, Patient-Centered Outcomes Research, Madison, NJ, USA
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17
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The Current Landscape of Research Advocacy and Education for Patients with Colorectal Cancer. Curr Treat Options Oncol 2022; 23:645-657. [PMID: 35353319 DOI: 10.1007/s11864-022-00970-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/14/2022] [Indexed: 11/03/2022]
Abstract
OPINION STATEMENT Research advocacy is an evolving concept and should be tailored for the colorectal cancer research community. Research advocacy training and evaluation must be designed for the patient community with their insight included at each step of engagement, training, and implementation. Patient advocates bring a great deal of expertise to the research review process, but it is important to ensure that their insight is appropriately placed, and they bring an appropriate orientation to the research process as the most informed patient. This can be accomplished in part by providing advocates with the proper training, employing universal core competencies, and applying principles of adult learning. Additionally, the research community, advocacy organizations, and industry partners must understand the need to diversify the voices that are being leveraged to guide research, recognizing the importance of adequate mental health tools and compensation commensurate with their experience. As a community, it is necessary that we create and implement training programs, as well as evaluate and measure their impact to continually improve and tailor the delivery of this specific education. Research advocacy has become a necessity to the field, and when implemented effectively, research advocates can have a significant impact on the delivery of health care research, improving health outcomes for all those affected by colorectal cancer.
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Boye KS, Jordan JB, Malik RE, Currie BM, Matza LS. Patient Perceptions of and Preferences Between Characteristics of Injectable Diabetes Treatments. Diabetes Ther 2021; 12:2387-2403. [PMID: 34297341 PMCID: PMC8385031 DOI: 10.1007/s13300-021-01097-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Accepted: 06/10/2021] [Indexed: 12/13/2022] Open
Abstract
INTRODUCTION The administration of medications targeting type 2 diabetes mellitus (T2D) has evolved over time. As injection delivery systems continue to evolve, it is necessary to understand patients' perceptions of currently available treatments. The objective of this study was to examine the patient perspective of injectable treatment for T2D and identify characteristics of these treatments that are most important to patients. METHODS Data were collected via an online survey study with a sample of individuals in the UK and US who were treated for T2D with injectable medication. The survey was designed to elicit perceptions of the treatment process for injectable glucagon-like peptide 1 (GLP-1) receptor agonists and insulin. RESULTS The sample included 504 participants (251 UK, 253 US). Approximately half (50.4%) were treated with a GLP-1 receptor agonist and half (49.6%) were treated with insulin. Respondents were presented with a list of 17 characteristics of injectable medication and asked to indicate which were most important to them. Respondents most frequently selected confidence in administering the correct dose (n = 300, 59.5%); ease of selecting the correct dose (n = 268, 53.2%); overall ease of using the injection device (n = 239, 47.4%); frequency of injections (n = 223, 44.2%); and ease of carrying the device when necessary to inject away from home (n = 190, 37.7%). Characteristics least frequently cited as important included dose escalation (n = 79, 15.7%); handling the needle (n = 74, 14.7%); connectivity to an electronic device (n = 70, 13.9%); and the time required to prepare and inject each dose (n = 62, 12.3%). CONCLUSION Results of this survey suggest that patients prioritize some attributes of injectable treatments over others. These findings may have implications for clinical practice and development of injection devices.
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Affiliation(s)
| | | | | | - Brooke M. Currie
- Evidera, 7101 Wisconsin Avenue, Suite 1400, Bethesda, MD 20814 USA
| | - Louis S. Matza
- Evidera, 7101 Wisconsin Avenue, Suite 1400, Bethesda, MD 20814 USA
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19
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Faulkner SD, Sayuri Ii S, Pakarinen C, Somers F, Jose Vicente Edo M, Prieto Remon L, Diaz Ponce A, Gove D, Ferrer E, Nafria B, Bertelsen N, Boudes M, Brooke N, Moutet A, Fahy N. Understanding multi-stakeholder needs, preferences and expectations to define effective practices and processes of patient engagement in medicine development: A mixed-methods study. Health Expect 2021; 24:601-616. [PMID: 33599067 PMCID: PMC8077078 DOI: 10.1111/hex.13207] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Revised: 11/26/2020] [Accepted: 01/19/2021] [Indexed: 01/23/2023] Open
Abstract
Background The holistic evolution of patient engagement in medicines development requires a more detailed understanding of the needs of all involved stakeholders, and one that better accounts for the specific needs of some potentially vulnerable patient populations and key stages in medicines development. Objective The purpose of this convergent mixed‐methods study was to better understand the needs of different stakeholders concerning patient engagement at three key stages in medicines development: research priority setting, clinical trial design and early dialogues with Health Technology Assessment bodies and regulators. Design This study brought together findings from three sources: i) an online questionnaire, ii) face‐to‐face consultations with two potentially vulnerable patient populations, a workshop with Health Technology Assessment bodies, and iii) three‐step modified Delphi methodology. Results Overall stakeholders still need additional varied support mechanisms to undertake, sustain or measure value of patient engagement. Health Technology Assessment bodies need better rationale for patient engagement in early dialogue and tools to support its implementation. Improved awareness and understanding of the need and value that involving patients, who are often considered as potentially vulnerable, can bring is needed, as is better accommodation of their specific needs. Similarly, weighted Delphi categories were as follows: aims and objectives, and sustainability. Several additional themes were common across the three key stages in medicines development. Conclusion This broad‐reaching study provides the blocks needed to build a framework for patient engagement in medicines development. Patient or Public Contribution Patients were involved in review and interpretation of data.
