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de Wit M, Aouad K, Elhai M, Benavent D, Bertheussen H, Blackburn S, Böhm P, Duarte C, Falahee M, Karlfeldt S, Kiltz U, Mateus EF, Richards DP, Rodríguez-Carrio J, Sagen J, Shumnalieva R, Stones SR, Tas SW, Tillett W, Vieira A, Wilhelmer TC, Zabalan C, Primdahl J, Studenic P, Gossec L. EULAR recommendations for the involvement of patient research partners in rheumatology research: 2023 update. Ann Rheum Dis 2024; 83:1443-1453. [PMID: 38876509 PMCID: PMC11503179 DOI: 10.1136/ard-2024-225566] [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: 01/22/2024] [Accepted: 05/22/2024] [Indexed: 06/16/2024]
Abstract
BACKGROUND Since the publication of the 2011 European Alliance of Associations for Rheumatology (EULAR) recommendations for patient research partner (PRP) involvement in rheumatology research, the role of PRPs has evolved considerably. Therefore, an update of the 2011 recommendations was deemed necessary. METHODS In accordance with the EULAR Standardised Operational Procedures, a task force comprising 13 researchers, 2 health professionals and 10 PRPs was convened. The process included an online task force meeting, a systematic literature review and an in-person second task force meeting to formulate overarching principles (OAPs) and recommendations. The level of agreement of task force members was assessed anonymously (0-10 scale). RESULTS The task force developed five new OAPs, updated seven existing recommendations and formulated three new recommendations. The OAPs address the definition of a PRP, the contribution of PRPs, the role of informal caregivers, the added value of PRPs and the importance of trust and communication in collaborative research efforts. The recommendations address the research type and phases of PRP involvement, the recommended number of PRPs per project, the support necessary for PRPs, training of PRPs and acknowledgement of PRP contributions. New recommendations concern the benefits of support and guidance for researchers, the need for regular evaluation of the patient-researcher collaboration and the role of a designated coordinator to facilitate collaboration. Agreements within the task force were high and ranged between 9.16 and 9.96. CONCLUSION The updated EULAR recommendations for PRP involvement are more substantially based on evidence. Together with added OAPs, they should serve as a guide for researchers and PRPs and will ultimately strengthen the involvement of PRPs in rheumatology research.
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Affiliation(s)
- Maarten de Wit
- Patient Research Partner, EULAR, Amsterdam, The Netherlands
| | - Krystel Aouad
- Saint George Hospital University Medical Center, Beirut, Lebanon
| | - Muriel Elhai
- University Hospital Zürich, University of Zürich, Zürich, Switzerland
| | - Diego Benavent
- Rheumatology, Hospital Universitari de Bellvitge, Madrid, Spain
| | | | - Steven Blackburn
- Institute of Applied Health Research, Univeristy of Birmingham, Birmingham, UK
| | - Peter Böhm
- Patient Research Partner, EULAR, Berlin, Germany
| | - Catia Duarte
- Rheumatology, Centro Hospitalar e Universitario de Coimbra, Coimbra, Portugal
| | - Marie Falahee
- Institute of Inflammation and Ageing, University of Birmingham Rheumatology Research Group, Birmingham, UK
| | - Susanne Karlfeldt
- Academic Specialist Center, Karolinska Institutet, Stockholm, Sweden
| | - Uta Kiltz
- Ruhr University Bochum, Bochum, Germany
- Rheumazentrum Ruhrgebiet, Herne, Germany
| | - Elsa F Mateus
- Patient Research Partner, EULAR, Lisbon, Portugal
- Portuguese League Against Rheumatic Diseases (LPCDR), Lisbon, Portugal
| | - Dawn P Richards
- Canadian Arthritis Patient Alliance, Toronto, Ontario, Canada
| | - Javier Rodríguez-Carrio
- Area of Immunology, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), University of Oviedo, Oviedo, Spain
| | - Joachim Sagen
- Norwegian National Advisory Unit on Rehabilitation in Rheumatology, Oslo, Norway
- Norwegian Rheumatism Association, Oslo, Norway
| | - Russka Shumnalieva
- Department of Rheumatology, Clinic of Rheumatology, University Hospital “St Ivan Rilski”, Medical University-Sofia, Sofia, Bulgaria
| | - Simon R Stones
- Patient Research Partner, EULAR, Manchester, UK
- Envision Pharma Group, Wilmslow, UK
| | - Sander W Tas
- Department of Rheumatology and Clinical Immunology, Amsterdam Rheumatology and Immunology Center, Amsterdam University Medical Centres, Amsterdam, The Netherlands
| | - William Tillett
- Royal National Hospital for Rheumatic Disease, Bath, UK
- Life Sciences, Centre for Therapeutic Innovation, University of Bath, Bath, UK
| | - Ana Vieira
- Portuguese League Against Rheumatic Diseases (LPCDR), Lisbon, Portugal
- Patient Research Partner, EULAR, Lissabon, Portugal
| | - Tanita-Christina Wilhelmer
- EULAR Young PARE, Zürich, Switzerland
- Österreichische Rheumaliga, Maria Alm, Austria
- EULAR PRP, Vienna, Austria
| | - Condruta Zabalan
- Romanian League Against Rheumatism, Bucharest, Romania
- EULAR PRP, Bucharest, Romania
| | - Jette Primdahl
- Danish Hospital for Rheumatic Diseases, University Hospital of Southern Denmark, Sønderborg, Denmark
- Department of Regional Health Research, University of Southern Denmark, Odense, Denmark
| | - Paul Studenic
- Internal Medicine 3, Division of Rheumatology, Medical University Vienna, Vienna, Austria
- Department of Medicine (Solna), Karolinska Institutet, Division of Rheumatology, Stockholm, Sweden
| | - Laure Gossec
- INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, INSERM, Sorbonne Universite, Paris, France
- APHP, Rheumatology Department, Hopital Universitaire Pitie Salpetriere, Paris, France
