1
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Scholes-Robertson N, Guha C, Gutman T, Howell M, Yip A, Cashmore B, Roberts I, Lopez-Vargas P, Wong G, MacGinley R, Synnot A, Craig JC, Jauré A, Krishnasamy R, Tunnicliffe DJ. Consumer involvement in the development and dissemination of chronic kidney disease guidelines: a summary of a meaningful and sustainable approach developed by Caring for Australians and New ZealandeRs with kidney Impairment guidelines. J Clin Epidemiol 2024; 170:111330. [PMID: 38537911 DOI: 10.1016/j.jclinepi.2024.111330] [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: 09/22/2023] [Revised: 03/10/2024] [Accepted: 03/18/2024] [Indexed: 04/19/2024]
Abstract
OBJECTIVES The involvement of consumers (people with lived experience of disease) in guidelines is widely advocated to improve their relevance and uptake. However, the approaches to consumer involvement in guidelines vary and are not well documented. We describe the consumer involvement framework of Caring for Australians and New ZealandeRs with kidney Impairment Guidelines. STUDY DESIGN AND SETTING We used a descriptive document analysis to collate all relevant policies, documents, e-mails, and presentations on consumer involvement in our organizations. We performed a narrative synthesis of collated data to summarize our evolving consumer involvement approach in guidelines. RESULTS We involve consumers at all levels of Caring for Australians and New ZealandeRs with kidney Impairment guideline development and dissemination according to their capacity, from conducting consumer workshops to inform the scope of guidelines, to including consumers as members of the guideline Working Groups and overseeing operations and governance as members of the Steering Committee and staff. Our approach has resulted in tangible outcomes including high-priority topics on patient education, psychosocial care, and clinical care pathways, and focusing the literature reviews to assess patient-important outcomes. The ongoing partnership with consumers led to the generation of consumer version guidelines to improve guideline dissemination and translation to support shared decision-making. CONCLUSION Meaningful consumer involvement can be achieved through a comprehensive approach across the entire lifecycle of guidelines. However, it must be individualized by ensuring that the involvement of consumers is timely and flexible. Future work is needed to assess the impact of consumer involvement in guideline development.
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Affiliation(s)
- Nicole Scholes-Robertson
- Sydney School of Public Health, The University of Sydney, Sydney, New South Wales, Australia; Centre for Kidney Research, The Children's Hospital at Westmead, Sydney, New South Wales, Australia
| | - Chandana Guha
- Sydney School of Public Health, The University of Sydney, Sydney, New South Wales, Australia; Centre for Kidney Research, The Children's Hospital at Westmead, Sydney, New South Wales, Australia
| | - Talia Gutman
- Sydney School of Public Health, The University of Sydney, Sydney, New South Wales, Australia; Centre for Kidney Research, The Children's Hospital at Westmead, Sydney, New South Wales, Australia
| | - Martin Howell
- Sydney School of Public Health, The University of Sydney, Sydney, New South Wales, Australia; Centre for Kidney Research, The Children's Hospital at Westmead, Sydney, New South Wales, Australia
| | - Adela Yip
- Sydney School of Public Health, The University of Sydney, Sydney, New South Wales, Australia; Centre for Kidney Research, The Children's Hospital at Westmead, Sydney, New South Wales, Australia
| | - Brydee Cashmore
- Sydney School of Public Health, The University of Sydney, Sydney, New South Wales, Australia; Centre for Kidney Research, The Children's Hospital at Westmead, Sydney, New South Wales, Australia
| | - Ieyesha Roberts
- Sydney School of Public Health, The University of Sydney, Sydney, New South Wales, Australia; Centre for Kidney Research, The Children's Hospital at Westmead, Sydney, New South Wales, Australia
| | - Pamela Lopez-Vargas
- Child Protection Unit, The Sydney Children's Hospital Network, Sydney, New South Wales, Australia
| | - Germaine Wong
- Sydney School of Public Health, The University of Sydney, Sydney, New South Wales, Australia; Centre for Kidney Research, The Children's Hospital at Westmead, Sydney, New South Wales, Australia
| | - Robert MacGinley
- Eastern Health Clinical School, Monash University, Melbourne, Victoria, Australia
| | - Anneliese Synnot
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia; Centre for Health Communication and Participation, Department of Public Health, La Trobe University, Melbourne, Victoria, Australia
| | - Jonathan C Craig
- College of Medicine and Public Health, Flinders University, Adelaide, Australia
| | - Allison Jauré
- Sydney School of Public Health, The University of Sydney, Sydney, New South Wales, Australia; Centre for Kidney Research, The Children's Hospital at Westmead, Sydney, New South Wales, Australia
| | - Rathika Krishnasamy
- Centre for Kidney Disease Research, The University of Queensland, Brisbane, Australia; Department of Nephrology, Sunshine Coast University Hospital, Birtinya, Australia
| | - David J Tunnicliffe
- Sydney School of Public Health, The University of Sydney, Sydney, New South Wales, Australia; Centre for Kidney Research, The Children's Hospital at Westmead, Sydney, New South Wales, Australia.