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Affiliation(s)
- Stuart D Faulkner
- Radcliffe Primary Care Building, Radcliffe Observatory Quarter, Oxford, UK
| | - Suzanne Sayuri Ii
- Radcliffe Primary Care Building, Radcliffe Observatory Quarter, Oxford, UK
| | | | | | - Maria Jose Vicente Edo
- Aragon Health Sciences Insitute, Instituto Aragonés de Ciencias de la Salud (IACS), Zaragoza, Spain
| | - Lucia Prieto Remon
- Aragon Health Sciences Insitute, Instituto Aragonés de Ciencias de la Salud (IACS), Zaragoza, Spain
| | | | | | | | - Begonya Nafria
- Patient Engagement in Research, Institut de Recerca Sant Joan de Déu- Hospital Sant Joan de Déu, Barcelona, Spain
| | | | | | | | | | - Nick Fahy
- Radcliffe Primary Care Building, Radcliffe Observatory Quarter, Oxford, UK
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20
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Rasiah J, Manafò E, Krawec K, Nielssen I, Amirav I, Macphail EC, Lavigne LA, Asis S. Albertans for Health Research Network: Form, Fit, and Function. J Patient Exp 2021; 7:973-977. [PMID: 33457531 PMCID: PMC7786747 DOI: 10.1177/2374373520925245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
The patient engagement (PE) platform staff of Alberta Strategy for Patient Oriented Research Support for People and Patient Oriented Research Trials Unit developed a patient-powered PE network called Albertans for Health Research Network (AB4HR); an enhanced tool to better connect patient partners and researchers online. AB4HR was developed in response to an identified need—a user-friendly online forum for both patient partners and researchers to access, so that they can better work together, as partners, in health research. We codesigned AB4HR and identified ways to improve the form, fit, and function of an existing registry through discussion groups with patient partners and researchers. We found 3 main themes derived from the perspective shared by patient partners and researchers. Patient partners and researchers agreed that the existing registry provides a forum to connect with one another in an easy, low-barrier way. However, there were opportunities for improvement with AB4HR, including possibilities for greater interaction between patient partners and researchers to promote more collaborative partnerships.
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Affiliation(s)
- Jananee Rasiah
- Patient Engagement Platform, Alberta SPOR SUPPORT Unit, Alberta, Canada.,Faculty of Health Disciplines, Athabasca University, Alberta, Canada.,Faculty of Nursing, University of Alberta, Alberta, Canada
| | - Elizabeth Manafò
- Patient Engagement Platform, Alberta SPOR SUPPORT Unit, Alberta, Canada.,Faculty of Health Disciplines, Athabasca University, Alberta, Canada
| | - Kiara Krawec
- Patient Engagement Platform, Alberta SPOR SUPPORT Unit, Alberta, Canada.,Faculty of Health Disciplines, Athabasca University, Alberta, Canada
| | - Ingrid Nielssen
- Faculty of Health Disciplines, Athabasca University, Alberta, Canada.,Department of Pediatrics, University of Alberta, Alberta, Canada.,Cumming School of Medicine, University of Calgary, Alberta, Canada
| | - Israel Amirav
- Department of Pediatrics, University of Alberta, Alberta, Canada
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21
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Smith J, Damm K, Hover G, Chien J. Lessons from an Experiential Approach to Patient Community Engagement in Rare Disease. Clin Ther 2020; 43:421-429. [PMID: 33375998 DOI: 10.1016/j.clinthera.2020.12.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Revised: 12/01/2020] [Accepted: 12/06/2020] [Indexed: 01/09/2023]
Abstract
Meaningful engagement between biopharmaceutical companies and patient communities has increasingly become an important part of the therapeutic-development process, as such engagement improves the understanding of the multifaceted challenges and unmet needs that communities experience and provides an opportunity to inform the approach to the development of new therapies and services. Presented here are learnings from a community-advisor program designed to engage families of patients with Duchenne muscular dystrophy (DMD) in a manner that enabled caregivers to make valuable contributions to the therapeutic-development process and to the DMD community. Parents of children with DMD, representing the broader DMD community, were identified in partnership with patient-advocacy organizations and invited to participate in a community-advisor meeting with members of Wave Life Sciences. The community-advisor meeting was designed to provide participants with an opportunity to share their personal experiences with DMD, to help to inform the therapeutic-development process, and to identify potential solutions for addressing unmet needs. Three community-advisor meetings were held with a total of 30 parents, representing 36 children with DMD. Key themes that emerged from the advisors' discussion included the importance of the community's emotional and mental support, the inconsistencies in DMD care, the increased challenges and disparities faced by underserved communities, and the need for more comprehensive, holistic approaches to the treatment and management of DMD. The advisors viewed the meetings as an opportunity to share their voices with a biopharmaceutical company, coupled with the advantage of meeting other families living with similar challenges. Most of the advisors stated that this was their first advisor meeting. This community-focused approach empowered participants to voice their needs and perspectives, to brainstorm potential solutions for addressing those needs, and to initiate and foster connections in ways that had a considerable impact on one another and on therapeutic-development programs at Wave Life Sciences.
