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Gens-Barberà M, Astier-Peña MP, Hernández-Vidal N, Hospital-Guardiola I, Bejarano-Romero F, Oya-Girona EM, Mengíbar-Garcia Y, Mansergas-Collado N, Vila-Rovira A, Martínez-Torres S, Rey-Reñones C, Martín-Luján F. Patient Safety Incidents in Primary Care: Comparing APEAS-2007 (Spanish Patient Safety Adverse Events Study in Primary Care) with Data from a Health Area in Catalonia (Spain) in 2019. Healthcare (Basel) 2024; 12:1086. [PMID: 38891161 PMCID: PMC11172342 DOI: 10.3390/healthcare12111086] [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: 03/25/2024] [Revised: 05/08/2024] [Accepted: 05/22/2024] [Indexed: 06/21/2024] Open
Abstract
The initial APEAS study, conducted in June 2007, examined adverse events (AEs) in Spanish Primary Healthcare (PHC). Since then, significant changes have occurred in healthcare systems. To evaluate these changes, a study was conducted in the Camp de Tarragona PHC region (CTPHC) in June 2019. This cross-sectional study aimed to identify AEs in 20 PHC centres in Camp de Tarragona. Data collection used an online questionnaire adapted from APEAS-2007, and a comparative statistical analysis between APEAS-2007 and CTPHC-2019 was performed. The results revealed an increase in nursing notifications and a decrease in notifications from family doctors. Furthermore, fewer AEs were reported overall, particularly in medication-related incidents and healthcare-associated infections, with an increase noted in no-harm incidents. However, AEs related to worsened clinical outcomes, communication issues, care management, and administrative errors increased. Concerning severity, there was a decrease in severe AEs, coupled with an increase in moderate AEs. Despite family doctors perceiving a reduction in medication-related incidents, the overall preventability of AEs remained unchanged. In conclusion, the reporting patterns, nature, and causal factors of AEs in Spanish PHC have evolved over time. While there has been a decrease in medication-related incidents and severe AEs, challenges persist in communication, care management, and clinical outcomes. Although professionals reported reduced severity, the perception of preventability remains an area that requires attention.
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Affiliation(s)
- Montserrat Gens-Barberà
- Quality and Patient Safety Central Functional Unit, Gerència d’Atenció Primària Camp de Tarragona, Institut Català de la Salut, 43005 Tarragona, Spain (F.B.-R.); (N.M.-C.)
- QiSP-Tar Research Group, Fundació Institut Universitari per a la Recerca a l’Atenció Primària de Salut—IDIAP Jordi Gol, 08007 Barcelona, Spain (F.M.-L.)
- ISAC Research Group (Intervencions Sanitàries i Activitats Comunitàries; 2021 SGR 00884), Fundació Institut Universitari per a la Recerca a l’Atenció Primària de Salut—IDIAPJGol, 08007 Barcelona, Spain
| | - Maria-Pilar Astier-Peña
- QiSP-Tar Research Group, Fundació Institut Universitari per a la Recerca a l’Atenció Primària de Salut—IDIAP Jordi Gol, 08007 Barcelona, Spain (F.M.-L.)
- Universitas Health Center, Health Service of Aragon, 50080 Zaragoza, Spain
| | - Núria Hernández-Vidal
- Quality and Patient Safety Central Functional Unit, Gerència d’Atenció Primària Camp de Tarragona, Institut Català de la Salut, 43005 Tarragona, Spain (F.B.-R.); (N.M.-C.)
- QiSP-Tar Research Group, Fundació Institut Universitari per a la Recerca a l’Atenció Primària de Salut—IDIAP Jordi Gol, 08007 Barcelona, Spain (F.M.-L.)
- ISAC Research Group (Intervencions Sanitàries i Activitats Comunitàries; 2021 SGR 00884), Fundació Institut Universitari per a la Recerca a l’Atenció Primària de Salut—IDIAPJGol, 08007 Barcelona, Spain
| | - Immaculada Hospital-Guardiola
- Quality and Patient Safety Central Functional Unit, Gerència d’Atenció Primària Camp de Tarragona, Institut Català de la Salut, 43005 Tarragona, Spain (F.B.-R.); (N.M.-C.)
- QiSP-Tar Research Group, Fundació Institut Universitari per a la Recerca a l’Atenció Primària de Salut—IDIAP Jordi Gol, 08007 Barcelona, Spain (F.M.-L.)
- ISAC Research Group (Intervencions Sanitàries i Activitats Comunitàries; 2021 SGR 00884), Fundació Institut Universitari per a la Recerca a l’Atenció Primària de Salut—IDIAPJGol, 08007 Barcelona, Spain
| | - Ferran Bejarano-Romero
- Quality and Patient Safety Central Functional Unit, Gerència d’Atenció Primària Camp de Tarragona, Institut Català de la Salut, 43005 Tarragona, Spain (F.B.-R.); (N.M.-C.)
- QiSP-Tar Research Group, Fundació Institut Universitari per a la Recerca a l’Atenció Primària de Salut—IDIAP Jordi Gol, 08007 Barcelona, Spain (F.M.-L.)
- ISAC Research Group (Intervencions Sanitàries i Activitats Comunitàries; 2021 SGR 00884), Fundació Institut Universitari per a la Recerca a l’Atenció Primària de Salut—IDIAPJGol, 08007 Barcelona, Spain
| | - Eva Mª Oya-Girona
- Quality and Patient Safety Central Functional Unit, Gerència d’Atenció Primària Camp de Tarragona, Institut Català de la Salut, 43005 Tarragona, Spain (F.B.-R.); (N.M.-C.)
- QiSP-Tar Research Group, Fundació Institut Universitari per a la Recerca a l’Atenció Primària de Salut—IDIAP Jordi Gol, 08007 Barcelona, Spain (F.M.-L.)
- ISAC Research Group (Intervencions Sanitàries i Activitats Comunitàries; 2021 SGR 00884), Fundació Institut Universitari per a la Recerca a l’Atenció Primària de Salut—IDIAPJGol, 08007 Barcelona, Spain
| | - Yolanda Mengíbar-Garcia
- Quality and Patient Safety Central Functional Unit, Gerència d’Atenció Primària Camp de Tarragona, Institut Català de la Salut, 43005 Tarragona, Spain (F.B.-R.); (N.M.-C.)
- QiSP-Tar Research Group, Fundació Institut Universitari per a la Recerca a l’Atenció Primària de Salut—IDIAP Jordi Gol, 08007 Barcelona, Spain (F.M.-L.)
| | - Nuria Mansergas-Collado
- Quality and Patient Safety Central Functional Unit, Gerència d’Atenció Primària Camp de Tarragona, Institut Català de la Salut, 43005 Tarragona, Spain (F.B.-R.); (N.M.-C.)
