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Feeney M, Evers C, Agpalo D, Cone L, Fleisher J, Schroeder K. Utilizing patient advocates in Parkinson's disease: A proposed framework for patient engagement and the modern metrics that can determine its success. Health Expect 2020; 23:722-730. [PMID: 32363785 PMCID: PMC7495075 DOI: 10.1111/hex.13064] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2019] [Revised: 03/31/2020] [Accepted: 04/04/2020] [Indexed: 01/25/2023] Open
Abstract
The wide application of patient engagement and its associated benefits has increased across government, academic and pharmaceutical research. However, neither an identified standard practice for the process of engagement, nor utilization of common metrics to assess associated outcomes, exists. Parkinson's Foundation developed a patient engagement framework and metrics to assess engagement within the academic research and drug development sectors. This approach was developed over the course of several years through assessing the literature, acquiring feedback from researchers and people with Parkinson's disease and adapting practices to be relevant and generalizable across patient engagement projects. This framework includes the: 1) creation of a scope of work, 2) establishment of guiding principles, 3) selection and training of participants, 4) co‐determination of project metrics, 5) execution of the project and 6) dissemination of project findings. Parkinson's Foundation has also worked with academic, government and pharmaceutical stakeholders to identify metrics that assess both the quality of patient engagement and outcomes associated with patient engagement on projects. By improving patient engagement project methodologies and metrics, global clinical trials can have access to evidence‐based patient engagement practices to more efficiently capture the needs of, and potentially benefit, the patient community.
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Affiliation(s)
| | | | | | - Lisa Cone
- Parkinson's Foundation, New York, New York
| | - Jori Fleisher
- Section of Movement Disorders, Department of Neurological Sciences, Rush University Medical Center, Chicago, Illinois
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Barger S, Sullivan SD, Bell-Brown A, Bott B, Ciccarella AM, Golenski J, Gorman M, Johnson J, Kreizenbeck K, Kurttila F, Mason G, Myers J, Seigel C, Wade JL, Walia G, Watabayashi K, Lyman GH, Ramsey SD. Effective stakeholder engagement: design and implementation of a clinical trial (SWOG S1415CD) to improve cancer care. BMC Med Res Methodol 2019; 19:119. [PMID: 31185918 PMCID: PMC6560751 DOI: 10.1186/s12874-019-0764-2] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2018] [Accepted: 06/04/2019] [Indexed: 01/21/2023] Open
Abstract
Background The Fred Hutchinson Cancer Research Center has engaged an External Stakeholder Advisory Group (ESAG) in the planning and implementation of the TrACER Study (S1415CD), a five-year pragmatic clinical trial assessing the effectiveness of a guideline-based colony stimulating factor standing order intervention. The trial is being conducted by SWOG through the National Cancer Institute Community Oncology Research Program in 45 clinics. The ESAG includes ten patient partners, two payers, two pharmacists, two guideline experts, four providers and one medical ethicist. This manuscript describes the ESAG’s role and impact on the trial. Methods During early trial development, the research team assembled the ESAG to inform plans for each phase of the trial. ESAG members provide feedback and engage in problem solving to improve trial implementation. Each year, members participate in one in-person meeting, web conferences and targeted email discussion. Additionally, they complete a survey that assesses their satisfaction with communication and collaboration. The research team collected and reviewed stakeholder input from 2014 to 2018 for impact on the trial. Results The ESAG has informed trial design, implementation and dissemination planning. The group advised the trial’s endpoints, regimen list and development of cohort and usual care arms. Based on ESAG input, the research team enhanced patient surveys and added pharmacy-related questions to the component application to assess order entry systems. ESAG patient partners collaborated with the research team to develop a patient brochure and study summary for clinic staff. In addition to identifying recruitment strategies and patient-oriented platforms for publicly sharing results, ESAG members participated as co-authors on this manuscript and a conference poster presentation highlighting stakeholder influence on the trial. The annual satisfaction survey results suggest that ESAG members were satisfied with the methods, frequency and target areas of their engagement in the trial during project years 1–3. Conclusions Diverse stakeholder engagement has been essential in optimizing the design, implementation and planned dissemination of the TrACER Study. The lessons described in the manuscript may assist others to effectively partner with stakeholders on clinical research.