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Affiliation(s)
| | - Kelly Damm
- Wave Life Sciences USA Inc, Cambridge, MA, USA
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22
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Roennow A, Sauvé M, Welling J, Riggs RJ, Kennedy AT, Galetti I, Brown E, Leite C, Gonzalez A, Portales Guiraud AP, Houÿez F, Camp R, Gilbert A, Gahlemann M, Moros L, Luna Flores JL, Schmidt F, Sauter W, Finnern H. Collaboration between patient organisations and a clinical research sponsor in a rare disease condition: learnings from a community advisory board and best practice for future collaborations. BMJ Open 2020; 10:e039473. [PMID: 33328257 PMCID: PMC7745690 DOI: 10.1136/bmjopen-2020-039473] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Introduction Transparent collaborations between patient organisations (POs) and clinical research sponsors (CRS) can identify and address the unmet needs of patients and caregivers. These insights can improve clinical trial participant experience and delivery of medical innovations necessary to advance health outcomes and standards of care. We share our experiences from such a collaboration undertaken surrounding the SENSCIS® clinical trial (NCT02597933), and discuss its impact during, and legacy beyond, the trial.Summary We describe the establishment of a community advisory board (CAB): a transparent, multiyear collaboration between the scleroderma patient community and a CRS. We present shared learnings from the collaboration, which is split into three main areas: (1) the implementation and conduct of the clinical trial; (2) analysis and dissemination of the results; and (3) aspects of the collaboration not related to the trial.1. The scleroderma CAB reviewed and provided advice on trial conduct and reporting. This led to the improvement and optimisation of trial procedures; meaningful, patient-focused adaptations were made to address challenges relevant to scleroderma-associated interstitial lung disease patients.2. To ensure that results of the trial were accessible to lay audiences and patients, written lay summaries were developed by the trial sponsor with valuable input from the CAB to ensure that language and figures were understandable.3. The CAB and the CRS also collaborated to co-develop opening tools for medication blister packs and bottles. In addition, to raise disease awareness among physicians, patients and caregivers, educational materials to improve diagnosis and management of scleroderma were co-created and delivered by the CAB and CRS.Conclusions This collaboration between POs and a CRS, in a rare disease condition, led to meaningful improvements in patient safety, comfort and self-management and addressed information needs. This collaboration may serve as a template of best practice for future collaborations between POs, research sponsors and other healthcare stakeholders.
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Affiliation(s)
- Annelise Roennow
- Federation of European Scleroderma Associations aisbl, Saint-Maur, Belgium
- Sklerodermiforening, Rødovre, Denmark
| | | | - Joep Welling
- Federation of European Scleroderma Associations aisbl, Saint-Maur, Belgium
| | - Robert J Riggs
- Scleroderma Foundation, Inc, Danvers, Massachusetts, USA
| | | | - Ilaria Galetti
- Federation of European Scleroderma Associations aisbl, Saint-Maur, Belgium
- Gruppo Italiano per la Lotta alla Sclerodermia, Milan, Italy
| | | | - Catarina Leite
- Portuguese Association of Patients with Scleroderma, Monção, Portugal
| | - Alex Gonzalez
- Scleroderma Research Foundation, San Francisco, California, USA
| | | | | | - Rob Camp
- EURORDIS-Rare Diseases Europe, Barcelona, Spain
| | | | | | - Lizette Moros
- Boehringer Ingelheim International GmbH, Ingelheim am Rhein, Rheinland-Pfalz, Germany
| | - Jose Luis Luna Flores
- Boehringer Ingelheim International GmbH, Ingelheim am Rhein, Rheinland-Pfalz, Germany
| | - Friedrich Schmidt
- Boehringer Ingelheim International GmbH, Ingelheim am Rhein, Rheinland-Pfalz, Germany
| | - Wiebke Sauter
- Boehringer Ingelheim Pharma GmbH and Co KG Biberach, Biberach, Baden-Württemberg, Germany
| | - Henrik Finnern
- Boehringer Ingelheim International GmbH, Ingelheim am Rhein, Rheinland-Pfalz, Germany
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23
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Lin HM, Pan X, Biller A, J Covey K, Huang H, Sugarman R, Scipione F, West H. Humanistic burden of living with anaplastic lymphoma kinase-positive non-small-cell lung cancer: findings from the ALKConnect patient insight network and research platform. Lung Cancer Manag 2020; 10:LMT42. [PMID: 33318754 PMCID: PMC7724653 DOI: 10.2217/lmt-2020-0018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Aim: Evaluate real-world patient preferences, experiences and outcomes (health-related quality of life [HRQoL]) from patients with anaplastic lymphoma kinase-positive (ALK+) non-small-cell lung cancer (NSCLC) utilizing the ALKConnect Patient Insight Network. Patients & methods: Demographics, disease history/status/treatment, patient preferences and HRQoL (MD Anderson Symptom Inventory lung cancer module, reported as symptom severity and interference) were evaluated for US adults with ALK+ NSCLC. Results: Among 104 patients (median age: 53.0 years, 67.3% female, 40.0% employed), HRQoL and 3-month delay in disease progression were important treatment attributes. Burdensome symptoms included fatigue and disturbed sleep. Symptoms interfered most with work and day-to-day activity. Higher HRQoL was associated with ALK tyrosine kinase inhibitor (TKI) treatment and employment. Conclusion: ALKConnect demonstrated that disease progression, HRQoL, fatigue/sleep, ALK TKIs and employment matter in ALK+ NSCLC.