- QiSP-Tar Research Group, Fundació Institut Universitari per a la Recerca a l’Atenció Primària de Salut—IDIAP Jordi Gol, 08007 Barcelona, Spain (F.M.-L.)
| | - Angel Vila-Rovira
- Quality and Patient Safety Central Functional Unit, Gerència d’Atenció Primària Camp de Tarragona, Institut Català de la Salut, 43005 Tarragona, Spain (F.B.-R.); (N.M.-C.)
- QiSP-Tar Research Group, Fundació Institut Universitari per a la Recerca a l’Atenció Primària de Salut—IDIAP Jordi Gol, 08007 Barcelona, Spain (F.M.-L.)
| | - Sara Martínez-Torres
- QiSP-Tar Research Group, Fundació Institut Universitari per a la Recerca a l’Atenció Primària de Salut—IDIAP Jordi Gol, 08007 Barcelona, Spain (F.M.-L.)
- ISAC Research Group (Intervencions Sanitàries i Activitats Comunitàries; 2021 SGR 00884), Fundació Institut Universitari per a la Recerca a l’Atenció Primària de Salut—IDIAPJGol, 08007 Barcelona, Spain
- Research Support Unit Camp of Tarragona, Department of Primary Care Camp de Tarragona, Institut Català de la Salut, 43202 Reus, Spain
| | - Cristina Rey-Reñones
- QiSP-Tar Research Group, Fundació Institut Universitari per a la Recerca a l’Atenció Primària de Salut—IDIAP Jordi Gol, 08007 Barcelona, Spain (F.M.-L.)
- ISAC Research Group (Intervencions Sanitàries i Activitats Comunitàries; 2021 SGR 00884), Fundació Institut Universitari per a la Recerca a l’Atenció Primària de Salut—IDIAPJGol, 08007 Barcelona, Spain
- Research Support Unit Camp of Tarragona, Department of Primary Care Camp de Tarragona, Institut Català de la Salut, 43202 Reus, Spain
- Department of Medicine and Surgery, School of Medicine and Health Sciences, Universitat Rovira i Virgili, 43201 Reus, Spain
| | - Francisco Martín-Luján
- QiSP-Tar Research Group, Fundació Institut Universitari per a la Recerca a l’Atenció Primària de Salut—IDIAP Jordi Gol, 08007 Barcelona, Spain (F.M.-L.)
- ISAC Research Group (Intervencions Sanitàries i Activitats Comunitàries; 2021 SGR 00884), Fundació Institut Universitari per a la Recerca a l’Atenció Primària de Salut—IDIAPJGol, 08007 Barcelona, Spain
- Research Support Unit Camp of Tarragona, Department of Primary Care Camp de Tarragona, Institut Català de la Salut, 43202 Reus, Spain
- Department of Medicine and Surgery, School of Medicine and Health Sciences, Universitat Rovira i Virgili, 43201 Reus, Spain
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Hammoud S, Alsabek L, Rogers L, McAuliffe E. Systematic review on the frequency and quality of reporting patient and public involvement in patient safety research. BMC Health Serv Res 2024; 24:532. [PMID: 38671476 PMCID: PMC11046929 DOI: 10.1186/s12913-024-11021-z] [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: 01/10/2024] [Accepted: 04/21/2024] [Indexed: 04/28/2024] Open
Abstract
BACKGROUND In recent years, patient and public involvement (PPI) in research has significantly increased; however, the reporting of PPI remains poor. The Guidance for Reporting Involvement of Patients and the Public (GRIPP2) was developed to enhance the quality and consistency of PPI reporting. The objective of this systematic review is to identify the frequency and quality of PPI reporting in patient safety (PS) research using the GRIPP2 checklist. METHODS Searches were performed in Ovid MEDLINE, EMBASE, PsycINFO, and CINAHL from 2018 to December, 2023. Studies on PPI in PS research were included. We included empirical qualitative, quantitative, mixed methods, and case studies. Only articles published in peer-reviewed journals in English were included. The quality of PPI reporting was assessed using the short form of the (GRIPP2-SF) checklist. RESULTS A total of 8561 studies were retrieved from database searches, updates, and reference checks, of which 82 met the eligibility criteria and were included in this review. Major PS topics were related to medication safety, general PS, and fall prevention. Patient representatives, advocates, patient advisory groups, patients, service users, and health consumers were the most involved. The main involvement across the studies was in commenting on or developing research materials. Only 6.1% (n = 5) of the studies reported PPI as per the GRIPP2 checklist. Regarding the quality of reporting following the GRIPP2-SF criteria, our findings show sub-optimal reporting mainly due to failures in: critically reflecting on PPI in the study; reporting the aim of PPI in the study; and reporting the extent to which PPI influenced the study overall. CONCLUSIONS Our review shows a low frequency of PPI reporting in PS research using the GRIPP2 checklist. Furthermore, it reveals a sub-optimal quality in PPI reporting following GRIPP2-SF items. Researchers, funders, publishers, and journals need to promote consistent and transparent PPI reporting following internationally developed reporting guidelines such as the GRIPP2. Evidence-based guidelines for reporting PPI should be encouraged and supported as it helps future researchers to plan and report PPI more effectively. TRIAL REGISTRATION The review protocol is registered with PROSPERO (CRD42023450715).
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Affiliation(s)
- Sahar Hammoud
- UCD Centre for Interdisciplinary Research, Education and Innovation in Health Systems (UCD IRIS), School of Nursing, Midwifery and Health Systems, Health Sciences Centre, University College Dublin, Dublin, Ireland.