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Aouad K, de Wit M, Elhai M, Benavent D, Bertheussen H, Zabalan C, Primdahl J, Studenic P, Gossec L. Patient research partner involvement in rheumatology research: a systematic literature review informing the 2023 updated EULAR recommendations for the involvement of patient research partners. Ann Rheum Dis 2024; 83:1268-1277. [PMID: 38724076 PMCID: PMC11503057 DOI: 10.1136/ard-2024-225567] [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: 01/22/2024] [Accepted: 04/28/2024] [Indexed: 10/02/2024]
Abstract
BACKGROUND Patient research partners (PRPs) are people with a disease who collaborate in a research team as partners. The aim of this systematic literature review (SLR) was to assess barriers and facilitators to PRP involvement in rheumatology research. METHODS The SLR was conducted in PubMed/Medline for articles on PRP involvement in rheumatology research, published between 2017 and 2023; websites were also searched in rheumatology and other specialties. Data were extracted regarding the definition of PRPs, their role and added value, as well as barriers and facilitators to PRP involvement. The quality of the articles was assessed. Quantitative data were analysed descriptively, and principles of thematic content analysis was applied to qualitative data. RESULTS Of 1016 publications, 53 articles were included; the majority of these studies were qualitative studies (26%), opinion articles (21%), meeting reports (17%) and mixed-methods studies (11%). Roles of PRPs ranged from research partners to patient advocates, advisors and patient reviewers. PRPs were reported/advised to be involved early in the project (32% of articles) and in all research phases (30%), from the conception stage to the implementation of research findings. The main barriers were challenges in communication and support for both PRPs and researchers. Facilitators of PRP involvement included more than one PRP per project, training of PRPs and researchers, a supportive environment for PRPs (including adequate communication, acknowledgement and compensation of PRPs) and the presence of a PRP coordinator. CONCLUSION This SLR identified barriers and facilitators to PRP involvement, and was key to updating the European Alliance of Associations for Rheumatology recommendations for PRP-researcher collaboration based on scientific evidence.
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Affiliation(s)
- Krystel Aouad
- Rheumatology Division, Saint George University of Beirut, Saint George Hospital University Medical Center, Beirut, Lebanon
| | - Maarten de Wit
- EULAR Study Group for collaborative research, Patient Research Partner, Amsterdam, The Netherlands
| | - Muriel Elhai
- Rheumatology Department, University of Zurich, University Hospital Zurich, Zurich, Switzerland
| | - Diego Benavent
- Rheumatology Department, Hospital Universitari de Bellvitge, Barcelona, Spain
| | | | | | - Jette Primdahl
- Danish Hospital for Rheumatic Diseases, University Hospital of Southern Denmark, Sønderborg, Denmark
| | - Paul Studenic
- Rheumatology Division, Department of Medicine(Solna), Karolinska Institutet, Stockholm, Sweden
- Rheumatology Division, Internal Medicine Department, Medical University of Vienna, Vienna, Austria
| | - Laure Gossec
- Rheumatology Department, University Hospital Pitié Salpêtrière, Paris, France
- INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Sorbonne Université, Paris, France
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Choufani M, Kay J, Ermann J. Axial spondyloarthritis guidelines - aiming for maximum impact. Curr Opin Rheumatol 2024; 36:251-260. [PMID: 38661436 DOI: 10.1097/bor.0000000000001020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/26/2024]
Abstract
PURPOSE OF REVIEW This review discusses international clinical practice guidelines (CPGs) for axial spondyloarthritis (axSpA) focusing on methodology, guideline quality, and implementation. RECENT FINDINGS The Assessment of SpondyloArthritis International Society/European Alliance of Associations for Rheumatology (ASAS/EULAR) and Pan-American League of Associations for Rheumatology (PANLAR) recently published axSpA CPGs and updates of the American College of Rheumatology/Spondylitis Association of America/Spondyloarthritis Research and Treatment Network (ACR/SAA/SPARTAN) and Asia-Pacific League of Associations for Rheumatology (APLAR) CPGs are expected. GRADE has emerged as the dominant framework for CPG development and has been used by three of the four international axSpA guidelines. Notable differences exist among these guidelines in the way that the recommendations are presented. Two of the four acknowledge the need for implementation strategies, but little detail about this is provided. The few studies that have evaluated the implementation of axSpA CPGs have identified poor adherence to recommendations on physical therapy/exercise and disease activity monitoring. Implementation science has identified many barriers and facilitators affecting guideline uptake, including those related to healthcare professionals and to the guidelines themselves. Creation of a tailored implementation plan simultaneously with the CPG is recommended. SUMMARY While methodological rigor in the creation of evidence-based recommendations is the focus of CPG development, recommendations must be presented in a user-friendly format that makes them easy to apply. 'Living guidelines' could facilitate keeping content up to date. Implementation is critical for the success of a CPG and should be emphasized in future axSpA guideline updates. Further research is needed to better understand the factors impacting the successful implementation of axSpA CPGs.