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Affiliation(s)
- Huamao M Lin
- Millennium Pharmaceuticals, Inc., Cambridge, MA 02139, USA, a wholly owned subsidiary of Takeda Pharmaceutical Company Limited
| | - Xiaoyun Pan
- Millennium Pharmaceuticals, Inc., Cambridge, MA 02139, USA, a wholly owned subsidiary of Takeda Pharmaceutical Company Limited
| | - Alyssa Biller
- Millennium Pharmaceuticals, Inc., Cambridge, MA 02139, USA, a wholly owned subsidiary of Takeda Pharmaceutical Company Limited
| | - Kyla J Covey
- Invitae Corporation, San Francisco, CA 94103, USA
| | - Hui Huang
- Millennium Pharmaceuticals, Inc., Cambridge, MA 02139, USA, a wholly owned subsidiary of Takeda Pharmaceutical Company Limited
| | | | - Fatima Scipione
- Millennium Pharmaceuticals, Inc., Cambridge, MA 02139, USA, a wholly owned subsidiary of Takeda Pharmaceutical Company Limited
| | - Howard West
- City of Hope Comprehensive Cancer Center, Duarte, CA 91010, USA
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24
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Januskaite P, Xu X, Ranmal SR, Gaisford S, Basit AW, Tuleu C, Goyanes A. I Spy with My Little Eye: A Paediatric Visual Preferences Survey of 3D Printed Tablets. Pharmaceutics 2020; 12:E1100. [PMID: 33212847 PMCID: PMC7698452 DOI: 10.3390/pharmaceutics12111100] [Citation(s) in RCA: 70] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Revised: 11/11/2020] [Accepted: 11/14/2020] [Indexed: 12/18/2022] Open
Abstract
3D printing (3DP) in the pharmaceutical field is a disruptive technology that allows the preparation of personalised medicines at the point of dispensing. The paediatric population presents a variety of pharmaceutical formulation challenges such as dose flexibility, patient compliance, taste masking and the fear or difficulty to swallow tablets, all factors that could be overcome using the adaptable nature of 3DP. User acceptability studies of 3D printed formulations have been previously carried out in adults; however, feedback from children themselves is essential in establishing the quality target product profile towards the development of age-appropriate medicines. The aim of this study was to investigate the preference of children for different 3D printed tablets (Printlets™) as an important precursor to patient acceptability studies. Four different 3DP technologies; digital light processing (DLP), selective laser sintering (SLS), semi-solid extrusion (SSE) and fused deposition modeling (FDM) were used to prepare placebo printlets with similar physical attributes including size and shape. A single-site, two-part survey was completed with participants aged 4-11 years to determine their preference and opinions based on visual inspection of the printlets. A total of 368 participants completed an individual open questionnaire to visually select the best and worst printlet, and 310 participants completed further non-compulsory open questions to elaborate on their choices. Overall, the DLP printlets were the most visually appealing to the children (61.7%) followed by the SLS printlets (21.2%), and with both the FDM (5.4%) and SSE (11.7%) printlets receiving the lowest scores. However, after being informed that the SSE printlets were chewable, the majority of participants changed their selection and favoured this printlet, despite their original choice, in line with children's preference towards chewable dosage forms. Participant age and sex displayed no significant differences in printlet selection. Printlet descriptions were grouped into four distinct categories; appearance, perceived taste, texture and familiarity, and were found to be equally important when creating a quality target product profile for paediatric 3D printed formulations. This study is the first to investigate children's perceptions of printlets, and the findings aim to provide guidance for further development of paediatric-appropriate medicines using different 3DP technologies.
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Affiliation(s)
- Patricija Januskaite
- Department of Pharmaceutics, UCL School of Pharmacy, University College London, 29-39 Brunswick Square, London WC1N 1AX, UK; (P.J.); (X.X.); (S.R.R.); (S.G.)
| | - Xiaoyan Xu
- Department of Pharmaceutics, UCL School of Pharmacy, University College London, 29-39 Brunswick Square, London WC1N 1AX, UK; (P.J.); (X.X.); (S.R.R.); (S.G.)
| | - Sejal R. Ranmal
- Department of Pharmaceutics, UCL School of Pharmacy, University College London, 29-39 Brunswick Square, London WC1N 1AX, UK; (P.J.); (X.X.); (S.R.R.); (S.G.)
| | - Simon Gaisford
- Department of Pharmaceutics, UCL School of Pharmacy, University College London, 29-39 Brunswick Square, London WC1N 1AX, UK; (P.J.); (X.X.); (S.R.R.); (S.G.)
- FabRx Ltd., 3 Romney Road, Ashford, Kent TN24 0RW, UK
| | - Abdul W. Basit
- Department of Pharmaceutics, UCL School of Pharmacy, University College London, 29-39 Brunswick Square, London WC1N 1AX, UK; (P.J.); (X.X.); (S.R.R.); (S.G.)
- FabRx Ltd., 3 Romney Road, Ashford, Kent TN24 0RW, UK
| | - Catherine Tuleu
- Department of Pharmaceutics, UCL School of Pharmacy, University College London, 29-39 Brunswick Square, London WC1N 1AX, UK; (P.J.); (X.X.); (S.R.R.); (S.G.)
| | - Alvaro Goyanes
- Department of Pharmaceutics, UCL School of Pharmacy, University College London, 29-39 Brunswick Square, London WC1N 1AX, UK; (P.J.); (X.X.); (S.R.R.); (S.G.)
- FabRx Ltd., 3 Romney Road, Ashford, Kent TN24 0RW, UK
- Departamento de Farmacología, Farmacia y Tecnología Farmacéutica, I + D Farma Group (GI-1645), Universidad de Santiago de Compostela, 15782 Santiago de Compostela, A Coruña, Spain
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Webb EJD, Meads D, Al-Janabi H, Kind P, Torelli F, Horton M, Oyebode J, Wright P. UK General Population Utility Values for the SIDECAR-D Instrument Measuring the Impact of Caring for People With Dementia. VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2020; 23:1079-1086. [PMID: 32828221 PMCID: PMC7456787 DOI: 10.1016/j.jval.2020.04.1827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/08/2019] [Revised: 09/26/2019] [Accepted: 04/18/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVES Dementia affects many people, with numbers expected to grow as populations age. Many people with dementia receive informal/family/unpaid care, for example, from a spouse or child, which may affect carer quality of life. Measuring the effectiveness of health/social care interventions for carers requires a value measure of the quality-of-life impact of caring. This motivated development of the Scales Measuring the Impact of Dementia on Carers-D (SIDECAR-D) instrument. This study aimed to obtain general population values for SIDECAR-D to aid incorporating the impact of caring in economic evaluation. METHODS Members of the UK general public completed a best-worst scaling object case survey, which included the 18 SIDECAR-D items and EQ-5D-3L descriptions. Responses were analyzed using scale-adjusted finite mixture models. Relative importance scores (RISs) for the 18 SIDECAR-D items formed the SIDECAR-D relative scale measuring the relative impact of caring. The SIDECAR-D tariff, on the full health = 1, dead = 0 scale, was derived by rescaling EQ-5D-3L and SIDECAR-D RISs so the EQ-5D-3L RISs equaled anchored valuations of the EQ-5D-3L pits state from a visual analog scale task. RESULTS Five hundred ten respondents completed the survey. The model had 2 parameter and 3 scale classes. Additive utility decrements of SIDECAR-D items ranged from -0.05 to -0.162. Utility scores range from 0.95 for someone affirming 1 item to -0.297 for someone affirming all 18. CONCLUSION SIDECAR-D is a needs-based scale of the impact on quality of life of caring for someone with dementia, with a valuation tariff to support its use in economic evaluation.