| | - Laith Alsabek
- UCD Centre for Interdisciplinary Research, Education and Innovation in Health Systems (UCD IRIS), School of Nursing, Midwifery and Health Systems, Health Sciences Centre, University College Dublin, Dublin, Ireland
- Department of Oral and Maxillofacial Surgery, University Hospital Galway, Galway, Ireland
| | - Lisa Rogers
- UCD Centre for Interdisciplinary Research, Education and Innovation in Health Systems (UCD IRIS), School of Nursing, Midwifery and Health Systems, Health Sciences Centre, University College Dublin, Dublin, Ireland
| | - Eilish McAuliffe
- UCD Centre for Interdisciplinary Research, Education and Innovation in Health Systems (UCD IRIS), School of Nursing, Midwifery and Health Systems, Health Sciences Centre, University College Dublin, Dublin, Ireland
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Ahuja S, Phillips L, Smartt C, Khalid S, Coldham T, Fischer L, Rae S, Sevdalis N, Boaz A, Robinson S, Gaughran F, Lelliott Z, Jones P, Thornicroft G, Munshi JD, Drummond C, Perez J, Littlejohns P. What interventions should we implement in England's mental health services? The mental health implementation network (MHIN) mixed-methods approach to rapid prioritisation. FRONTIERS IN HEALTH SERVICES 2023; 3:1204207. [PMID: 37638343 PMCID: PMC10456870 DOI: 10.3389/frhs.2023.1204207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Accepted: 07/17/2023] [Indexed: 08/29/2023]
Abstract
Introduction Setting mental health priorities helps researchers, policy makers, and service funders improve mental health services. In the context of a national mental health implementation programme in England, this study aims to identify implementable evidence-based interventions in key priority areas to improve mental health service delivery. Methods A mixed-methods research design was used for a three step prioritisation approach involving systematic scoping reviews (additional manuscript under development), expert consultations and data triangulation. Groups with diverse expertise, including experts by experience, worked together to improve decision-making quality by promoting more inclusive and comprehensive discussions. A multi-criteria decision analysis (MCDA) model was used to combine participants' varied opinions, data and judgments about the data's relevance to the issues at hand during a decision conferencing workshop where the priorities were finalised. Results The study identified mental health interventions in three mental health priority areas: mental health inequalities, child and adolescent mental health, comorbidities with a focus on integration of mental and physical health services and mental health and substance misuse problems. Key interventions in all the priority areas are outlined. The programme is putting some of these evidence-based interventions into action nationwide in each of these three priority mental health priority areas. Conclusion We report an inclusive attempt to ensure that the list of mental health service priorities agrees with perceived needs on the ground and focuses on evidence-based interventions. Other fields of healthcare may also benefit from this methodological approach if they need to make rapid health-prioritisation decisions.
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Affiliation(s)
- Shalini Ahuja
- Methodologies Research Division, Florence Nightingale Faculty of Nursing Midwifery and Palliative Care, King's College London, London, United Kingdom
| | - Lawrence Phillips
- Department of Management, London School of Economics and Political Science, London, United Kingdom
| | - Caroline Smartt
- Department of Health Service & Population Research, School of Mental Health & Psychological Sciences, King's College London, London, United Kingdom
| | - Sundus Khalid
- Department of Health Service & Population Research, School of Mental Health & Psychological Sciences, King's College London, London, United Kingdom
| | - Tina Coldham
- Participation Involvement & Engagement Advisor at NIHR (National Institute for Health Research), London, United Kingdom
| | - Laura Fischer
- Department of Health Service & Population Research, School of Mental Health & Psychological Sciences, King's College London, London, United Kingdom
| | - Sarah Rae
- Independent Expert by Experience, and Patient Community Involvement and Engagement Participation (PCIEP) Lead, co-Lead Workstream 2 (Patient and Public Involvement), London, United Kingdom
| | - Nick Sevdalis
- Department of Psychological Medicine, National University of Singapore, Singapore, Singapore
| | - Annette Boaz
- Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, University of London, London, United Kingdom
| | - Sarah Robinson
- Eastern Academic Health Science Network, Cambridge, United Kingdom
| | - Fiona Gaughran
- Social and Psychiatric Epidemiology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Zoe Lelliott
- Social and Psychiatric Epidemiology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Peter Jones
- Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom
| | - Graham Thornicroft
- Department of Health Service & Population Research, School of Mental Health & Psychological Sciences, King's College London, London, United Kingdom
| | - Jayati-Das Munshi
- Social and Psychiatric Epidemiology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Colin Drummond
- Social and Psychiatric Epidemiology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Jesus Perez
- Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom
| | - Peter Littlejohns
- Social and Psychiatric Epidemiology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
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4
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Morris RL, Giles S, Campbell S. Involving patients and carers in patient safety in primary care: A qualitative study of a co-designed patient safety guide. Health Expect 2023; 26:630-639. [PMID: 36645147 PMCID: PMC10010084 DOI: 10.1111/hex.13673] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Revised: 10/28/2022] [Accepted: 11/06/2022] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND Involving patients is a key premise of national and international policies on patient safety, which requires understanding how patients or carers want to be involved and developing resources to support this. This paper examines patients' and carers' views of being involved in patient safety in primary care and their views of potentially using a co-designed patient safety guide for primary care (PSG-PC) to foster both involvement and their safety. METHODS A qualitative study using semistructured face-to-face interviews with 18 patients and/or carers in primary care. Interviews were transcribed and analysis was conducted using an inductive thematic approach. RESULTS Overall participants expressed enthusiasm for the PSG-PC as a tool to support patients and carers to be involved in patient safety in primary care. However, for some participants being involved in patient safety was seen as taking on the role of General Practitioner and had the potential to add an additional workload for patients. Participants' willingness or ability to be involved in patient safety was influenced by a range of factors including an invisible, often underacknowledged role of everyday safety for patients' interactions with primary care; the levels of involvement that patients wanted in their care and safety and the work of embedding the PSG-PC for patients into their routine interactions with primary care. Participants identified components of the PSG-PC that would be useful to them, in particular, if they had a responsibility for caring for a family member if they had more complex care or long-term conditions. CONCLUSION Involving patients and carers in patient safety needs a tailored and personalized approach that enables patients and carers to use resources like the PSG-PC routinely and helps challenge assumptions about their willingness and ability to be involved in patient safety. Doing so would raise awareness of opportunities to be involved in safety in line with personal preference. PATIENT OR PUBLIC CONTRIBUTION Patient and public involvement were central to the research study. This included working in partnership to develop the PSG-PC with patients and carers and throughout our study including in the design of the study, recruiting participants, interpretation of findings.
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Affiliation(s)
- Rebecca L Morris
- NIHR Greater Manchester Patient Safety Translational Research Centre, Centre for Primary Care and Health Services Research, Division of Population Health, Health Services Research and Primary Care, University of Manchester, Manchester, UK
| | - Sally Giles
- NIHR Greater Manchester Patient Safety Translational Research Centre, Centre for Primary Care and Health Services Research, Division of Population Health, Health Services Research and Primary Care, University of Manchester, Manchester, UK
| | - Stephen Campbell
- NIHR Greater Manchester Patient Safety Translational Research Centre, Centre for Primary Care and Health Services Research, Division of Population Health, Health Services Research and Primary Care, University of Manchester, Manchester, UK
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Grimes T, Marcilly R, Bonnici West L, Cordina M. Medication-Related Outcomes and Health Equity: Evidence for Pharmaceutical Care. PHARMACY 2023; 11:pharmacy11020060. [PMID: 36961038 PMCID: PMC10037618 DOI: 10.3390/pharmacy11020060] [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: 02/01/2023] [Revised: 03/13/2023] [Accepted: 03/14/2023] [Indexed: 03/25/2023] Open
Abstract
Marginalised people experience diminished access to pharmaceutical care and worse medication-related outcomes than the general population. Health equity is a global priority. This article explores the key evidence of health inequity and medication use, structures the causes and contributory factors and suggests opportunities that can be taken to advance the pharmaceutical care agenda so as to achieve health equity. The causes of, and contributors to, this inequity are multi-fold, with patient- and person-related factors being the most commonly reported. Limited evidence is available to identify risk factors related to other aspects of a personal medication use system, such as technology, tasks, tools and the internal and the external environments. Multiple opportunities exist to enhance equity in medication-related outcomes through pharmaceutical care research and practice. To optimise the effects and the sustainable implementation of these opportunities, it is important to (1) ensure the meaningful inclusion and engagement of members of marginalised groups, (2) use a person-centred approach and (3) apply a systems-based approach to address all of the necessary components of a system that interact and form a network as work processes that produce system outcomes.