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2
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Cazzolli R, Sluiter A, Bateman S, Candler H, Cho Y, Cooper T, Craig JC, Dominello A, Duncanson E, Guha C, Hawley CM, Hewawasam E, Hickey L, Hill K, Howard K, Howell M, Huuskes BM, Irish GL, Jesudason S, Johnson DW, Kelly A, Leary D, Manera K, Mazis J, McDonald S, McLennan H, Muthuramalingam S, Pummeroy M, Scholes-Robertson N, Teixeira-Pinto A, Tunnicliffe DJ, van Zwieten A, Viecelli AK, Wong G, Jaure A. Improving Diverse and Equitable Involvement of Patients and Caregivers in Research in CKD: Report of a Better Evidence and Translation-Chronic Kidney Disease (BEAT-CKD) Workshop. Am J Kidney Dis 2024:S0272-6386(24)00784-4. [PMID: 38810688 DOI: 10.1053/j.ajkd.2024.03.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Revised: 03/21/2024] [Accepted: 03/27/2024] [Indexed: 05/31/2024]
Abstract
Patient and caregiver involvement can enhance the uptake and impact of research, but the involvement of patients and caregivers who are underserved and marginalized is often limited. A better understanding of how to make involvement in research more broadly accessible, supportive, and inclusive for patients with chronic kidney disease (CKD) and caregivers is needed. We conducted a national workshop involving patients, caregivers, clinicians, and researchers from across Australia to identify strategies to increase the diversity of patients and caregivers involved in CKD research. Six themes were identified. Building trust and a sense of safety was considered pivotal to establishing meaningful relationships to support knowledge exchange. Establishing community and connectedness was expected to generate a sense of belonging to motivate involvement. Balancing stakeholder goals, expectations, and responsibilities involved demonstrating commitment and transparency by researchers. Providing adequate resources and support included strategies to minimize the burden of involvement for patients and caregivers. Making research accessible and relatable was about nurturing patient and caregiver interest by appealing to intrinsic motivators. Adapting to patient and caregiver needs and preferences required tailoring the approach for individuals and the target community. Strategies and actions to support these themes may support more diverse and equitable involvement of patients and caregivers in research in CKD.
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Affiliation(s)
- Rosanna Cazzolli
- Sydney School of Public Health, Faculty of Medicine and Health, Sydney; University of Sydney, and Centre for Kidney Research, Children's Hospital at Westmead, Sydney.
| | - Amanda Sluiter
- Sydney School of Public Health, Faculty of Medicine and Health, Sydney; University of Sydney, and Centre for Kidney Research, Children's Hospital at Westmead, Sydney
| | - Samantha Bateman
- Faculty of Health and Medical Sciences, University of Adelaide, Adelaide; Central Northern Adelaide Renal and Transplantation Service, Royal Adelaide Hospital, Adelaide; Australia and New Zealand Dialysis and Transplant Registry (ANZDATA), South Australian Health & Medical Research Institute, Adelaide
| | | | - Yeoungjee Cho
- Australasian Kidney Trials Network, Brisbane; Faculty of Medicine, Brisbane; University of Queensland, and Department of Kidney and Transplant Services, Princess Alexandra Hospital, Brisbane
| | - Tess Cooper
- Sydney School of Public Health, Faculty of Medicine and Health, Sydney; University of Sydney, and Centre for Kidney Research, Children's Hospital at Westmead, Sydney
| | - Jonathan C Craig
- College of Medicine and Public Health, Flinders University, Adelaide
| | - Amanda Dominello
- Sydney School of Public Health, Faculty of Medicine and Health, Sydney; University of Sydney, and Centre for Kidney Research, Children's Hospital at Westmead, Sydney
| | - Emily Duncanson
- Australia and New Zealand Dialysis and Transplant Registry (ANZDATA), South Australian Health & Medical Research Institute, Adelaide
| | - Chandana Guha
- Sydney School of Public Health, Faculty of Medicine and Health, Sydney; University of Sydney, and Centre for Kidney Research, Children's Hospital at Westmead, Sydney
| | - Carmel M Hawley
- Australasian Kidney Trials Network, Brisbane; Faculty of Medicine, Brisbane; University of Queensland, and Department of Kidney and Transplant Services, Princess Alexandra Hospital, Brisbane
| | - Erandi Hewawasam
- Faculty of Health and Medical Sciences, University of Adelaide, Adelaide; Australia and New Zealand Dialysis and Transplant Registry (ANZDATA), South Australian Health & Medical Research Institute, Adelaide
| | | | - Kathy Hill
- Sydney School of Public Health, Faculty of Medicine and Health, Sydney
| | | | - Martin Howell
- Sydney School of Public Health, Faculty of Medicine and Health, Sydney; Menzies Centre for Health Policy and Economics, Sydney; University of Sydney, and Centre for Kidney Research, Children's Hospital at Westmead, Sydney
| | - Brooke M Huuskes