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Affiliation(s)
- Edward J D Webb
- Leeds Institute of Health Sciences, University of Leeds, Leeds, England, UK.
| | - David Meads
- Leeds Institute of Health Sciences, University of Leeds, Leeds, England, UK
| | - Hareth Al-Janabi
- Institute of Applied Health Research, University of Birmingham, Birmingham, England, UK
| | - Paul Kind
- Leeds Institute of Health Sciences, University of Leeds, Leeds, England, UK
| | - Francesca Torelli
- Leeds Institute of Health Sciences, University of Leeds, Leeds, England, UK
| | - Mike Horton
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, England, UK
| | - Jan Oyebode
- Centre for Applied Dementia Studies, University of Bradford, Bradford, England, UK
| | - Penny Wright
- Leeds Institute of Medical Research at St James's, University of Leeds, Leeds, England, UK
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Development and Initial Evaluation of a Multifaceted Intervention to Improve Mental Health and Quality of Life Among Prostate Cancer Survivors. Int J Ment Health Addict 2020. [DOI: 10.1007/s11469-019-00108-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
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Lanar S, Acquadro C, Seaton J, Savre I, Arnould B. To what degree are orphan drugs patient-centered? A review of the current state of clinical research in rare diseases. Orphanet J Rare Dis 2020; 15:134. [PMID: 32493385 PMCID: PMC7268539 DOI: 10.1186/s13023-020-01400-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2019] [Accepted: 05/06/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Over the past 30 years, the healthcare industry has increasingly turned its attention to rare diseases. Regulators have emphasized the need for clinical research in this area to be patient-centered. However, there is a lack of evidence concerning whether this need is actually met. In this paper, we aim to address this gap. METHODS First, we describe the state of patient-centricity in clinical research in rare diseases based on a targeted literature review. Second, we discuss recommendations from scientific bodies on patient-reported outcome (PRO) measures in rare diseases. Third, we analyze data collected from EMA's and FDA's websites concerning rare disease labeling claims and data from Clinicaltrials.gov concerning the use of PRO measures in rare disease pivotal trials. Fourth, we perform an exhaustive literature review on the use of PRO measures in the pharmaceutical industry, including all phases of clinical research, observational/registry studies, and instrument development and validation. RESULTS There is limited information on rare disease patient engagement in study design, recruitment, and retention. None of the initiatives describing methods for developing PRO measures in rare diseases provide the clear guidance clinical researchers need. Only 17.4% of orphan drug labels contain a PRO measure. Less than half of pivotal trials in orphan drugs have a PRO measure as a primary or a secondary endpoint. Although the number of publications about PRO measures in rare diseases has risen in the past fifteen years, our results indicate that substantial improvements are needed to achieve patient-centricity. CONCLUSIONS The nature and extent of patient engagement in rare disease research is under-documented. The current paradigm for developing and using PRO measures in clinical research is failing to meet the needs of rare disease patients. Not only are PROs rarely used as high-level endpoints in clinical trials or taken into account in labeling claims, they are also under-researched overall - there are too few measures for the multitude of rare diseases. We call for a clear guidance on patient engagement and suggest a realistic approach to the adaptation of PRO strategy to the specific context of clinical research in rare diseases.
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Affiliation(s)
- Sally Lanar
- ICON plc, Patient-Centered Outcomes, 27 rue de la Villette, 69003 Lyon, France
| | - Catherine Acquadro
- ICON plc, Patient-Centered Outcomes, 27 rue de la Villette, 69003 Lyon, France
| | - James Seaton
- Seaton Associates, LLC, 9039 Sligo Creek Parkway #1408, Silver Spring, MD 20901 USA
| | - Isabelle Savre
- Mapi Research Trust, 27 rue de la Villette, 69003 Lyon, France
| | - Benoit Arnould
- ICON plc, Patient-Centered Outcomes, 27 rue de la Villette, 69003 Lyon, France
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Harrington RL, Hanna ML, Oehrlein EM, Camp R, Wheeler R, Cooblall C, Tesoro T, Scott AM, von Gizycki R, Nguyen F, Hareendran A, Patrick DL, Perfetto EM. Defining Patient Engagement in Research: Results of a Systematic Review and Analysis: Report of the ISPOR Patient-Centered Special Interest Group. VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2020; 23:677-688. [PMID: 32540224 DOI: 10.1016/j.jval.2020.01.019] [Citation(s) in RCA: 68] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/07/2019] [Revised: 01/17/2020] [Accepted: 01/30/2020] [Indexed: 05/13/2023]
Abstract
OBJECTIVES Lack of clarity on the definition of "patient engagement" has been highlighted as a barrier to fully implementing patient engagement in research. This study identified themes within existing definitions related to patient engagement and proposes a consensus definition of "patient engagement in research." METHODS A systematic review was conducted to identify definitions of patient engagement and related terms in published literature (2006-2018). Definitions were extracted and qualitatively analyzed to identify themes and characteristics. A multistakeholder approach, including academia, industry, and patient representation, was taken at all stages. A proposed definition is offered based on a synthesis of the findings. RESULTS Of 1821 abstracts identified and screened for eligibility, 317 were selected for full-text review. Of these, 169 articles met inclusion criteria, from which 244 distinct definitions were extracted for analysis. The most frequently defined terms were: "patient-centered" (30.5%), "patient engagement" (15.5%), and "patient participation" (13.4%). The majority of definitions were specific to the healthcare delivery setting (70.5%); 11.9% were specific to research. Among the definitions of "patient engagement," the most common themes were "active process," "patient involvement," and "patient as participant." In the research setting, the top themes were "patient as partner," "patient involvement," and "active process"; these did not appear in the top 3 themes of nonresearch definitions. CONCLUSION Distinct themes are associated with the term "patient engagement" and with engagement in the "research" setting. Based on an analysis of existing literature and review by patient, industry, and academic stakeholders, we propose a scalable consensus definition of "patient engagement in research."