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Affiliation(s)
| | - Jonathan Kay
- UMass Chan Medical School and UMass Memorial Medical Center, Worcester
| | - Joerg Ermann
- Brigham and Women's Hospital, Boston
- Harvard Medical School, Boston, Massachusetts, USA
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Macdonald GG, Leese J, Hoens AM, Kerr S, Lum W, Gulka L, Nimmon L, Li LC. A patienthood that transcends the patient: An analysis of patient research partners' narratives of involvement in a Canadian arthritis patient advisory board. J Health Serv Res Policy 2024; 29:22-30. [PMID: 37632271 PMCID: PMC10729530 DOI: 10.1177/13558196231197288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/27/2023]
Abstract
OBJECTIVES Incorporating the perspectives of patients and public into the conduct of research has the potential to make scientific research more democratic. This paper explores how being a patient partner on an arthritis patient advisory board shapes the patienthood of a person living with arthritis. METHODS An analysis was undertaken of the narratives of 22 patient research partners interviewed about their experiences on the Arthritis Patient Advisory Board (APAB), based in Vancouver, Canada. RESULTS Participants' motivations to become involved in APAB stemmed largely from their desire to change their relationship with their condition. APAB was a living collective project in which participants invested their hope, both for their own lives as patients and for others with the disease. CONCLUSIONS Our findings highlight how the journeys of patient partners connect and integrate seemingly disparate conceptions of what it means to be a patient. One's experience as a clinical 'patient' transforms into the broader notion of civic patienthood.
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Affiliation(s)
- Graham G Macdonald
- Graduate Programs in Rehabilitation Sciences, University of British Columbia, Vancouver, British Columbia, Canada
| | - Jenny Leese
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada
| | - Alison M Hoens
- Department of Physical Therapy, University of British Columbia, Vancouver, British Columbia, Canada
| | - Sheila Kerr
- Arthritis Patient Advisory Board, Arthritis Research Canada, Vancouver, British Columbia, Canada
| | - Wendy Lum
- Arthritis Patient Advisory Board, Arthritis Research Canada, Vancouver, British Columbia, Canada
| | - Lianne Gulka
- Arthritis Patient Advisory Board, Arthritis Research Canada, Vancouver, British Columbia, Canada
| | - Laura Nimmon
- Department of Occupational Science and Occupational Therapy, University of British Columbia, Vancouver, British Columbia, Canada
| | - Linda C Li
- Department of Physical Therapy, University of British Columbia, Vancouver, British Columbia, Canada
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5
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Elhai M, Benavent D, Aouad K, Studenic P, Bertheussen H, Primdahl J, Zabalan C, de Wit M, Gossec L. Involving patients as research partners in research in rheumatology: a literature review in 2023. RMD Open 2023; 9:e003566. [PMID: 37996123 PMCID: PMC10668287 DOI: 10.1136/rmdopen-2023-003566] [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: 08/01/2023] [Accepted: 09/06/2023] [Indexed: 11/25/2023] Open
Abstract
OBJECTIVE The inclusion of patient research partners (PRPs) in research projects is increasingly recognised and recommended in rheumatology. The level of involvement of PRPs in translational research in rheumatology remains unknown, while in randomised clinical trials (RCTs), it has been reported to be 2% in 2020. Therefore, we aimed to assess the involvement of PRPs in recent translational studies and RCTs in rheumatology. METHODS We conducted a scoping literature review of the 80 most recent articles (40 translational studies and 40 RCTs) from four target diseases: rheumatoid arthritis, psoriatic arthritis, systemic lupus erythematosus and lower extremity osteoarthritis. We selected 20 papers from each disease, published up until 1 March 2023, in rheumatology and general scientific journals. In each paper, the extent of PRP involvement was assessed. Analyses were descriptive. RESULTS Of 40 translational studies, none reported PRP involvement. Of 40 RCTs, eight studies (20%) reported PRP involvement. These trials were mainly from Europe (75%) and North America (25%). Most of them (75%) were non-industry funded. The type of PRP involvement was reported in six of eight studies: six studies reported PRP participation in the study design or design of the intervention and two of them in the interpretation of the results. All the trials reporting the number of PRPs (75%), involved at least two PRPs. CONCLUSION Despite a worldwide movement advocating for increased patient involvement in research, PRPs in translational research and RCTs in rheumatology are significantly under-represented. This limited involvement of PRPs in research highlights a persistent gap between the existing recommendations and actual practice.