- Department of Microbiology, Anatomy, Physiology and Pharmacology, School of Agriculture. Biomedicine and Environment, La Trobe University, Melbourne
| | - Georgina L Irish
- Faculty of Health and Medical Sciences, University of Adelaide, Adelaide; Central Northern Adelaide Renal and Transplantation Service, Royal Adelaide Hospital, Adelaide
| | - Shilpanjali Jesudason
- Faculty of Health and Medical Sciences, University of Adelaide, Adelaide; Central Northern Adelaide Renal and Transplantation Service, Royal Adelaide Hospital, Adelaide
| | - David W Johnson
- Australasian Kidney Trials Network, Brisbane; Faculty of Medicine, Brisbane; University of Queensland, and Department of Kidney and Transplant Services, Princess Alexandra Hospital, Brisbane
| | - Ayano Kelly
- University of Sydney, and Centre for Kidney Research, Children's Hospital at Westmead, Sydney
| | - Diana Leary
- University of Queensland, and Department of Kidney and Transplant Services, Princess Alexandra Hospital, Brisbane
| | - Karine Manera
- Sydney School of Public Health, Faculty of Medicine and Health, Sydney; University of Sydney, and Centre for Kidney Research, Children's Hospital at Westmead, Sydney
| | - Jasmin Mazis
- Australia and New Zealand Dialysis and Transplant Registry (ANZDATA), South Australian Health & Medical Research Institute, Adelaide
| | - Stephen McDonald
- Faculty of Health and Medical Sciences, University of Adelaide, Adelaide; Central Northern Adelaide Renal and Transplantation Service, Royal Adelaide Hospital, Adelaide; Australia and New Zealand Dialysis and Transplant Registry (ANZDATA), South Australian Health & Medical Research Institute, Adelaide
| | - Helen McLennan
- Sydney School of Public Health, Faculty of Medicine and Health, Sydney; University of Sydney, and Centre for Kidney Research, Children's Hospital at Westmead, Sydney
| | - Shyamsundar Muthuramalingam
- Australia and New Zealand Dialysis and Transplant Registry (ANZDATA), South Australian Health & Medical Research Institute, Adelaide; Central Adelaide Local Health Network, Adelaide
| | | | - Nicole Scholes-Robertson
- University of Sydney, and Centre for Kidney Research, Children's Hospital at Westmead, Sydney; College of Medicine and Public Health, Flinders University, Adelaide
| | - Armando Teixeira-Pinto
- Sydney School of Public Health, Faculty of Medicine and Health, Sydney; University of Sydney, and Centre for Kidney Research, Children's Hospital at Westmead, Sydney
| | - David J Tunnicliffe
- Sydney School of Public Health, Faculty of Medicine and Health, Sydney; University of Sydney, and Centre for Kidney Research, Children's Hospital at Westmead, Sydney
| | - Anita van Zwieten
- Sydney School of Public Health, Faculty of Medicine and Health, Sydney; University of Sydney, and Centre for Kidney Research, Children's Hospital at Westmead, Sydney
| | - Andrea K Viecelli
- Australasian Kidney Trials Network, Brisbane; Faculty of Medicine, Brisbane; University of Queensland, and Department of Kidney and Transplant Services, Princess Alexandra Hospital, Brisbane
| | - Germaine Wong
- Sydney School of Public Health, Faculty of Medicine and Health, Sydney; University of Sydney, and Centre for Kidney Research, Children's Hospital at Westmead, Sydney
| | - Allison Jaure
- Sydney School of Public Health, Faculty of Medicine and Health, Sydney; University of Sydney, and Centre for Kidney Research, Children's Hospital at Westmead, Sydney
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3
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Dobrijevic E, Scholes-Robertson N, Guha C, Howell M, Jauré A, Wong G, van Zwieten A. Patient-Centered Research and Outcomes in Cancer and Kidney Transplantation. Semin Nephrol 2024; 44:151499. [PMID: 38538454 DOI: 10.1016/j.semnephrol.2024.151499] [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] [Indexed: 06/30/2024]
Abstract
Cancer has been identified by kidney transplant recipients as a critically important outcome. The co-occurrence of cancer and kidney transplantation represents a complex intersection of diseases, symptoms, and competing priorities for treatments. Research that focuses on biochemical parameters and clinical events may not capture the priorities of patients. Patient-centered research can improve the relevance and efficiency of research and is particularly pertinent in the setting of cancer and kidney transplantation to facilitate shared decision-making in complex clinical situations. In addition, patient-reported outcomes can facilitate the assessment of patients' experiences, symptom burden, treatment side effects, and quality of life. This review discusses patient-centered research in the context of kidney transplantation and cancer, including consumer involvement in research and patient-centered outcomes and their measures and inclusion in core outcome sets.
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Affiliation(s)
- Ellen Dobrijevic
- Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia; Centre for Kidney Research, Kids Research Institute, The Children's Hospital at Westmead, Westmead, Australia.