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Affiliation(s)
| | - Maya L Hanna
- Boehringer Ingelheim Pharmaceuticals Inc., Ridgefield, CT USA
| | | | - Rob Camp
- Community Advisory Board Programme, EURORDIS, Barcelona, Spain
| | | | - Clarissa Cooblall
- Scientific & Health Policy Initiatives, ISPOR, Lawrenceville, NJ, USA
| | - Theresa Tesoro
- Scientific & Health Policy Initiatives, ISPOR, Lawrenceville, NJ, USA
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Pitts PJ. Towards Meaningful Engagement for the Patient Voice. PATIENT-PATIENT CENTERED OUTCOMES RESEARCH 2020; 12:361-363. [PMID: 31165399 DOI: 10.1007/s40271-019-00366-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Peter J Pitts
- Center for Medicine in the Public Interest, University of Paris Descartes Medical School, New York, USA.
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Manning E, Herndon M, Frye W, Ice TS, Thyssen N, Pushparajah DS, Yates SL. Giving Voice to Clinical Study Participants: Development and Deployment of Sequential Patient Experience Surveys for Global Clinical Studies. Ther Innov Regul Sci 2020; 54:1001-1009. [PMID: 31965539 PMCID: PMC7458896 DOI: 10.1007/s43441-020-00115-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2019] [Accepted: 12/09/2019] [Indexed: 11/25/2022]
Abstract
Background Biopharmaceutical companies are piloting patient experience surveys (PES) to help enhance patient satisfaction with clinical studies. However, most PES have been conducted at study close-out, which can hinder recall and responsiveness, and at a limited number of sites, which restricts their applicability to global studies. Our aim was to investigate the feasibility of developing sequential PES, which would be deployed globally, and to provide practical recommendations based on our real-world experience. Methods To develop sequential PES (introductory, interim, close-out), we customized a previously developed patient experience close-out survey. Extensive input was gained from multiple stakeholders (e.g., survey experts, patient advisors, psychometricians, clinical trialists, lawyers). To deploy the PES in global studies, we prepared PES-specific ethics committee submissions, training materials (e.g., slides, videos), and PES invitation aids (postcards, digital app reminders). Results Developing and deploying sequential PES in global clinical studies was feasible. The 3-part online PES (25 to 37 questions per survey) passed health literacy testing. To facilitate benchmarking, the PES included core questions (including a Net Promoter Score question). The PES gained ethics approval and was deployed globally in 2017–2018 in 12 phase 2 and 3 clinical studies in North America, Europe, and the Asia–Pacific. Based on the real-world insights gained and the challenges encountered, we have made recommendations for PES. Conclusions Our practical recommendations on the development and deployment of sequential global PES may assist others to implement PES efficiently and effectively, allowing them to gain feedback from patients globally during clinical studies. Electronic supplementary material The online version of this article (10.1007/s43441-020-00115-5) contains supplementary material, which is available to authorized users.
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Affiliation(s)
| | - Mitch Herndon
- UCB Pharma, 8010 Arco Corporate Drive, Raleigh, NC, 27617, USA
| | - Wendy Frye
- UCB Pharma, 8010 Arco Corporate Drive, Raleigh, NC, 27617, USA
| | - Tammy S Ice
- Accelerated Enrollment Solutions, Pharmaceutical Product Development, LLC, Wake Forest, NC, USA
| | | | | | - Stephen L Yates
- UCB Pharma, 8010 Arco Corporate Drive, Raleigh, NC, 27617, USA
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Scavone C, di Mauro G, Pietropaolo M, Alfano R, Berrino L, Rossi F, Tomino C, Capuano A. The European clinical trials regulation (No 536/2014): changes and challenges. Expert Rev Clin Pharmacol 2019; 12:1027-1032. [PMID: 31608706 DOI: 10.1080/17512433.2019.1680282] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Introduction: In recent years, a significant decrease in the number of clinical trials was observed among EU countries. This decline could be attributed to several factors, including the financial crisis of EU countries, the requirements introduced by the Directive 2001/20/EC and the increased market attractiveness of not EU countries.Areas covered: The EU Clinical Trials Regulation (CTR) 536/2014 was adopted in April 2014 by the European Parliament. The main changes arising from the CTR, including but not limited to the activation of a new EU portal, the potentiation of the already existing EU database and the requirement to provide plain language summaries of clinical trials, are aimed to improve the competitiveness of Europe in clinical research scenario and promote a faster approval of clinical trials. In this review, data related to the CTR 536/2014 and its potential implications in terms of transparency are based on pertinent papers that were retrieved by the PubMed database and the internet.Expert opinion: The full implementation of the CTR 536/2014 requires close cooperation between EU member states and regulatory agencies. Some aspects should be carefully considered such as the interaction with ethics committees, the insurance coverage and the protection of personal data issues.