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Affiliation(s)
- Muriel Elhai
- Department of Rheumatology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Diego Benavent
- Rheumatology, Hospital Universitario La Paz, Madrid, Spain
| | - Krystel Aouad
- Department of Rheumatology, Saint George Hospital University Medical Center, Saint George University of Beirut, Beirut, Lebanon
| | - Paul Studenic
- Division of Rheumatology, Department of Medicine (Solna), Karolinska Institute, Stockholm, Sweden
- Department of Internal Medicine III, Division of Rheumatology, Medical University of Vienna, Vienna, Austria
| | | | - Jette Primdahl
- Department of Regional Health Research, University of Southern Denmark, Odense, Denmark
- Danish Hospital for Rheumatic Diseases, University hospital of Southern Denmark, Sønderborg, Denmark
| | - Codruta Zabalan
- EULAR Patient Research Partner - Romanian League Against Rheumatism, Bucharest, Romania
| | - Maarten de Wit
- EULAR PRP network, EULAR patient research partner, Amsterdam, the Netherlands
| | - Laure Gossec
- INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Sorbonne Universite, Paris, France
- APHP, Rheumatology Department, Hopital Universitaire Pitie Salpetriere, Paris, France
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6
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Simons G, Birch R, Stocks J, Insch E, Rijckborst R, Neag G, McColm H, Romaniuk L, Wright C, Phillips BE, Jones SW, Pratt AG, Siebert S, Raza K, Falahee M. The student patient alliance: development and formative evaluation of an initiative to support collaborations between patient and public involvement partners and doctoral students. BMC Rheumatol 2023; 7:36. [PMID: 37789423 PMCID: PMC10548699 DOI: 10.1186/s41927-023-00359-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Accepted: 09/18/2023] [Indexed: 10/05/2023] Open
Abstract
BACKGROUND While the integration of patient and public involvement (PPI) in clinical research is now widespread and recommended as standard practice, meaningful PPI in pre-clinical, discovery science research is more difficult to achieve. One potential way to address this is by integrating PPI into the training programmes of discovery science postgraduate doctoral students. This paper describes the development and formative evaluation of the Student Patient Alliance (SPA), a programme developed at the University of Birmingham that connects PPI partners with doctoral students. METHODS Following a successful pilot of the SPA by the Rheumatology Research Group at the University of Birmingham, the scheme was implemented across several collaborating Versus Arthritis / Medical Research Council (MRC) centres of excellence. Doctoral students were partnered with PPI partners, provided with initial information and guidance, and then encouraged to work together on research and public engagement activities. After six months, students, their PPI partners and the PPI coordinators at each centre completed brief surveys about their participation in the SPA. RESULTS Both doctoral students and their PPI partners felt that taking part in SPA had a positive impact on understanding, motivation and communication skills. Students reported an increased understanding of PPI and patient priorities and reported improved public engagement skills. Their PPI partners reported a positive impact of the collaboration with the students. They enjoyed learning about the student's research and contributing to the student's personal development. PPI coordinators also highlighted the benefits of the SPA, but noted some challenges they had experienced, such as difficulties matching students with PPI partners. CONCLUSIONS The SPA was valued by students and PPI partners, and it is likely that initiatives of this kind would enhance students' PPI and public engagement skills and awareness of patients' experiences on a wider scale. However, appropriate resources are needed at an institutional level to support the implementation of effective programmes of this kind on a larger scale.
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Affiliation(s)
- Gwenda Simons
- Rheumatology Research Group, Institute of Inflammation and Ageing, College of Medical and Dental Sciences, University of Birmingham, Birmingham, B15 2WB, UK
| | - Rebecca Birch
- Research & Knowledge Transfer Office, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
| | - Joanne Stocks
- National Institute for Health and Care Research (NIHR) Nottingham Biomedical Research Centre, University of Nottingham, Nottingham, UK
- Centre for Sport Exercise and Osteoarthritis Research Versus Arthritis, University of Nottingham, Nottingham, UK
- Pain Centre Versus Arthritis, University of Nottingham, Nottingham, UK
- Injury, Recovery and Inflammation Sciences, School of Medicine, University of Nottingham, Nottingham, UK
| | - Elspeth Insch
- Rheumatology Research Patient Partnership, University of Birmingham, Birmingham, UK
| | - Rob Rijckborst
- Rheumatology Research Patient Partnership, University of Birmingham, Birmingham, UK
| | - Georgiana Neag
- Rheumatology Research Group, Institute of Inflammation and Ageing, College of Medical and Dental Sciences, University of Birmingham, Birmingham, B15 2WB, UK
| | - Heidi McColm
- Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle, UK
| | - Leigh Romaniuk
- Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle, UK
| | - Claire Wright
- School of Infection and Immunity, University of Glasgow, Glasgow, UK
- Research into Inflammatory Arthritis Centre Versus Arthritis, University of Glasgow, Glasgow, UK
| | - Bethan E Phillips
- Centre of Metabolism, Ageing & Physiology (COMAP), University of Nottingham, Royal Derby Hospital, Derby, UK
- MRC-Versus Arthritis Centre for Musculoskeletal Ageing Research, University of Nottingham, Royal Derby Hospital, Derby, UK
| | - Simon W Jones
- MRC- Versus Arthritis Centre for Musculoskeletal Ageing Research, Institute for Inflammation and Ageing, University of Birmingham, Birmingham, UK
| | - Arthur G Pratt
- Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle, UK
- Research into Inflammatory Arthritis Centre Versus Arthritis, Newcastle University, Newcastle, UK
- Translational and Clinical Research Institute, Newcastle University, Newcastle, UK
| | - Stefan Siebert
- School of Infection and Immunity, University of Glasgow, Glasgow, UK
- Research into Inflammatory Arthritis Centre Versus Arthritis, University of Glasgow, Glasgow, UK
| | - Karim Raza
- Rheumatology Research Group, Institute of Inflammation and Ageing, College of Medical and Dental Sciences, University of Birmingham, Birmingham, B15 2WB, UK
- Research into Inflammatory Arthritis Centre Versus Arthritis, University of Birmingham, Birmingham, UK
- Sandwell and West Birmingham NHS Trust, Birmingham, UK
- Birmingham Biomedical Research Centre, National Institute for Health and Care Research (NIHR), Birmingham, UK
| | - Marie Falahee
- Rheumatology Research Group, Institute of Inflammation and Ageing, College of Medical and Dental Sciences, University of Birmingham, Birmingham, B15 2WB, UK.