| | - Nicole Scholes-Robertson
- Centre for Kidney Research, Kids Research Institute, The Children's Hospital at Westmead, Westmead, Australia; Rural and Remote Health NT, Flinders University, Alice Springs, Australia
| | - Chandana Guha
- Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia; Centre for Kidney Research, Kids Research Institute, The Children's Hospital at Westmead, Westmead, Australia
| | - Martin Howell
- Centre for Kidney Research, Kids Research Institute, The Children's Hospital at Westmead, Westmead, Australia; Menzies Centre for Health Policy and Economics, The University of Sydney, Sydney, Australia
| | - Allison Jauré
- Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia; Centre for Kidney Research, Kids Research Institute, The Children's Hospital at Westmead, Westmead, Australia
| | - Germaine Wong
- Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia; Centre for Kidney Research, Kids Research Institute, The Children's Hospital at Westmead, Westmead, Australia; Centre for Transplant and Renal Research, Westmead Hospital, Westmead, Australia
| | - Anita van Zwieten
- Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia; Centre for Kidney Research, Kids Research Institute, The Children's Hospital at Westmead, Westmead, Australia
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Hughes A, Guha C, Sluiter A, Himmelfarb J, Jauré A. Patient-Centered Research and Innovation in Nephrology. ADVANCES IN KIDNEY DISEASE AND HEALTH 2024; 31:52-67. [PMID: 38403395 DOI: 10.1053/j.akdh.2023.12.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/06/2023] [Revised: 12/07/2023] [Accepted: 12/11/2023] [Indexed: 02/27/2024]
Abstract
Patient involvement in research can improve the relevance of research, consequently enhancing the recruitment, retention, and uptake of interventions and policies impacting patient outcomes. Despite this, patients are not often involved in the design and conduct of research. The research agenda and innovations are frequently determined by the interest of health and industry professionals rather than proactively aligning with the priorities of patients. It is now being encouraged and recommended to engage patients in research priority setting to ensure interventions and trials report outcomes valuable to patients, moving away from a history of overlooking the outcomes that reflect the feel and function of patients. Involving patients ensures constant innovative research in nephrology, as this broader depth of evidence fortifies reliability and validity through knowledge gained from lived experience. Findings from such research can enhance clinical practice and strengthen decision-making and policy to support better outcomes. We aim to outline principles and strategies for patient involvement in research, including setting research priorities, identifying and designing interventions, selecting outcomes, and disseminating and translating research. Principles and strategies including engagement, education and training, empowerment, and connection and community provide guidance in patient involvement. There are increasing efforts to involve patients across all stages of research including setting research priorities. Efforts are rising to involve patients across all stages of research including priority setting, identifying and designing interventions, selecting outcomes, and dissemination and translation. Patient involvement throughout the research cycle drives innovative investigations ensuring funding, efforts, and resources are directed toward priorities of patients, contributing to catalyst advancements in care and outcomes.
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Affiliation(s)
- Anastasia Hughes
- Sydney School of Public Health, The University of Sydney, Sydney, Australia; Centre for Kidney Research, The Children's Hospital at Westmead, Sydney, Australia.
| | - Chandana Guha
- Sydney School of Public Health, The University of Sydney, Sydney, Australia; Centre for Kidney Research, The Children's Hospital at Westmead, Sydney, Australia
| | - Amanda Sluiter
- Sydney School of Public Health, The University of Sydney, Sydney, Australia; Centre for Kidney Research, The Children's Hospital at Westmead, Sydney, Australia
| | - Jonathan Himmelfarb
- Division of Nephrology, Department of Medicine, University of Washington, Seattle, Washington; Kidney Research Institute, Seattle, WA
| | - Allison Jauré
- Sydney School of Public Health, The University of Sydney, Sydney, Australia; Centre for Kidney Research, The Children's Hospital at Westmead, Sydney, Australia
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5
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Cazzolli R, Sluiter A, Guha C, Huuskes B, Wong G, Craig JC, Jaure A, Scholes-Robertson N. Partnering with patients and caregivers to enrich research and care in kidney disease: values and strategies. Clin Kidney J 2023; 16:i57-i68. [PMID: 37711636 PMCID: PMC10497378 DOI: 10.1093/ckj/sfad063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Indexed: 09/16/2023] Open
Abstract
Patient and caregiver involvement broadens the scope of new knowledge generated from research and can enhance the relevance, quality and impact of research on clinical practice and health outcomes. Incorporating the perspectives of people with lived experience of chronic kidney disease (CKD) affords new insights into the design of interventions, study methodology, data analysis and implementation and has value for patients, healthcare professionals and researchers alike. However, patient involvement in CKD research has been limited and data on which to inform best practice is scarce. A number of frameworks have been developed for involving patients and caregivers in research in CKD and in health research more broadly. These frameworks provide an overall conceptual structure to guide the planning and implementation of research partnerships and describe values that are essential and strategies considered best practice when working with diverse stakeholder groups. This article aims to provide a summary of the strategies most widely used to support multistakeholder partnerships, the different ways patients and caregivers can be involved in research and the methods used to amalgamate diverse and at times conflicting points of view.