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Affiliation(s)
- Tamasine Grimes
- School of Pharmacy and Pharmaceutical Sciences, Trinity College Dublin, D02PN40 Dublin, Ireland
| | - Romaric Marcilly
- Univ. Lille, CHU Lille, ULR 2694-METRICS: Évaluation des Technologies de Santé et des Pratiques Médicales, F-59000 Lille, France
- Inserm, CIC-IT 1403, F-59000 Lille, France
| | - Lorna Bonnici West
- Applied Research and Innovation Centre, Malta College of Arts, Science and Technology, PLA9032 Paola, Malta
| | - Maria Cordina
- Department of Clinical Pharmacology & Therapeutics, WHO Collaborating Centre for Health Professionals Education and Research, Faculty of Medicine and Surgery, University of Malta, 2080 Msida, Malta
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Jung M, Cangadis‐Douglass H, Nielsen S, Lalic S, Dobbin M, Russell G, Prathivadi P, Wood P, Manias E, Lee CY, Arnold C, Kuleas M, Schumann JL, Ilomäki J, Bell JS. What are the research priorities for optimising the safe and effective use of opioids in Australian general practice? Drug Alcohol Rev 2023; 42:604-613. [PMID: 36065154 PMCID: PMC10946507 DOI: 10.1111/dar.13539] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Revised: 07/02/2022] [Accepted: 08/12/2022] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Persistent high rates of prescription opioid use and harms remain a concern in Australia, Europe and North America. Research priority setting can inform the research agenda, strategic responses and evidence-based interventions. The objective of this study was to establish research priorities related to the safe and effective use of prescription opioids in general practice. METHODS Consumers, clinicians and policy makers were invited to participate in a structured consensus workshop in May 2021. A modified nominal group technique was used to explore research priorities for the safe and effective use of opioids in Australian general practice. Research priorities were identified, consolidated and prioritised using a structured process. RESULTS Seventeen consumer, medical, pharmacy, nursing, allied health and policy participants generated 26 consolidated priorities across three domains: (i) consumer-focused priorities; (ii) clinician and practice-focused priorities; and (iii) system and policy-focused priorities. The highest ranked research priorities in each of the domains were consumer characteristics that influence opioid prescribing and outcomes, opioid deprescribing strategies, and system-level barriers to prescribing alternatives to opioids, in the consumer, clinician and practice, and system and policy domains, respectively. DISCUSSION AND CONCLUSION The priorities reflect opportunities for research priority setting within Australian general practice. The priorities provide a map for future qualitative and quantitative research that will inform safe and effective opioid prescribing.
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Affiliation(s)
- Monica Jung
- Monash Addiction Research Centre, Eastern Health Clinical SchoolMonash UniversityMelbourneAustralia
- Centre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical SciencesMonash UniversityMelbourneAustralia
| | - Helena Cangadis‐Douglass
- Monash Addiction Research Centre, Eastern Health Clinical SchoolMonash UniversityMelbourneAustralia
- Centre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical SciencesMonash UniversityMelbourneAustralia
| | - Suzanne Nielsen
- Monash Addiction Research Centre, Eastern Health Clinical SchoolMonash UniversityMelbourneAustralia
| | - Samanta Lalic
- Centre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical SciencesMonash UniversityMelbourneAustralia
- Pharmacy DepartmentMonash HealthMelbourneAustralia
| | - Malcolm Dobbin
- Department of Forensic MedicineMonash UniversityMelbourneAustralia
| | - Grant Russell
- Department of General PracticeMonash UniversityMelbourneAustralia
| | | | - Pene Wood
- Department of Pharmacy and Biomedical ScienceLa Trobe UniversityBendigoAustralia
| | - Elizabeth Manias
- School of Nursing and Midwifery, Centre for Quality and Patient Safety Research, Institute for Health TransformationDeakin UniversityMelbourneAustralia
- Department of Nursing, School of Health SciencesThe University of MelbourneMelbourneAustralia
- Department of MedicineRoyal Melbourne HospitalMelbourneAustralia
| | - Cik Y. Lee
- Centre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical SciencesMonash UniversityMelbourneAustralia
- Department of Nursing, School of Health SciencesThe University of MelbourneMelbourneAustralia
| | - Carolyn Arnold
- Caulfield Pain Management and Research CentreAlfred HealthMelbourneAustralia
- Department of Anaesthesiology and Perioperative Medicine, Central Clinical SchoolMonash UniversityMelbourneAustralia
| | | | - Jennifer L. Schumann
- Monash Addiction Research Centre, Eastern Health Clinical SchoolMonash UniversityMelbourneAustralia
- Department of Forensic MedicineMonash UniversityMelbourneAustralia
- Drug Intelligence UnitVictorian Institute of Forensic MedicineMelbourneAustralia
| | - Jenni Ilomäki
- Centre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical SciencesMonash UniversityMelbourneAustralia
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive MedicineMonash UniversityMelbourneAustralia
| | - J. Simon Bell
- Monash Addiction Research Centre, Eastern Health Clinical SchoolMonash UniversityMelbourneAustralia
- Centre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical SciencesMonash UniversityMelbourneAustralia
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive MedicineMonash UniversityMelbourneAustralia
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Grindlay DJC, Davis TRC, Kennedy D, Larson D, Furniss D, Cowan K, Giddins G, Jain A, Trickett RW, Karantana A. A proposed methodology for uncertainty extraction and verification in priority setting partnerships with the James Lind Alliance: an example from the Common Conditions Affecting the Hand and Wrist Priority Setting Partnership. BMC Med Res Methodol 2022; 22:292. [DOI: 10.1186/s12874-022-01777-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Accepted: 10/26/2022] [Indexed: 11/11/2022] Open
Abstract
Abstract
Background
To report our recommended methodology for extracting and then confirming research uncertainties – areas where research has failed to answer a research question – derived from previously published literature during a broad scope Priority Setting Partnership (PSP) with the James Lind Alliance (JLA).