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Liem SIE, Vliet Vlieland TPM, van de Ende CH, Dittmar S, Schriemer MR, Bodegom-Vos LV, Peter WFH, Vries-Bouwstra JKD. Consensus-based recommendations on communication and education regarding primary care physical therapy for patients with systemic sclerosis. Musculoskeletal Care 2023; 21:45-55. [PMID: 35689435 DOI: 10.1002/msc.1664] [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: 05/17/2022] [Revised: 05/23/2022] [Accepted: 05/23/2022] [Indexed: 11/08/2022]
Abstract
OBJECTIVE This study aimed to develop recommendations for communication and postgraduate education regarding primary care physical therapy for systemic sclerosis (SSc) patients. METHODS A virtual Nominal Group Technique was used with tasks forces for communication (n = 18) and education (n = 21). Both included rheumatologists, physical therapists (PTs) in primary, secondary or tertiary care, rheumatology nurses, advanced nurse practictioners and patient representatives. Three online meetings were organised for each task force to discuss (1) current bottlenecks; (2) potential solutions; and (3) the resulting draft recommendations. After the final adjustments, participants rated their level of agreement with each recommendation on a scale from 0 (not at all agree) to 100 (totally agree), using an online questionnaire. RESULTS 19 and 34 recommendations were formulated for communication and education, respectively. For communication the main recommendations concerned the provision of an overview of primary care physical therapists with expertise in rheumatic and musculoskeletal diseases to patients and rheumatologists, the inclusion of the indication by the rheumatologist in the referral to the physical therapist and low-threshold communication with the rheumatologist in case of questions or concerns of the physical therapist. For postgraduate education three types of "on demand" educational offerings were recommended with varying levels of content and duration, to match the competencies and preferences of individual primary care physical therapists. CONCLUSION Using a systematic qualitative approach, two multi-stakeholder task forces developed practical recommendations for primary care physical therapists' communication with hospital-based care providers and postgraduate education regarding the treatment of SSc patients.
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Affiliation(s)
- Sophie I E Liem
- Department of Rheumatology, Leiden University Medical Center, Leiden, The Netherlands
| | - Theodora P M Vliet Vlieland
- Department of Rheumatology, Leiden University Medical Center, Leiden, The Netherlands.,Department of Orthopaedics, Rehabilitation and Physical Therapy, Leiden University Medical Center, Leiden, The Netherlands
| | - Cornelia H van de Ende
- Department of Rheumatology, Radboud University Medical Center, Nijmegen, The Netherlands.,Department of Rheumatology, Sint Maartenskliniek, Nijmegen, The Netherlands
| | - Sonja Dittmar
- NVLE, Dutch Patient Organization for Systemic Autoimmune Diseases, Utrecht, The Netherlands
| | - Marisca R Schriemer
- NVLE, Dutch Patient Organization for Systemic Autoimmune Diseases, Utrecht, The Netherlands
| | - Leti van Bodegom-Vos
- Department of Biomedical Data Sciences, Medical Decision Making, Leiden University Medical Center, Leiden, Zuid-Holland, The Netherlands
| | - Wilfred F H Peter
- Department of Orthopaedics, Rehabilitation and Physical Therapy, Leiden University Medical Center, Leiden, The Netherlands
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8
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Schoemaker CG, Richards DP, de Wit M. Matching researchers' needs and patients' contributions: practical tips for meaningful patient engagement from the field of rheumatology. Ann Rheum Dis 2023; 82:312-315. [PMID: 36604151 PMCID: PMC9933154 DOI: 10.1136/ard-2022-223561] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Accepted: 12/13/2022] [Indexed: 01/07/2023]
Abstract
There is an increasing recognition of the importance of patient engagement and involvement in health research, specifically within the field of rheumatology. In general, researchers in this specialty appreciate the value of patients as partners in research. In practice, however, the majority of researchers does not involve patients on their research teams. Many researchers find it difficult to match their needs for patient engagement and the potential contributions from individuals living with rheumatic disease. In this Viewpoint, we provide researchers and patients practical tips for matching 'supply and demand,' based on our own experiences as patient engagement consultants and trainers in rheumatology research. All authors started as a 'naïve' patient or caregiver, an identity that evolved through a process of 'adversarial growth': positive changes that are experienced as a result of the struggle with highly challenging life circumstances. Here, we introduce four stages of adversarial growth in the context of research. We submit that all types of patients have their own experiences, qualities and skills, and can add specific input to research. The recommendations for engagement are not strict directives. They are meant as starting points for discussion or interview. Regardless of individual qualities and knowledge, we believe that all patients engaged in research have a single goal in common: to contribute to research that ultimately will change the lives of many other patients.