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Affiliation(s)
- Cristina Scavone
- Campania Regional Centre for Pharmacovigilance and Pharmacoepidemiology - Department of Experimental Medicine - Section of Pharmacology "L. Donatelli", University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Gabriella di Mauro
- Campania Regional Centre for Pharmacovigilance and Pharmacoepidemiology - Department of Experimental Medicine - Section of Pharmacology "L. Donatelli", University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Michela Pietropaolo
- Unità Operativa Semplice Interdipartimentale Programmazione e Coordinamento attività sanitaria, Azienda Ospedaliera Universitaria, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Roberto Alfano
- Unità Operativa Semplice Interdipartimentale Programmazione e Coordinamento attività sanitaria, Azienda Ospedaliera Universitaria, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Liberato Berrino
- Campania Regional Centre for Pharmacovigilance and Pharmacoepidemiology - Department of Experimental Medicine - Section of Pharmacology "L. Donatelli", University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Francesco Rossi
- Campania Regional Centre for Pharmacovigilance and Pharmacoepidemiology - Department of Experimental Medicine - Section of Pharmacology "L. Donatelli", University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Carlo Tomino
- Research and Development Center, IRCCS San Raffaele Pisana, Rome, Italy
| | - Annalisa Capuano
- Campania Regional Centre for Pharmacovigilance and Pharmacoepidemiology - Department of Experimental Medicine - Section of Pharmacology "L. Donatelli", University of Campania "Luigi Vanvitelli", Naples, Italy
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Vat LE, Finlay T, Jan Schuitmaker-Warnaar T, Fahy N, Robinson P, Boudes M, Diaz A, Ferrer E, Hivert V, Purman G, Kürzinger ML, Kroes RA, Hey C, Broerse JEW. Evaluating the "return on patient engagement initiatives" in medicines research and development: A literature review. Health Expect 2019; 23:5-18. [PMID: 31489988 PMCID: PMC6978865 DOI: 10.1111/hex.12951] [Citation(s) in RCA: 68] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2019] [Revised: 07/02/2019] [Accepted: 07/17/2019] [Indexed: 12/25/2022] Open
Abstract
Background Showing how engagement adds value for all stakeholders can be an effective motivator for broader implementation of patient engagement. However, it is unclear what methods can best be used to evaluate patient engagement. This paper is focused on ways to evaluate patient engagement at three decision‐making points in the medicines research and development process: research priority setting, clinical trial design and early dialogues with regulators and health technology assessment bodies. Objective Our aim was to review the literature on monitoring and evaluation of patient engagement, with a focus on indicators and methods. Search strategy and inclusion criteria We undertook a scoping literature review using a systematic search, including academic and grey literature with a focus on evaluation approaches or outcomes associated with patient engagement. No date limits were applied other than a cut‐off of publications after July 2018. Data extraction and synthesis Data were extracted from 91 publications, coded and thematically analysed. Main results A total of 18 benefits and 5 costs of patient engagement were identified, mapped with 28 possible indicators for their evaluation. Several quantitative and qualitative methods were found for the evaluation of benefits and costs of patient engagement. Discussion and conclusions Currently available indicators and methods are of some use in measuring impact but are not sufficient to understand the pathway to impact, nor whether interaction between researchers and patients leads to change. We suggest that the impacts of patient engagement can best be determined not by applying single indicators, but a coherent set of measures.
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Affiliation(s)
- Lidewij Eva Vat
- Athena Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Teresa Finlay
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | | | - Nick Fahy
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | | | | | - Ana Diaz
- Alzheimer Europe, Luxembourg, Luxembourg
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Nabarette H. [Involving patients in the evaluation of health technologies at the French National Authority for Health (HAS)]. SANTE PUBLIQUE (VANDOEUVRE-LES-NANCY, FRANCE) 2019; 30:767-775. [PMID: 30990265 DOI: 10.3917/spub.187.0767] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
OBJECTIVE The French National Authority for Health (HAS) wanted to establish a review about the first months of its new patient involvement process dedicated to drug and medical device evaluation (which began in November 2016). This process relies on written submissions from patient organizations (POs). METHODS Different sources of information were used: data monitoring, comparison with other contribution processes in HAS, sharing of practices with other Health Technology Assessment (HTA) bodies, feedback discussions with POs, pharmaceuticals firms, and evaluators (internal reviewers and members of Appraisal Committees). RESULTS There were contributions for 25 drugs among 75 opened to contribution during the first six months. The HAS Board defined three adjustments in September 2017 to improve the procedure: increasing the time for POs to contribute, publishing the contributions on the HAS website, improvement of the presentation of the submission to the committee. Some further necessary reflections were identified such as the information available to POs to elaborate their submission, or the exact nature of intellectual uptake of the contribution during the different stages of assessment/appraisal elaboration. CONCLUSIONS The different methods proved to be complementary and helped to define adjustments and clarify some future stakes for this new procedure. Data on this kind of process must be routinely collected. Comparisons with other involvement processes and discussions with stakeholders are rather used in dedicated studies or improvements projects.
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Deane K, Delbecque L, Gorbenko O, Hamoir AM, Hoos A, Nafria B, Pakarinen C, Sargeant I, Richards DP, Skovlund SE, Brooke N. Co-creation of patient engagement quality guidance for medicines development: an international multistakeholder initiative. BMJ INNOVATIONS 2019; 5:43-55. [PMID: 31645992 PMCID: PMC6792320 DOI: 10.1136/bmjinnov-2018-000317] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/03/2018] [Revised: 01/22/2019] [Accepted: 01/29/2019] [Indexed: 01/20/2023]
Abstract
INTRODUCTION Meaningful patient engagement (PE) can enhance medicines' development. However, the current PE landscape is fragmentary and lacking comprehensive guidance. METHODS We systematically searched for PE initiatives (SYNaPsE database/publications). Multistakeholder groups integrated these with their own PE expertise to co-create draft PE Quality Guidance which was evaluated by public consultation. Projects exemplifying good PE practice were identified and assessed against PE Quality Criteria to create a Book of Good Practices (BOGP). RESULTS Seventy-six participants from 51 organisations participated in nine multistakeholder meetings (2016-2018). A shortlist of 20relevant PE initiatives (from 170 screened) were identified. The co-created INVOLVE guidelines provided the main framework for PE Quality Guidance and was enriched with the analysis of the PE initiatives and the PE expertise of stakeholders. Seven key PE Quality Criteria were identified. Public consultation yielded 67 responses from diverse backgrounds. The PE Quality Guidance was agreed to be useful for achieving quality PE in practice, understandable, easy to use, and comprehensive. Overall, eight initiatives from the shortlist and from meeting participants were selected for inclusion in the BOGP based on demonstration of PE Quality Criteria and willingness of initiative owners to collaborate. DISCUSSION The PE Quality Guidance and BOGP are practical resources which will be continually updated in response to user feedback. They are not prescriptive, but rather based on core principles, which can be applied according to the unique needs of each interaction and initiative. Implementation of the guidance will facilitate improved and systematic PE across the medicines' development lifecycle.