Methods
This process was completed in the UK as part of the PSP for “Common Conditions Affecting the Hand and Wrist”, comprising of health professionals, patients and carers and reports the data (uncertainty) extraction phase of this. The PSP followed the robust methodology dictated by the JLA and sought to identify knowledge gaps, termed “uncertainties” by the JLA. Published Cochrane Systematic Reviews, Guidelines and Protocols, NICE (National Institute for Health and Care Excellence) Guidelines, and SIGN (Scottish Intercollegiate Guidelines Network) Guidelines were screened for documented “uncertainties”. A robust method of screening, internally verifying and then checking uncertainties was adopted. This included independent screening and data extraction by multiple researchers and use of a PRISMA flowchart, alongside steering group consensus processes.
Selection of research uncertainties was guided by the scope of the Common Conditions Affecting the Hand and Wrist PSP which focused on “common” hand conditions routinely treated by hand specialists, including hand surgeons and hand therapists limited to identifying questions concerning the results of intervention, and not the basic science or epidemiology behind disease.
Results
Of the 2358 records identified (after removal of duplicates) which entered the screening process, 186 records were presented to the PSP steering group for eligibility assessment; 79 were deemed within scope and included for the purpose of research uncertainty extraction (45 full Cochrane Reviews, 18 Cochrane Review protocols, 16 Guidelines). These yielded 89 research uncertainties, which were compared to the stakeholder survey, and added to the longlist where necessary; before derived uncertainties were checked against non-Cochrane published systematic reviews.
Conclusions
In carrying out this work, beyond reporting on output of the Common Conditions Affecting the Hand and Wrist PSP, we detail the methodology and processes we hope can inform and facilitate the work of future PSPs and other evidence reviews, especially those with a broader scope beyond a single disease or condition.
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Postma L, Luchtenberg ML, Verhagen AAE, Maeckelberghe EL. Involving children and young people in paediatric research priority setting: a narrative review. BMJ Paediatr Open 2022; 6:10.1136/bmjpo-2022-001610. [PMID: 36645790 PMCID: PMC9703322 DOI: 10.1136/bmjpo-2022-001610] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Accepted: 11/09/2022] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVE The objective of this study is twofold: first, to describe the methods used when involving children and young people (CYP) in developing a paediatric research agenda and, second, to evaluate how the existing literature describes the impact of involving CYP. We distinguish three forms of impact: impact on the research agenda (focused impact), impact on researchers and CYP (diffuse impact) and impact on future research (research impact). DESIGN A narrative review of MEDLINE, PsycINFO, Web of Science and Google Scholar was conducted from October 2016 to January 2022. The included studies involved at least one CYP in developing a research agenda and were published in English. RESULTS 22 studies were included; the CYP involved were aged between 6 years and 25 years. Little variation was found in the methods used to involve them. The methods used were James Lind Alliance (JLA) approach (n=16), focus groups (n=2), workshop (n=2), research prioritisation by affected communities (n=1) and combined methods (n=1). Impact was rarely described: focused impact in nine studies, diffuse impact in zero studies and research impact in three studies. CONCLUSION This study concludes that the JLA approach is most frequently used to involve CYP and that all methods used to involve them are rarely evaluated. It also concludes that the reported impact of involving CYPs is incomplete. This study implies that to convince sceptical researchers of the benefits of involving CYPs and to justify the costs, more attention should be paid to reporting these impacts.
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Affiliation(s)
- Laura Postma
- Faculty of Medical Sciences, University of Groningen, Groningen, The Netherlands .,Department of Pediatrics, University Medical Centre Groningen, Groningen, The Netherlands
| | - Malou L Luchtenberg
- Department of Pediatrics, University Medical Centre Groningen, Groningen, The Netherlands.,Department of Pediatrics, Medical Centre Leeuwarden, Leeuwarden, The Netherlands
| | - A A Eduard Verhagen
- Department of Pediatrics, University Medical Centre Groningen, Groningen, The Netherlands.,University Medical Centre Groningen, Groningen, The Netherlands
| | - Els L Maeckelberghe
- Department of Pediatrics, University Medical Centre Groningen, Groningen, The Netherlands
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9
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Yahya F, Nazar H, Hadi MA. Role of primary care pharmacists in the post-hospital discharge care of patients: a scoping review protocol. J Pharm Policy Pract 2022; 15:75. [PMID: 36309737 DOI: 10.1186/s40545-022-00473-5] [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: 07/25/2022] [Accepted: 10/18/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Evidence has shown that there is a significant problem with medication safety when patients are transferred between settings. The role of community pharmacists and hospital pharmacists in facilitating transition of care has been well-researched. However, with the developing role of pharmacists in general practice as part of a multi-disciplinary team, little is known about their role in improving transition of care when patients move from secondary to primary care. The key objective of this scoping review is to understand the nature and extent of the role of primary care pharmacists for patients recently discharged from secondary care. METHODS This scoping review will follow the Joanna Briggs Institute (JBI) methodology for scoping review underpinned by the Arksey and O'Malley methodology and reported in accordance with the Preferred Reporting Items for Systematic Reviews Extension for Scoping Reviews (PRISMA-ScR) guidelines. The following electronic databases will be systematically searched: MEDLINE, EMBASE, PubMed, Cochrane Central Register of Controlled Trials (CENTRAL), Web of Science and NICE Evidence. Reference lists of included full texts will be searched for relevant papers, in addition to grey literature which includes websites of relevant professional organisations. Primary studies, published in the English language that involved a primary care pharmacist-led intervention post-hospital discharge will be included. Two independent reviewers will screen studies against eligibility criteria and use a piloted data extraction form to extract data related to the review questions. The data will be presented in tabular form and assessed for key themes to identify gaps and inform future research. DISCUSSION This scoping review will map current evidence surrounding the role of primary care pharmacists in the post-hospital discharge care of patients. Findings will inform ongoing research to support safer transfer-of-care post-hospital discharge and identify ways in which collaboration between healthcare professionals can be improved. This review anticipates guiding the inclusion of patient and public involvement (PPI) at the consultation stage to validate and build on the findings.