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Affiliation(s)
- Rosanna Cazzolli
- Sydney School of Public Health, University of Sydney, Sydney, NSW, Australia
- Centre for Kidney Research, The Children's Hospital at Westmead, Westmead, NSW, Australia
| | - Amanda Sluiter
- Sydney School of Public Health, University of Sydney, Sydney, NSW, Australia
- Centre for Kidney Research, The Children's Hospital at Westmead, Westmead, NSW, Australia
| | - Chandana Guha
- Sydney School of Public Health, University of Sydney, Sydney, NSW, Australia
- Centre for Kidney Research, The Children's Hospital at Westmead, Westmead, NSW, Australia
| | - Brooke Huuskes
- Centre for Cardiovascular Biology and Disease Research, School of Agriculture, Biomedicine and Environment, La Trobe University, Melbourne, VIC, Australia
| | - Germaine Wong
- Sydney School of Public Health, University of Sydney, Sydney, NSW, Australia
- Centre for Kidney Research, The Children's Hospital at Westmead, Westmead, NSW, Australia
| | - Jonathan C Craig
- Centre for Kidney Research, The Children's Hospital at Westmead, Westmead, NSW, Australia
- College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia
| | - Allison Jaure
- Sydney School of Public Health, University of Sydney, Sydney, NSW, Australia
- Centre for Kidney Research, The Children's Hospital at Westmead, Westmead, NSW, Australia
| | - Nicole Scholes-Robertson
- Sydney School of Public Health, University of Sydney, Sydney, NSW, Australia
- Centre for Kidney Research, The Children's Hospital at Westmead, Westmead, NSW, Australia
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6
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DeBortoli E, Soyer HP, Milne D, Dissanayaka N, Gartner C, Holt J, Rae K, Robison L, Wallingford CK, McInerney-Leo AM. Measurable outcomes of consumer engagement in health research: A scoping review. Front Public Health 2022; 10:994547. [PMID: 36324444 PMCID: PMC9621387 DOI: 10.3389/fpubh.2022.994547] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Accepted: 09/28/2022] [Indexed: 11/13/2022] Open
Abstract
Background Consumer engagement is increasingly recognized as an instrumental component of health research, with many institutions and international bodies mandating it as part of the research and funding process. Given an increasing utilization of consumer engagement in health research, it is critical to identify the literature which support its value and tools that capture successful outcomes. To develop an overview of the literature, we conducted an umbrella scoping review exploring important outcomes of consumer engagement in health research combined with a scoping review of relevant frameworks. Specifically, we aimed to capture outcomes which reflect authentic and meaningful consumer engagement. Methods Four databases (PubMed, Embase, CINAHL and Cochrane Library) were searched using key search terms. Records were included if they were review articles or frameworks that addressed outcomes of consumer engagement in health research. Data was analyzed using descriptive statistics and an inductive qualitative content analysis. Identified outcomes were sorted based on the three most relevant stakeholder groups (consumer, researcher, institution). Results A total of twenty articles that explored a variety of health disciplines were included. We identified fifteen measurable outcomes of consumer engagement in health research. Eight core outcomes were relevant to all stakeholder groups, and were considered fundamental to authentic consumer engagement including (1) trust, (2) empowerment, (3) respect, (4) confidence in the outcomes of the research, (5) transparency of the research process, (6) satisfaction with the consumer engagement program, (7) knowledge and experiences of consumers, and (8) degree of consumer engagement. Outcomes pertaining to specific stakeholder groups included representativeness and diversity of the consumer groups, research relevance to consumers, funding opportunities, quality/validity of the research, recruitment/retention rates, translation and dissemination of research, and interpretation of results. Conclusion This review identified key measurable outcomes that could be captured when evaluating the impacts of consumer engagement on health research and the success of consumer engagement programs. All outcomes identified were relatively underexplored within the literature, and inadequately and/or inconsistently evaluated amongst studies. Future research should consult all stakeholder groups to identify outcomes perceived to be reflective of optimal consumer engagement.
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Affiliation(s)
- Emily DeBortoli
- Dermatology Research Centre, The University of Queensland Diamantina Institute, The University of Queensland, Brisbane, QLD, Australia
| | - H. Peter Soyer
- Dermatology Research Centre, The University of Queensland Diamantina Institute, The University of Queensland, Brisbane, QLD, Australia
- Dermatology Department, Princess Alexandra Hospital, Brisbane, QLD, Australia
| | - David Milne
- Human Research Ethics Committee, Translational Research Institute, Brisbane, QLD, Australia
| | - Nadeeka Dissanayaka
- Faculty of Medicine, Royal Brisbane and Women's Hospital, University of Queensland Centre for Clinical Research, The University of Queensland, Brisbane, QLD, Australia
- School of Psychology, The University of Queensland, Brisbane, QLD, Australia
- Department of Neurology, Royal Brisbane and Women's Hospital, Brisbane, QLD, Australia
| | - Coral Gartner
- Faculty of Medicine, School of Public Health, NHMRC Centre of Research Excellence on Achieving the Tobacco Endgame, The University of Queensland, Brisbane, QLD, Australia
| | - Jeanette Holt
- The University of Queensland Diamantina Institute, The University of Queensland, Brisbane, QLD, Australia
| | - Kym Rae
- Aubigny Place, Mater Research Institute, Brisbane, QLD, Australia
- Faculty of Medicine, University of Queensland, Herston, QLD, Australia
| | - Laura Robison
- Australasian Kidney Trials Network, Translational Research Institute, The University of Queensland, Brisbane, QLD, Australia
| | - Courtney K. Wallingford
- Dermatology Research Centre, The University of Queensland Diamantina Institute, The University of Queensland, Brisbane, QLD, Australia
- *Correspondence: Courtney K. Wallingford
| | - Aideen M. McInerney-Leo
- Dermatology Research Centre, The University of Queensland Diamantina Institute, The University of Queensland, Brisbane, QLD, Australia
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7
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Adams AMN, Chamberlain D, Thorup CB, Grønkjær M, Conroy T. Ethical and feasible stakeholder engagement in guideline development. Collegian 2022. [DOI: 10.1016/j.colegn.2022.08.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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8
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Tong A, Scholes-Robertson N, Hawley C, Viecelli AK, Carter SA, Levin A, Hemmelgarn BR, Harris T, Craig JC. Patient-centred clinical trial design. Nat Rev Nephrol 2022; 18:514-523. [PMID: 35668231 DOI: 10.1038/s41581-022-00585-w] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/26/2022] [Indexed: 11/09/2022]
Abstract
Patient involvement in clinical trial design can facilitate the recruitment and retention of participants as well as potentially increase the uptake of the tested intervention and the impact of the findings on patient outcomes. Despite these benefits, patients still have very limited involvement in designing and conducting trials in nephrology. Many trials do not address research questions and outcomes that are important to patients, including patient-reported outcomes that reflect how patients feel and function. This limitation can undermine the relevance, reliability and value of trial-based evidence for decision-making in clinical practice and health policy. However, efforts to involve patients with kidney disease are increasing across all stages of the trial process from priority setting, to study design (including selection of outcomes and approaches to improve participant recruitment and retention) and dissemination and implementation of the findings. Harnessing the patient voice in designing trials can ensure that efforts and resources are directed towards patient-centred trials that address the needs, concerns and priorities of patients living with kidney disease with the aim of achieving transformative improvements in care and outcomes.