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Affiliation(s)
- Katherine Deane
- School of Health Sciences, University of East Anglia, Norwich, UK
| | - Laure Delbecque
- Patient Reported Outcomes, Pharmerit International, Rotterdam, Belgium
| | - Oleksandr Gorbenko
- Chief Scientific and Medical Office – Patient Affairs, ViiV Healthcare, London, UK
| | | | - Anton Hoos
- Patient Focused Medicines Development, Brussels, Belgium
| | - Begonya Nafria
- Patient Engagement in Research, Institut de Recerca Sant Joan de Déu- Hospital Sant Joan de Déu, Esplugues de Llobregat, Spain
| | - Chi Pakarinen
- Patient Focused Medicines Development, Brussels, Belgium
| | - Ify Sargeant
- Patient Focused Medicines Development, Brussels, Belgium
| | | | - Soren Eik Skovlund
- Steno Diabetes Centre North Denmark, Aalborg University Hospital, Aalborg, Denmark
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Elrod JK, Fortenberry JL. Am I seeing things through the eyes of patients? An exercise in bolstering patient attentiveness and empathy. BMC Health Serv Res 2018; 18:929. [PMID: 30545353 PMCID: PMC6293489 DOI: 10.1186/s12913-018-3681-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Background Modern marketing thought heavily emphasizes the need for healthcare providers to possess a customer orientation, placing patients at the focal point of attention within health and medical establishments. This has motivated significant investments in tools and techniques that foster outstanding service, attention, and support. Such investments in isolation, however, offer no guarantees that a true customer orientation will emerge. Proper implementation also is required—and that falls on the shoulders of health and medical personnel. Discussion The most innovative and expensive of customer-oriented tools and techniques mean very little unless they are placed in the hands of capable individuals possessing the ability and desire to serve patients well. But the rigors of industry life complicate matters, resulting occasionally in lost focus, compromising the patient experience. One of the simplest and most effective methods for encouraging patient attentiveness rests with a reflective exercise that encourages staff members to see themselves and their actions from the perspective of patients. Asking the operative question, “Am I seeing things through the eyes of patients?” serves as an effective reminder of priorities, building empathy and motivating personnel to continually deliver their very best. Conclusions Viewing one’s actions from the perspective of patients can be very revealing, opening eyes wide and permitting opportunities for any necessary improvements, making for a simple but powerful learning experience. The “Am I seeing things through the eyes of patients?” reflective exercise helps well-intentioned staff members avoid tendencies which can lull them into states of complacency, ensuring that they remain focused on those in their care.
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Affiliation(s)
- James K Elrod
- Willis-Knighton Health System, 2600 Greenwood Road, Shreveport, LA, 71103, USA
| | - John L Fortenberry
- Willis-Knighton Health System, 2600 Greenwood Road, Shreveport, LA, 71103, USA. .,LSU Shreveport, 1 University Place, Shreveport, LA, 71115, USA.
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Gonzato O, Gronchi A. The evolving role of patient advocates in rare cancers: opportunities and challenges. Expert Rev Pharmacoecon Outcomes Res 2018; 19:1-3. [PMID: 30227750 DOI: 10.1080/14737167.2019.1526083] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Ornella Gonzato
- a Associazione Paola for Muskulo-Skeletal Tumors - Onlus , Udine , Italy
| | - Alessandro Gronchi
- b Department of Surgery , Fondazione IRCCS Istituto Nazionale dei Tumori , Milan , Italy
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Boudes M, Robinson P, Bertelsen N, Brooke N, Hoos A, Boutin M, Geissler J, Sargeant I. What do stakeholders expect from patient engagement: Are these expectations being met? Health Expect 2018; 21:1035-1045. [PMID: 29858529 PMCID: PMC6250871 DOI: 10.1111/hex.12797] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/07/2018] [Indexed: 11/30/2022] Open
Abstract
Background Meaningful patient engagement (PE) in medicines development and during the life cycle of a product requires all stakeholders have a clear understanding of respective expectations. Objective A qualitative survey was undertaken to understand stakeholder expectations. Design The survey explored 4 themes from the perspective of each stakeholder group: meaning, views, expectations and priorities for PE. Participants were grouped into 7 categories: policymakers/regulators; health‐care professionals (HCPs); research funders; payers/purchasers/HTA; patients/patient representatives; pharmaceutical/life sciences industry; and academic researchers. Results Fifty‐nine interviews were conducted across a range of geographies, PE experience and job seniority/role. There was consensus across stakeholders on meaning of PE; importance of promoting PE to a higher level than currently; need for a more structured process and guidance. There was little consensus on stakeholder expectations and roles. Policymakers/regulators were expected by others to drive PE, create a framework and facilitate PE, provide guidelines of good practice and connect stakeholders, but this expectation was not shared by the policymakers/regulators group. HCPs were seen as the link between patients and other stakeholders, but HCPs did not necessarily share this view. Discussion and conclusions Despite broad stakeholder categories, clear themes emerged: there is no “leader”; no stakeholder has a clear view on how to meaningfully engage with patients; there are educational gaps; and a structure and guidance for PE is urgently required. Given the diversity of stakeholders, there needs to be multistakeholder collaborative leadership. Effective collaboration requires consensus on roles, responsibilities and expectations to synergize efforts to deliver meaningful PE in medicines life cycle.
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Affiliation(s)
| | | | | | | | | | - Marc Boutin
- National Health Council, Washington, DC, USA
| | - Jan Geissler
- European Patients' Academy on Therapeutic Innovation, Brussels, Belgium
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