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Affiliation(s)
- Faiza Yahya
- Our Health Partnership, First Floor, 1856 Pershore Road, Cotteridge, Birmingham, B30 3AS, UK.
| | - Hamde Nazar
- School of Pharmacy, Newcastle University, King George VI Building, Newcastle-Upon-Tyne, NE1 7RU, UK
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10
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Freimann T, Põlluste K, Calsbeek H, Kangasniemi M, Lember M, Orrego C, Vall-Roqué H, van Tuijl A, Starkopf J. Identifying patient safety research priorities in Estonia: results of a Delphi consensus study. BMJ Open Qual 2022. [PMCID: PMC9445820 DOI: 10.1136/bmjoq-2022-001907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Affiliation(s)
- Tiina Freimann
- Institute of Clinical Medicine, University of Tartu, Tartu, Estonia
- Tartu Health Care College, Tartu, Estonia
| | - Kaja Põlluste
- Institute of Clinical Medicine, University of Tartu, Tartu, Estonia
| | - Hilly Calsbeek
- Radboud Institute for Health Sciences, Radboud University Medical Center, Scientific Center for Quality of Healthcare (IQ healthcare), Nijmegen, The Netherlands
| | - Mari Kangasniemi
- Institute of Family Medicine and Public Health, University of Tartu, Tartu, Estonia
- Department of Nursing Science, University of Turku, Turku, Finland
| | - Margus Lember
- Institute of Clinical Medicine, University of Tartu, Tartu, Estonia
- Tartu University Hospital, Tartu, Estonia
| | - Carola Orrego
- Avedis Donabedian Research Institute, Barcelona, Spain
- Autonomous University of Barcelona, Barcelona, Spain
| | - Helena Vall-Roqué
- Avedis Donabedian Research Institute, Barcelona, Spain
- Autonomous University of Barcelona, Barcelona, Spain
| | - Anne van Tuijl
- Radboud Institute for Health Sciences, Radboud University Medical Center, Scientific Center for Quality of Healthcare (IQ healthcare), Nijmegen, The Netherlands
| | - Joel Starkopf
- Institute of Clinical Medicine, University of Tartu, Tartu, Estonia
- Tartu University Hospital, Tartu, Estonia
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11
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Hubbard G, Grist F, Pope LM, Cunningham S, Maxwell M, Bennie M, Guthrie B, Mercer SW. Survey to identify research priorities for primary care in Scotland during and following the COVID-19 pandemic. BMJ Open 2022; 12:e056817. [PMID: 35504637 PMCID: PMC9066088 DOI: 10.1136/bmjopen-2021-056817] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Accepted: 04/04/2022] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVES To identify research priorities for primary care in Scotland following the COVID-19 pandemic. DESIGN Modified James Lind Alliance methodology; respondents completed an online survey to make research suggestions and rank research themes in order of priority. SETTING Scotland primary care. PARTICIPANTS Healthcare professionals in primary care in Scotland and members of primary care patient and public involvement groups. 512 respondents provided research suggestions; 8% (n=40) did not work in health or social care; of those who did work, 68.8% worked in primary care, 16.3% community care, 11.7% secondary care, 4.5% third sector, 4.2% university (respondents could select multiple options). Of those respondents who identified as healthcare professionals, 33% were in nursing and midwifery professions, 25% were in allied health professions (of whom 45% were occupational therapists and 35% were physiotherapists), 20% were in the medical profession and 10% were in the pharmacy profession. MAIN OUTCOMES Suggestions for research for primary care made by respondents were categorised into themes and subthemes by researchers and ranked in order of priority by respondents. RESULTS There were 1274 research suggestions which were categorised under 12 themes and 30 subthemes. The following five themes received the most suggestions for research: disease and illness (n=461 suggestions), access (n=202), workforce (n=164), multidisciplinary team (MDT; n=143) and integration (n=108). One hundred and three (20%) respondents to the survey participated in ranking the list of 12 themes in order of research priority. The five most highly ranked research priorities were disease and illness, health inequalities, access, workforce and MDTs. The disease and illness theme had the greatest number of suggestions for research and was scored the most highly in the ranking exercise. The subtheme ranked as the most important research priority in the disease and illness theme was 'mental health'. CONCLUSIONS The themes and subthemes identified in this study should inform research funders so that the direction of primary healthcare is informed by evidence.
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Affiliation(s)
- Gill Hubbard
- Nursing and Midwifery, University of the Highlands and Islands, Inverness, UK
| | - Fiona Grist
- Nursing and Midwifery, University of the Highlands and Islands, Inverness, UK
| | | | - Scott Cunningham
- School of Pharmacy and Life Sciences, Robert Gordon University, Aberdeen, UK
| | - Margaret Maxwell
- Nursing, Midwifery and Allied Health Professions Research Unit, University of Stirling, Stirling, UK
| | - Marion Bennie
- Pharmaceutical Sciences, University of Strathclyde, Glasgow, UK
| | - Bruce Guthrie
- College of Medicine and Veterinary Medicine, The University of Edinburgh College of Medicine and Veterinary Medicine, Edinburgh, UK
| | - Stewart W Mercer
- Usher Institute of Population Health Sciences and Informatics, The University of Edinburgh, Edinburgh, UK
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12
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Pagnamenta E, Longhurst L, Breaks A, Chadd K, Kulkarni A, Bryant V, Tier K, Rogers V, Bangera S, Wallinger J, Leslie P, Palmer R, Joffe V. Research priorities to improve the health of children and adults with dysphagia: a National Institute of Health Research and Royal College of Speech and Language Therapists research priority setting partnership. BMJ Open 2022; 12:e049459. [PMID: 35078835 PMCID: PMC8796217 DOI: 10.1136/bmjopen-2021-049459] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE To conduct the first UK-wide research priority setting project informing researchers and funders of critical knowledge gaps requiring investigation to improve the health and well-being of patients with eating, drinking and swallowing disorders (dysphagia) and their carers. DESIGN A priority setting partnership between the National Institute of Health Research (NIHR) and the Royal College of Speech and Language Therapists using a modified nominal group technique. A steering group and NIHR representatives oversaw four project phases: (1) survey gathering research suggestions, (2) verification and aggregation of suggestions with systematic review research recommendations, (3) multistakeholder workshop to develop research questions, (4) interim priority setting via an online ranking survey and (5) final priority setting. SETTING UK health services and community. PARTICIPANTS Patients with dysphagia, carers and professionals who work with children and adults with dysphagia from the UK. RESULTS One hundred and fifty-six speech and language therapists submitted 332 research suggestions related to dysphagia. These were mapped to 88 research recommendations from systematic reviews to form 24 'uncertainty topics' (knowledge gaps that are answerable by research). Four patients, 1 carer and 30 healthcare professionals collaboratively produced 77 research questions in relation to these topics. Thereafter, 387 patients, carers and professionals with experience of dysphagia prioritised 10 research questions using an interim prioritisation survey. Votes and feedback for each question were collated and reviewed by the steering and dysphagia reference groups. Nine further questions were added to the long-list and top 10 lists of priority questions were agreed. CONCLUSION Three top 10 lists of topics grouped as adults, neonates and children, and all ages, and a further long list of questions were identified by patients, carers and healthcare professionals as research priorities to improve the lives of those with dysphagia.