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Affiliation(s)
- Allison Tong
- Sydney School of Public Health, The University of Sydney, Sydney, NSW, Australia. .,Centre for Kidney Research, The Children's Hospital at Westmead, Sydney, NSW, Australia.
| | - Nicole Scholes-Robertson
- Sydney School of Public Health, The University of Sydney, Sydney, NSW, Australia.,Centre for Kidney Research, The Children's Hospital at Westmead, Sydney, NSW, Australia
| | - Carmel Hawley
- Department of Nephrology, Princess Alexandra Hospital, Brisbane, QLD, Australia.,Australasian Kidney Trials Network, Centre for Health Services Research, University of Queensland, Brisbane, QLD, Australia
| | - Andrea K Viecelli
- Department of Nephrology, Princess Alexandra Hospital, Brisbane, QLD, Australia.,Australasian Kidney Trials Network, Centre for Health Services Research, University of Queensland, Brisbane, QLD, Australia
| | - Simon A Carter
- Sydney School of Public Health, The University of Sydney, Sydney, NSW, Australia.,Centre for Kidney Research, The Children's Hospital at Westmead, Sydney, NSW, Australia
| | - Adeera Levin
- Division of Nephrology, University of British Columbia, Vancouver, BC, Canada
| | - Brenda R Hemmelgarn
- Faculty of Medicine and Dentistry at University of Alberta, Edmonton, AB, Canada
| | | | - Jonathan C Craig
- College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia
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9
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Dember LM. What Patients Teach Us About Patient Engagement in Research. Clin J Am Soc Nephrol 2022; 17:176-178. [PMID: 35131924 PMCID: PMC8823935 DOI: 10.2215/cjn.16561221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Affiliation(s)
- Laura M. Dember
- Renal-Electrolyte and Hypertension Division, Department of Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
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10
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Gutman T, Kelly A, Scholes-Robertson N, Craig JC, Jesudason S, Tong A. Patient and Caregiver Experiences and Attitudes about Their Involvement in Research in Chronic Kidney Disease. Clin J Am Soc Nephrol 2022; 17:215-227. [PMID: 35131928 PMCID: PMC8823931 DOI: 10.2215/cjn.05960521] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2021] [Accepted: 11/16/2021] [Indexed: 02/03/2023]
Abstract
BACKGROUND AND OBJECTIVES Although patient and caregiver involvement in research is widely advocated to improve the relevance and uptake of study findings, barriers and uncertainties in achieving this goal remain. This study aimed to describe patient and caregiver experiences and perspectives of their previous involvement in research, to inform strategies to strengthen patient involvement in research. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS Semistructured interviews were conducted with 23 adult patients with CKD and caregivers who had previously been involved in research, from Australia, the United States, the United Kingdom, and Denmark. Transcripts were analyzed thematically. RESULTS We identified six themes: grappling with CKD diagnosis (overwhelmed by the burden of illness, silenced by stigma and shame, absence of advocacy, and awareness), bearing the responsibility for involvement (autonomy in their own care, forced to be proactive to access opportunities, infrastructural support to connect researchers and patients), battling big agendas (struggling in a system of disincentive, changing research culture, becoming equals), seeing the person behind the patient (harnessing broader knowledge, expertise, skills and interests, understanding patient needs, motivations for involvement), sensitivity to complexities of payment (accounting for individual circumstances, denoting value, enabling diverse involvement), and championing the patient voice (links to important stakeholders, drivers of innovation, responsibility to end users). CONCLUSIONS The burden of CKD, limited opportunities, and power asymmetry between patients/caregivers and researchers were challenges to meaningful involvement in research. Building trust, awareness of opportunities, and recognizing the broad expertise and value of patients/caregivers, including and beyond their illness experience, may better support patient and caregiver involvement in research in CKD.