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Affiliation(s)
- Casper G Schoemaker
- Pediatric Rheumatology and Immunology, Wilhelmina Children's Hospital University Medical Centre, Utrecht, The Netherlands .,PGOsupport, Utrecht, The Netherlands
| | - Dawn P Richards
- Canadian Arthritis Patient Alliance, Toronto, Ontario, Canada,Five02 Labs Inc, Toronto, Ontario, Canada
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9
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Studenic P, Sekhon M, Carmona L, de Wit M, Nikiphorou E. Unmet need for patient involvement in rheumatology registries and observational studies: a mixed methods study. RMD Open 2022; 8:rmdopen-2022-002472. [PMID: 35985793 PMCID: PMC9396190 DOI: 10.1136/rmdopen-2022-002472] [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: 05/14/2022] [Accepted: 07/18/2022] [Indexed: 11/17/2022] Open
Abstract
Objective The contribution of patient research partners (PRPs) is well established in EULAR recommendation development. However, in observational and registry studies, PRP involvement is not well-defined and remains limited. Methods Based on a round table discussion during the EULAR Registries and Observational Drug Studies (RODS) meeting in 2019, a mixed methods study was undertaken, including a survey to RODS participants and EULAR PRPs and focus groups with volunteers from the survey. An inductive thematic analysis approach was applied to qualitative data and descriptive statistics to survey data. Results We retrieved 45 survey responses and ran 3 focus groups with a total of 17 participants. The notion of PRP involvement in research was positively perceived by PRPs and the wider academic rheumatology community. There is universal agreement that PRP involvement in registry research is low and inclusion in different parts of the research cycle is limited. Potential benefits of PRP involvement include: input on the research objectives based on patients’ needs, advice and support regarding recruitment and retention strategies, obtaining patient views on analysis and interpretation, and assistance in disseminating results. Researchers and PRPs highlighted that education, inclusion of PRPs with diverse backgrounds and a welcoming environment as important facilitators for PRP involvement. On the other hand, preconceptions of researchers and insufficient budget allocation have been identified as barriers. Conclusion There is an unmet need to involve PRPs in registries and observational studies and to better define their required input during all research stages. This study provides suggestions for successful PRP integration.
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Affiliation(s)
- Paul Studenic
- Department of Internal Medicine 3, Division of Rheumatology, Medical University of Vienna, Vienna, Austria .,Department of Medicine (Solna), Division of Rheumatology, Karolinska Institute, Stockholm, Sweden
| | - Mandeep Sekhon
- Centre for Applied Health and Social Care Research, Faculty of Health, Social Care and Education, University of London, London, UK.,School of Life Course & Population Sciences, Faculty of Life Sciences and Medicine, King's College London, London, UK
| | | | - Maarten de Wit
- Patient research partner, EULAR, Zaltbommel, Netherlands
| | - Elena Nikiphorou
- Centre for Rheumatic Diseases, King's College London, London, UK.,Rheumatology Department, King's College Hospital, London, UK
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Richards DP, Cobey KD, Proulx L, Dawson S, de Wit M, Toupin-April K. Identifying potential barriers and solutions to patient partner compensation (payment) in research. RESEARCH INVOLVEMENT AND ENGAGEMENT 2022; 8:7. [PMID: 35197113 PMCID: PMC8867631 DOI: 10.1186/s40900-022-00341-1] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Accepted: 02/11/2022] [Indexed: 06/14/2023]
Abstract
Research that engages patients on the research team is often supported by grant funding from different organizations and, in some cases, principal investigators (who control the grant funding) provide patient partners with compensation (or payment) for their contributions. However, we have noted a gap in resources that identify and address barriers to compensating patient partners (no matter the size, degree or length of their engagement). In this paper, we present thoughts and experiences related to barriers to compensating patient partners with the goal of helping individuals identify and find solutions to these obstacles. Based on our experiences as individuals who live with chronic conditions and are patient partners, and those who are researchers who engage patient partners, we have identified eight barriers to compensating patient partners. We discuss each of these barriers: lack of awareness about patient partnership, institutional inflexibility, policy guidance from funders, compensation not prioritized in research budgets, leadership hesitancy to create a new system, culture of research teams, preconceived beliefs about the skills and abilities of patient partners, and expectations placed on patient partners. We demonstrate these barriers with real life examples and we offer some solutions. To further demonstrate these barriers, we ask readers to reflect on some scenarios that present realistic parallel situations to those that patient partners face. The intention is to illustrate, through empathy or putting yourself in someone else's shoes, how we might all do better with respect to institutional barriers related to patient partner compensation. Last, we issue a call to action to share resources and identify actions to overcome these barriers from which we will create an online resource repository.