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Affiliation(s)
- Emma Pagnamenta
- School of Psychology and Clinical Language Sciences, University of Reading, Reading, UK
| | - Lauren Longhurst
- Child and Adolescent Mental Health Service, Whittington Health NHS Trust, London, UK
| | - Anne Breaks
- Acute Speech and Language Therapy Service, Evelina London Children's Hospital, London, UK
| | - Katie Chadd
- Research and Outcomes, Royal College of Speech and Language Therapists, London, UK
| | - Amit Kulkarni
- Research and Outcomes, Royal College of Speech and Language Therapists, London, UK
| | | | - Kathy Tier
- NIHR Evaluation, Trials and Studies Coordinating Centre, National Institute for Health Research, London, UK
| | | | - Sai Bangera
- School of Health and Social Care, University of Essex, Colchester, UK
| | - Josephine Wallinger
- Division of Language and Communication Science, City University of London, London, UK
| | - Paula Leslie
- Center for Bioethics & Health Law, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Rebecca Palmer
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Victoria Joffe
- School of Health and Social Care, University of Essex, Colchester, UK
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13
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Davies K, Cheraghi-Sohi S, Ong BN, Cheraghi-Sohi S, Perryman K, Sanders C. Co-designing an Adaption of a Mobile App to Enhance Communication, Safety, and Well-being Among People Living at Home With Early-Stage Dementia: Protocol for an Exploratory Multiple Case Study. JMIR Res Protoc 2021; 10:e19543. [PMID: 34932011 PMCID: PMC8726030 DOI: 10.2196/19543] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Revised: 07/01/2020] [Accepted: 08/06/2020] [Indexed: 01/20/2023] Open
Abstract
Background There is a growing interest in using mobile apps to support communication, safety, and well-being. Evidence directly from people with dementia regarding the usability, usefulness, and relevance of mobile apps is limited. Objective This paper describes the protocol of a study that will evaluate an app designed for supporting communication, safety, and well-being among people living with dementia. The study aims to understand if the app can enhance safety through improved communication among users. Methods The study will use participatory qualitative methods over 3 cycles of evaluation with co-designers (service users, their families, and care practitioners). The study will be developed in partnership with a specialist home care service in England. Purposive case selection will be performed to ensure that the cases exemplify differences in experiences. The app will be evaluated in a walk-through workshop by people living with early-stage dementia and then trialed at home by up to 12 families in a try-out cycle. An amended version will be evaluated in a final walk-through workshop during cycle 3. Data will be collected from at least 4 data sources during the try-out phase and analyzed thematically. An explanatory multiple case study design will be used to synthesize and present the evidence from the three cycles, drawing on the Normalization Process Theory to support the interpretation of the findings. Results The study is ready to be implemented, but it was paused to protect vulnerable individuals during the COVID-19 pandemic in 2020. The findings will be particularly relevant for understanding how to support vulnerable people living in the community during social distancing and the period following the pandemic as well as for providing insight into the challenges of social isolation that arise from living with dementia. Conclusions Evaluating a mobile app for enhancing communication, safety, and well-being among people living with dementia contributes to the key ambitions enshrined in policy and practice—championing the use of digital technology and supporting people with dementia to live safely in their own homes. The study will involve co-designers living with dementia, so that the voices of service users can be used to highlight the benefits and challenges of assistive technology and shape the future development of apps that enhance safety by improving communication. International Registered Report Identifier (IRRID) PRR1-10.2196/19543
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Affiliation(s)
- Karen Davies
- National Institute for Health Research Patient Safety Research Translation Centre, University of Manchester, Manchester, United Kingdom
| | - Sudeh Cheraghi-Sohi
- National Institute for Health Research Patient Safety Research Translation Centre, University of Manchester, Manchester, United Kingdom
| | - Bie Nio Ong
- National Institute for Health Research Patient Safety Research Translation Centre, University of Manchester, Manchester, United Kingdom.,Primary Care Department, Keele University, Keele, United Kingdom
| | - Sudeh Cheraghi-Sohi
- National Institute for Health Research Patient Safety Research Translation Centre, University of Manchester, Manchester, United Kingdom
| | - Katherine Perryman
- National Institute for Health Research Patient Safety Research Translation Centre, University of Manchester, Manchester, United Kingdom
| | - Caroline Sanders
- National Institute for Health Research Patient Safety Research Translation Centre, University of Manchester, Manchester, United Kingdom.,National Institute for Heath Resaerch School for Primary Care Research, Keele, United Kingdom
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14
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Gens-Barberà M, Hernández-Vidal N, Vidal-Esteve E, Mengíbar-García Y, Hospital-Guardiola I, Oya-Girona EM, Bejarano-Romero F, Castro-Muniain C, Satué-Gracia EM, Rey-Reñones C, Martín-Luján FM. Analysis of Patient Safety Incidents in Primary Care Reported in an Electronic Registry Application. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:8941. [PMID: 34501530 PMCID: PMC8430626 DOI: 10.3390/ijerph18178941] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Revised: 08/13/2021] [Accepted: 08/17/2021] [Indexed: 11/16/2022]
Abstract
OBJECTIVES (1) To describe the epidemiology of patient safety (PS) incidents registered in an electronic notification system in primary care (PC) health centres; (2) to define a risk map; and (3) to identify the critical areas where intervention is needed. DESIGN Descriptive analytical study of incidents reported from 1 January to 31 December 2018, on the TPSC Cloud™ platform (The Patient Safety Company) accessible from the corporate website (Intranet) of the regional public health service. SETTING 24 Catalan Institute of Health PC health centres of the Tarragona region (Spain). PARTICIPANTS Professionals from the PC health centres and a Patient Safety Functional Unit. MEASUREMENTS Data obtained from records voluntarily submitted to an electronic, standardised and anonymised form. Data recorded: healthcare unit, notifier, type of incident, risk matrix, causal and contributing factors, preventability, level of resolution and improvement actions. RESULTS A total of 1544 reports were reviewed and 1129 PS incidents were analysed: 25.0% of incidents did not reach the patient; 66.5% reached the patient without causing harm, and 8.5% caused adverse events. Nurses provided half of the reports (48.5%), while doctors reported more adverse events (70.8%; p < 0.01). Of the 96 adverse events, 46.9% only required observation, 34.4% caused temporary damage that required treatment, 13.5% required (or prolonged) hospitalization, and 5.2% caused severe permanent damage and/or a situation close to death. Notably, 99.2% were considered preventable. The main critical areas were: communication (27.8%), clinical-administrative management (25.1%), care delivery (23.5%) and medicines (18.4%); few incidents were related to diagnosis (3.6%). CONCLUSIONS PS incident notification applications are adequate for reporting incidents and adverse events associated with healthcare. Approximately 75% and 10% of incidents reach the patient and cause some damage, respectively, and most cases are considered preventable. Adequate and strengthened risk management of critical areas is required to improve PS.