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Affiliation(s)
- Talia Gutman
- Sydney School of Public Health, The University of Sydney, Sydney, Australia,Centre for Kidney Research, The Children’s Hospital at Westmead, Sydney, Australia
| | - Ayano Kelly
- Centre for Kidney Research, The Children’s Hospital at Westmead, Sydney, Australia
| | - Nicole Scholes-Robertson
- Sydney School of Public Health, The University of Sydney, Sydney, Australia,Centre for Kidney Research, The Children’s Hospital at Westmead, Sydney, Australia
| | - Jonathan C. Craig
- College of Medicine and Public Health, Flinders University, Adelaide, Australia
| | | | - Allison Tong
- Sydney School of Public Health, The University of Sydney, Sydney, Australia,Centre for Kidney Research, The Children’s Hospital at Westmead, Sydney, Australia
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11
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Jegatheesan DK, Modderman R, Krishnasamy R, Tong A, Coombes JS, Viecelli AK, Johnson DW, Isbel N. A Systematic Review of Scope and Consistency of Outcome Measures for Physical Fitness in Chronic Kidney Disease Trials. Kidney Int Rep 2021; 6:1280-1288. [PMID: 34013106 PMCID: PMC8116757 DOI: 10.1016/j.ekir.2021.02.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Accepted: 02/01/2021] [Indexed: 11/29/2022] Open
Abstract
Introduction Impaired physical fitness is prevalent in people with chronic kidney disease (CKD), associating with an increased risk of mortality, falls, and hospitalization. A plethora of physical fitness outcomes have been reported in randomized trials. This study aimed to assess the scope and consistency of physical fitness outcomes and outcome measures reported in trials in CKD. Methods A systematic review of randomized trials reporting physical fitness outcomes in adults with CKD (not requiring kidney replacement therapy) receiving hemodialysis (HD) or peritoneal dialysis and kidney transplant recipients was conducted. Studies were identified from MEDLINE, Embase, and the Cochrane Library from 2000 to 2019. The scope, frequency, and characteristics of outcome measures were categorized and analyzed. Results From 111 trials, 87 tests/measurements were used to evaluate 30 outcomes measures that reported on 23 outcomes, categorized into five domains of physical fitness: neuromuscular fitness (reported in 76% of trials), exercise capacity (64%), physiological-metabolic (49%), body composition (36%), and cardiorespiratory fitness (30%). Neuromuscular fitness was examined by 37 tests/measurements including the physical function component of questionnaires (27%), one-repetition maximum (9%), and hand-grip strength (9%). Outcome measures were assessed by lab-based (58% of all trials), field-based (31%), and patient-reported measures (11%), and commonly evaluated at 12 (30%), 26 (23%) and 52 weeks (10%), respectively. Conclusion There is large heterogeneity in the reporting of physical fitness outcomes, with inconsistencies particularly in the definitions of outcome measures. Standardization in the assessment of physical fitness will likely improve the comparability of trial outcomes and enhance clinical recommendations.
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Affiliation(s)
- Dev K Jegatheesan
- Department of Nephrology, Princess Alexandra Hospital, Woolloongabba, Australia.,Centre for Kidney Disease Research, The University of Queensland, St. Lucia, Australia
| | - Richard Modderman
- Department of Physiotherapy, Princess Alexandra Hospital, Woolloongabba, Australia
| | - Rathika Krishnasamy
- Centre for Kidney Disease Research, The University of Queensland, St. Lucia, Australia.,Department of Nephrology, Sunshine Coast University Hospital, Birtinya, Australia
| | - Allison Tong
- Sydney School of Public Health, The University of Sydney, Sydney, Australia.,Centre for Kidney Disease Research, The Children's Hospital at Westmead, New South Wales, Australia
| | - Jeff S Coombes
- School of Human Movement and Nutrition Sciences, The University of Queensland, St. Lucia, Australia
| | - Andrea K Viecelli
- Department of Nephrology, Princess Alexandra Hospital, Woolloongabba, Australia.,Centre for Kidney Disease Research, The University of Queensland, St. Lucia, Australia
| | - David W Johnson
- Department of Nephrology, Princess Alexandra Hospital, Woolloongabba, Australia.,Centre for Kidney Disease Research, The University of Queensland, St. Lucia, Australia
| | - Nicole Isbel
- Department of Nephrology, Princess Alexandra Hospital, Woolloongabba, Australia.,Centre for Kidney Disease Research, The University of Queensland, St. Lucia, Australia
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12
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Browne T, Swoboda A, Ephraim PL, Lang-Lindsey K, Green JA, Hill-Briggs F, Jackson GL, Ruff S, Schmidt L, Woods P, Danielson P, Bolden S, Bankes B, Hauer C, Strigo T, Boulware LE. Engaging patients and family members to design and implement patient-centered kidney disease research. RESEARCH INVOLVEMENT AND ENGAGEMENT 2020; 6:66. [PMID: 33292683 PMCID: PMC7604920 DOI: 10.1186/s40900-020-00237-y] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/25/2020] [Accepted: 10/07/2020] [Indexed: 06/04/2023]
Abstract
We need more research projects that partner and engage with patients and family members as team members. Doing this requires that patients and family members set research priorities and fully participate in research teams. Models for this patient and family member engagement as research partners can help increase patient centered outcomes research. In this article, we describe how we have successfully engaged patients with kidney disease and family members as Co-Investigators on a 5-year research project testing a health system intervention to improve kidney disease care. Background This article describes a method for successful engagement of patients and family members in all stages of a 5-year comparative effectiveness research trial to improve transitions of care for patients from chronic kidney disease to end-stage kidney disease. Methods This project utilized the Patient-Centered Outcomes Research Institute's conceptual model for engagement with patients and family members. We conducted a qualitative analysis of grant planning meetings to determine patient and family member Co-Investigators' priorities for research and to include these engagement efforts in the research design. Patient and family member Co-Investigators partnered in writing this paper. Results Patients and family members were successfully engaged in remote and in-person meetings to contribute actively to research planning and implementation stages. Three patient-centered themes emerged from our data related to engagement that informed our research plan: kidney disease treatment decision-making, care transitions from chronic to end-stage kidney disease, and patient-centered outcomes. Conclusions The model we have employed represents a new paradigm for kidney disease research in the United States, with patients and family members engaged as full research partners. As a result, the study tests an intervention that directly responds to their needs, and it prioritizes the collection of outcomes data most relevant to patient and family member Co-Investigators. Trial registration NCT02722382 .