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Affiliation(s)
- Dawn P Richards
- Five02 Labs Inc, Toronto, ON, Canada.
- Canadian Institutes of Health Research Institute of Musculoskeletal Health and Arthritis, University of British Columbia, Vancouver, BC, Canada.
- Canadian Arthritis Patient Alliance, Ottawa, ON, Canada.
- Patient Research Partner, Toronto, ON, Canada.
| | - Kelly D Cobey
- Meta-Research and Open Science Program, University of Ottawa Heart Institute, Ottawa, ON, Canada
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada
| | - Laurie Proulx
- Canadian Arthritis Patient Alliance, Ottawa, ON, Canada
- Patient Research Partner, Ottawa, ON, Canada
| | - Shoba Dawson
- Bristol Medical School, University of Bristol, Bristol, UK
| | | | - Karine Toupin-April
- School of Rehabilitation Sciences, University of Ottawa, Ottawa, ON, Canada
- Department of Pediatrics, University of Ottawa, Ottawa, ON, Canada
- Children's Hospital of Eastern Ontario Research Institute, Ottawa, ON, Canada
- Institut du Savoir Montfort, Ottawa, ON, Canada
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Collaboration between doctoral researchers and patient research partners: reflections and considerations. RESEARCH FOR ALL 2022. [DOI: 10.14324/rfa.06.1.02] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
A key principle of working in collaboration with patient research partners (patients contributing to research projects as team members, rather than as participants) is that they should be equal partners with researchers and health professionals. This presents a challenge in doctoral research, where students are expected to own their research decisions. Consequently, efforts are required to ensure that patient partners’ involvements are not tokenistic. This case study brings together the reflections of a recently completed doctoral student and a patient partner, who was part of the doctoral supervisory team. It discusses the role that the patient partner took during the doctorate and the activities in which he was involved. Both the researcher and the patient partner reflect on their expectations and experiences of collaboration. These reflections include factors that facilitated good working practices, the process of building rapport, and the benefits each got out of their collaboration. The interactions exploring ‘the dance of academia’ (the processes that were formally part of the PhD process or the aspects of academic work that were not directly related to completing the research) required recognition. Open, ongoing communication and practical considerations to support the patient partner were key to establishing a strong working relationship, and to determining what a meaningful contribution looked like at each stage of the process. Working with a patient partner as a doctoral student adds value to the doctoral process, and it is a vital opportunity to develop good practice as a researcher.
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Kinikli Gİ, Pettersson S, Karahan S, Gunnarsson I, Svenungsson E, Boström C. Factors associated with self-reported capacity to walk, jog and run in individuals with systemic lupus erythematosus. Arch Rheumatol 2020; 36:89-100. [PMID: 34046573 PMCID: PMC8140879 DOI: 10.46497/archrheumatol.2021.8193] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2020] [Accepted: 07/03/2020] [Indexed: 11/03/2022] Open
Abstract
Objectives This study aims to explore how disease and health-related quality of life (HRQOL) factors are associated with self-reported physical capacity in walking, jogging and running in systemic lupus erythematosus (SLE). Patients and methods This cross-sectional study is part of an ongoing cohort research project which started in 2014. A total of 198 patients (21 males, 177 females; mean age 51.5±16.1 years; range, 20 to 82 years) with SLE answered a question concerning physical capacity and the answers were categorized as low (can walk less than 2 km) and high (can jog and run at least 2 km) capacity. Additional measurements of disease activity (Systemic Lupus Activity Measure-Revised, SLAM-R), organ damage (Systemic Lupus International Collaborating Clinics-Damage Index, SLICC-DI), physical activity (International Physical Activity Questionnaire-Short Form, IPAQ-SF), exercise during the past year, Hospital Anxiety and Depression Scale (HADS), and HRQOL according to EuroQol five-dimension score and EuroQol visual analog scale (EQ-VAS) were included. The independent variables in the multiple logistic regression analysis were age, body mass index (BMI), disease duration, SLAM-R, SLICC-DI, IPAQ-SF category, sitting hours (IPAQ-SF), and exercise during the past year as well as HADS and EQ-VAS. Results Patients that reported low physical capacity (n=120) were older (p<0.001), had longer disease duration (p<0.001), had more organ damage (p<0.001), reported that they were less physically active (p=0.003), exercised less during the past year (p=0.001), reported more pain/discomfort and depressive symptom (p<0.001) and had lower overall HRQOL (p<0.001) and mobility and usual activities than those that reported high capacity (n=78). The regression analysis showed that age (median ≤49 vs >49) (Exp) (B): 4.52 (95% confidence interval [CI]: 2.05 to 9.98) (p<0.001), disease duration (median ≤17 vs >17) Exp (B): 2.53 (95% CI: 1.15 to 5.60) (p=0.02), SLICC-DI (median <1 vs ≥1) Exp (B): 3.60 (95% CI: 1.48 to 8.73) (p=0.005), and EQ-VAS (median <72 vs ≥72) Exp (B): 4.63 (95% CI: 2.13 to 10.05) (p<0.001) were significant factors associated with physical capacity (Nagelkerke R Squared=0.46). Conclusion Patients with low physical capacity were less physically active, exercised less and had more pain and depressive symptoms than those that reported a high capacity. However, only age, disease duration, organ damage and overall HRQOL were indicators of low physical capacity. In order to increase physical capacity in the management of SLE, it is important to address overall HRQOL.