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Affiliation(s)
- Sarah Barger
- Hutchinson Institute for Cancer Outcomes Research, Seattle, WA, USA
| | - Sean D Sullivan
- CHOICE Institute, School of Pharmacy, University of Washington, Seattle, WA, 98195, USA.
| | - Ari Bell-Brown
- Hutchinson Institute for Cancer Outcomes Research, Seattle, WA, USA
| | - Brad Bott
- Intermountain Healthcare, Salt Lake City, UT, USA
| | - Anne Marie Ciccarella
- Independent Patient Research Partner and SWOG Digital Engagement Committee Member, New York, NY, USA
| | - John Golenski
- Kairoi Healthcare Strategies, San Francisco, CA, USA
| | - Mark Gorman
- Cancer Survivor Advisor, Silver Spring, MD, USA
| | - Judy Johnson
- SWOG Lung Committee Patient Advocate, St. Louis, MO, USA
| | | | | | - Ginny Mason
- SWOG Breast Committee Patient Advocate, West Lafayette, IN, USA
| | - Jamie Myers
- University of Kansas, School of Nursing, Kansas City, KS, USA
| | - Carole Seigel
- SWOG GI (Pancreatic Cancer) Committee, Patient Advocate, Boston, MA, USA
| | | | | | - Kate Watabayashi
- Hutchinson Institute for Cancer Outcomes Research, Seattle, WA, USA
| | - Gary H Lyman
- Hutchinson Institute for Cancer Outcomes Research, Seattle, WA, USA
| | - Scott D Ramsey
- Hutchinson Institute for Cancer Outcomes Research, Seattle, WA, USA
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Abstract
Recent advances in engagement of stakeholders and patient partners in clinical research have bridged the disconnect between researchers and stakeholders, resulting in improved research goals with relevant outcomes, increased clinical trial enrollment, and improved communication of research results. This article focuses on the mechanisms, challenges, and benefits of patient and stakeholder engagement, with strategies for improvement. The 3 stages of clinical research and key iterative steps to create a reciprocal relationship are presented. Despite recent advances in stakeholder engagement, additional investigation and improved reporting of methods will facilitate strong reciprocal relationships between researchers and stakeholders.
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Affiliation(s)
- Kathryn E Hacker
- Department of Urology, University of North Carolina at Chapel Hill, 170 Manning Drive, 2115 Physicians Office Building, CB #7235, Chapel Hill, NC 27599-7235, USA
| | - Angela B Smith
- Department of Urology, University of North Carolina at Chapel Hill, 170 Manning Drive, 2115 Physicians Office Building, CB #7235, Chapel Hill, NC 27599-7235, USA.
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Garg T, Connors JN, Ladd IG, Bogaczyk TL, Larson SL. Defining Priorities to Improve Patient Experience in Non-Muscle Invasive Bladder Cancer. Bladder Cancer 2018; 4:121-128. [PMID: 29430512 PMCID: PMC5798497 DOI: 10.3233/blc-170138] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Background: Although approximately 75% of bladder cancers are non-muscle invasive (NMIBC) at diagnosis, most research tends to focus on invasive disease (e.g., experiences related to radical cystectomy and urinary diversion). There is a lack of studies on quality of life, and especially qualitative research, in bladder cancer generally. As a result, relatively little is known about the experiences and needs of NMIBC patients. Objective: To understand patient experience, define care priorities, and identify targets for care improvement in NMIBC across the cancer continuum. Methods: Through focus groups, patients treated for NMIBC (stage <T2) were invited to share their care experiences including diagnosis, treatment, and survivorship. Transcripts were analyzed using conventional content analysis to identify themes and subthemes. Results: Twenty patients (16 male, 4 female, all white) participated in three focus groups. Five primary themes emerged: access to care, provider characteristics and communication, quality of life, goals of care/influences on decision-making, and role of social support. Patients with NMIBC desired timely access to care and honest and caring provider communication. They described urinary function and emotional quality of life changes resulting from diagnosis and treatment. Avoiding cystectomy and being alive for family were the major decision influencers. Conclusion: In this qualitative study, we identified access to care, provider characteristics and communication, quality of life, values/influences on decision-making, and social support as priority areas to improve patient experience in NMIBC. Care redesign efforts should focus on improving access, enhancing provider communication, reducing side effects, and supporting caregiver roles.
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Affiliation(s)
- Tullika Garg
- Department of Urology, Geisinger, Danville, PA, USA.,Department of Epidemiology and Health Services Research, Geisinger, Danville, PA, USA
| | - Jill Nault Connors
- Department of Emergency Medicine, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Ilene G Ladd
- Department of Epidemiology and Health Services Research, Geisinger, Danville, PA, USA
| | - Tyler L Bogaczyk
- Department of Epidemiology and Health Services Research, Geisinger, Danville, PA, USA
| | - Sharon L Larson
- Department of Epidemiology and Health Services Research, Geisinger, Danville, PA, USA
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