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Affiliation(s)
- Teri Browne
- College of Social Work, University of South Carolina, Columbia, SC, USA
| | | | - Patti L Ephraim
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- Welch Center for Prevention, Epidemiology and Clinical Research, Baltimore, MD, USA
| | - Katina Lang-Lindsey
- Present address: Alabama Agriculture & Mechanical University, Huntsville, AL, USA
- Department of Social Work, Alabama A & M University, Huntsville, AL, USA
| | - Jamie A Green
- Department of Nephrology, Geisinger Commonwealth School of Medicine, Danville, PA, USA
- Kidney Health Research Institute, Geisinger, Danville, PA, USA
| | - Felicia Hill-Briggs
- Division of General Internal Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - George L Jackson
- Division of General Internal Medicine, Duke University School of Medicine, 200 Morris Street, 3rd floor, Durham, NC, 27701, USA
| | | | | | | | | | | | | | - Chelsie Hauer
- Center for Clinical Innovation, Institute for Advanced Application, Geisinger, Danville, PA, USA
| | - Tara Strigo
- Division of General Internal Medicine, Duke University School of Medicine, 200 Morris Street, 3rd floor, Durham, NC, 27701, USA
| | - L Ebony Boulware
- Division of General Internal Medicine, Duke University School of Medicine, 200 Morris Street, 3rd floor, Durham, NC, 27701, USA.
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13
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Dansie K, Viecelli AK, Pascoe EM, Johnson DW, McDonald S, Clayton P, Hawley C. Novel trial strategies to enhance the relevance, efficiency, effectiveness, and impact of nephrology research. Kidney Int 2020; 98:572-578. [PMID: 32464216 DOI: 10.1016/j.kint.2020.04.050] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2020] [Revised: 04/13/2020] [Accepted: 04/22/2020] [Indexed: 12/12/2022]
Abstract
Randomized controlled trials (RCTs) are considered the gold standard for evaluating the effectiveness of interventions. However, criticisms of traditional designs are that they can be inefficient, inflexible, expensive, and conducted in a manner disconnected from real-life clinical practice. Novel strategies and approaches are being utilized to overcome these limitations, including comprehensive consumer engagement, core outcome sets, novel trial designs, streamlined data collection, cost-effectiveness and return on investment evaluations, knowledge dissemination plans, and impact evaluation. These strategies can be implemented at the design, conduct, implementation, and dissemination stages of the trial process. This review aims to provide an overview of these strategies and approaches to improve the relevance, efficiency, effectiveness, and impact of nephrology research.
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Affiliation(s)
- Kathryn Dansie
- Australia and New Zealand Dialysis and Transplant Registry (ANZDATA), South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia.
| | - Andrea K Viecelli
- Department of Nephrology, Princess Alexandra Hospital, Woolloongabba, Queensland, Australia; Australasian Kidney Trials Network, University of Queensland, Brisbane, Queensland, Australia
| | - Elaine M Pascoe
- Australasian Kidney Trials Network, University of Queensland, Brisbane, Queensland, Australia; Translational Research Institute, Brisbane, Queensland, Australia
| | - David W Johnson
- Department of Nephrology, Princess Alexandra Hospital, Woolloongabba, Queensland, Australia; Australasian Kidney Trials Network, University of Queensland, Brisbane, Queensland, Australia; Translational Research Institute, Brisbane, Queensland, Australia
| | - Stephen McDonald
- Australia and New Zealand Dialysis and Transplant Registry (ANZDATA), South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia; Adelaide Medical School, University of Adelaide, Adelaide, South Australia, Australia; Central Northern Adelaide Renal and Transplantation Service, Royal Adelaide Hospital, Adelaide, South Australia, Australia
| | - Philip Clayton
- Australia and New Zealand Dialysis and Transplant Registry (ANZDATA), South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia; Adelaide Medical School, University of Adelaide, Adelaide, South Australia, Australia; Central Northern Adelaide Renal and Transplantation Service, Royal Adelaide Hospital, Adelaide, South Australia, Australia
| | - Carmel Hawley
- Department of Nephrology, Princess Alexandra Hospital, Woolloongabba, Queensland, Australia; Australasian Kidney Trials Network, University of Queensland, Brisbane, Queensland, Australia; Translational Research Institute, Brisbane, Queensland, Australia
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14
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Epidemiology research to foster improvement in chronic kidney disease care. Kidney Int 2020; 97:477-486. [DOI: 10.1016/j.kint.2019.11.010] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Revised: 11/12/2019] [Accepted: 11/15/2019] [Indexed: 11/24/2022]
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