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Affiliation(s)
- Gizem İrem Kinikli
- Department of Orthopedic Physiotherapy and Rehabilitation, Hacettepe University, Faculty of Physical Therapy and Rehabilitation, Ankara, Turkey
| | - Susanne Pettersson
- Karolinska University Hospital, Theme Inflammation and Infection, Po Gastro Hud Och Reuma, Stockholm, Sweden
| | - Sevilay Karahan
- Department of Biostatistics, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Iva Gunnarsson
- Department of Medicine, Division of Rheumatology, Karolinska Institute, Stockholm, Sweden
| | - Elisabet Svenungsson
- Department of Medicine, Division of Rheumatology, Karolinska Institute, Stockholm, Sweden
| | - Carina Boström
- Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm, Sweden
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de Wit M, Guillemin F, Grimm S, Boonen A, Fautrel B, Joore M. Patient engagement in health technology assessment (HTA) and the regulatory process: what about rheumatology? RMD Open 2020; 6:rmdopen-2020-001286. [PMID: 33148783 PMCID: PMC7856120 DOI: 10.1136/rmdopen-2020-001286] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Revised: 07/31/2020] [Accepted: 08/04/2020] [Indexed: 11/23/2022] Open
Affiliation(s)
- Maarten de Wit
- Patient Research Partner, EULAR, Zaltbommel, Netherlands
| | - Francis Guillemin
- School of Public Health, Nancy, France.,Universite de Lorraine, APEMAC, School of Public Health, Nancy, France
| | - Sabine Grimm
- Maastricht University Medical Centre+, Maastricht, Netherlands
| | - Annelies Boonen
- Department of Internal Medicine, Division of Rheumatology, Maastricht University Medical Center, and the Caphri Research Institute Maastricht University, Maastricht, Netherlands
| | - Bruno Fautrel
- Rheumatology, Assistance Publique - Hopitaux De Paris, Paris, France.,GRC08 - Iplesp, UPMC Faculte De Medecine, Paris, France
| | - Manuela Joore
- Maastricht University Medical Centre+, Maastricht, Netherlands
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[Participatory research in the German Rheumatism League. Content implementation and practical realisation of participatory research in a patient organisation]. ZEITSCHRIFT FUR EVIDENZ FORTBILDUNG UND QUALITAET IM GESUNDHEITSWESEN 2020; 155:64-70. [PMID: 32753283 DOI: 10.1016/j.zefq.2020.04.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Revised: 04/21/2020] [Accepted: 04/21/2020] [Indexed: 01/05/2023]
Abstract
The German Rheumatism League ("Deutsche Rheuma-Liga") is the largest patient organisation in Germany, with about 300,000 members. In the sense of participatory research, the Deutsche Rheuma-Liga involves trained patient representatives in research projects funded by either the Deutsche Rheuma-Liga or other organisations. In order to invigorate the principle of participatory research in the field of rheumatology in Germany various measures have been undertaken: the principle of participatory research has been implemented as obligatory in the funding guidelines of the German Rheumatism League. A training course for German-speaking patients was created, and reference cards and an explanatory brochure were provided. In a letter campaign, about 70 universities and hospitals with rheumatology departments were contacted and informed about the benefits of participatory research. Since 2014, three training courses with 21 participants have been conducted. The trained patient representatives have participated in more than 30 projects up to the end of 2019. The overall experience of the patient representatives actively involved in research projects was mainly positive, and participatory research was perceived as being interesting and enriching. The implementation of participatory research in the German Rheumatism League can be described as successful. The article describes the measures taken to implement the principle of participatory research into the structures of the German Rheumatism League and summarises the experiences of patients and the patient organisation during five years of active participation in research projects.
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Affiliation(s)
- Zoe Paskins
- Primary Care Centre Versus Arthritis, School of Primary, Community and Social Care, Keele University, Staffordshire
- Haywood Academic Rheumatology Centre, Haywood Hospital, Midland Partnership NHS Foundation Trust, Stoke-on-Trent, UK
| | - Peter R Croft
- Primary Care Centre Versus Arthritis, School of Primary, Community and Social Care, Keele University, Staffordshire
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