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Affiliation(s)
- Montserrat Gens-Barberà
- Quality and Patient Safety Central Functional Unit, Gerència d’Atenció Primària Camp de Tarragona, Institut Català de la Salut, 43005 Tarragona, Spain; (N.H.-V.); (E.V.-E.); (Y.M.-G.); (I.H.-G.); (E.M.O.-G.); (F.B.-R.); (C.C.-M.)
| | - Núria Hernández-Vidal
- Quality and Patient Safety Central Functional Unit, Gerència d’Atenció Primària Camp de Tarragona, Institut Català de la Salut, 43005 Tarragona, Spain; (N.H.-V.); (E.V.-E.); (Y.M.-G.); (I.H.-G.); (E.M.O.-G.); (F.B.-R.); (C.C.-M.)
| | - Elisa Vidal-Esteve
- Quality and Patient Safety Central Functional Unit, Gerència d’Atenció Primària Camp de Tarragona, Institut Català de la Salut, 43005 Tarragona, Spain; (N.H.-V.); (E.V.-E.); (Y.M.-G.); (I.H.-G.); (E.M.O.-G.); (F.B.-R.); (C.C.-M.)
| | - Yolanda Mengíbar-García
- Quality and Patient Safety Central Functional Unit, Gerència d’Atenció Primària Camp de Tarragona, Institut Català de la Salut, 43005 Tarragona, Spain; (N.H.-V.); (E.V.-E.); (Y.M.-G.); (I.H.-G.); (E.M.O.-G.); (F.B.-R.); (C.C.-M.)
| | - Immaculada Hospital-Guardiola
- Quality and Patient Safety Central Functional Unit, Gerència d’Atenció Primària Camp de Tarragona, Institut Català de la Salut, 43005 Tarragona, Spain; (N.H.-V.); (E.V.-E.); (Y.M.-G.); (I.H.-G.); (E.M.O.-G.); (F.B.-R.); (C.C.-M.)
- Primary Health-Care Centre, Institut Català de la Salut, 43005 Tarragona, Spain
| | - Eva M. Oya-Girona
- Quality and Patient Safety Central Functional Unit, Gerència d’Atenció Primària Camp de Tarragona, Institut Català de la Salut, 43005 Tarragona, Spain; (N.H.-V.); (E.V.-E.); (Y.M.-G.); (I.H.-G.); (E.M.O.-G.); (F.B.-R.); (C.C.-M.)
- Primary Health-Care Centre, Institut Català de la Salut, 43005 Tarragona, Spain
| | - Ferran Bejarano-Romero
- Quality and Patient Safety Central Functional Unit, Gerència d’Atenció Primària Camp de Tarragona, Institut Català de la Salut, 43005 Tarragona, Spain; (N.H.-V.); (E.V.-E.); (Y.M.-G.); (I.H.-G.); (E.M.O.-G.); (F.B.-R.); (C.C.-M.)
- Pharmacy Unit, Gerència d’Atenció Primària Camp de Tarragona, Institut Català de la Salut, 43005 Tarragona, Spain
| | - Carles Castro-Muniain
- Quality and Patient Safety Central Functional Unit, Gerència d’Atenció Primària Camp de Tarragona, Institut Català de la Salut, 43005 Tarragona, Spain; (N.H.-V.); (E.V.-E.); (Y.M.-G.); (I.H.-G.); (E.M.O.-G.); (F.B.-R.); (C.C.-M.)
| | - Eva M. Satué-Gracia
- Research Support Unit Tarragona-Reus, Institut Universitari D’investigació en L’atenció Primària Jordi Gol, (IDIAP Jordi Gol), Institut Català de la Salut, 43202 Reus, Spain; (E.M.S.-G.); (C.R.-R.); (F.M.M.-L.)
| | - Cristina Rey-Reñones
- Research Support Unit Tarragona-Reus, Institut Universitari D’investigació en L’atenció Primària Jordi Gol, (IDIAP Jordi Gol), Institut Català de la Salut, 43202 Reus, Spain; (E.M.S.-G.); (C.R.-R.); (F.M.M.-L.)
- Faculty of Medicine and Health Sciences, Universitat Rovira i Virgili, 43201 Reus, Spain
| | - Francisco M. Martín-Luján
- Research Support Unit Tarragona-Reus, Institut Universitari D’investigació en L’atenció Primària Jordi Gol, (IDIAP Jordi Gol), Institut Català de la Salut, 43202 Reus, Spain; (E.M.S.-G.); (C.R.-R.); (F.M.M.-L.)
- Faculty of Medicine and Health Sciences, Universitat Rovira i Virgili, 43201 Reus, Spain
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15
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Madsen K, Wibe T, Bye A, Debesay J, Bergland A. Top 10 research priorities to improve the everyday life of older patients with multimorbidity: A James Lind Alliance (JLA) inspired Priority Setting Partnership (PSP). TIDSSKRIFT FOR OMSORGSFORSKNING 2021. [DOI: 10.18261/issn.2387-5984-2021-02-05] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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16
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Medication-related harm in New Zealand general practice: a retrospective records review. Br J Gen Pract 2021; 71:e626-e633. [PMID: 33798090 PMCID: PMC8252858 DOI: 10.3399/bjgp.2020.1126] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Accepted: 03/25/2021] [Indexed: 11/26/2022] Open
Abstract
Background The extent of medication-related harm in general practice is unknown. Aim To identify and describe all medication-related harm in electronic general practice records. The secondary aim was to investigate factors potentially associated with medication-related harm. Design and setting Retrospective cohort records review study in 44 randomly selected New Zealand general practices for the 3 years 2011–2013. Method Eight GPs reviewed 9076 randomly selected patient records. Medication-related harms were identified when the causal agent was prescribed in general practice. Harms were coded by type, preventability, and severity. The number and proportion of patients who experienced medication-related harm was calculated. Weighted logistic regression was used to identify factors associated with harm. Results In total, 976 of 9076 patients (10.8%) experienced 1762 medication-related harms over 3 years. After weighting, the incidence rate of all medication-related harms was 73.9 harms per 1000 patient–years, and the incidence of preventable, or potentially preventable, medication-related harms was 15.6 per 1000 patient–years. Most harms were minor (n = 1385/1762, 78.6%), but around one in five harms were moderate or severe (n = 373/1762, 21.2%); three patients died. Eighteen study patients were hospitalised; after weighting this correlates to a hospitalisation rate of 1.1 per 1000 patient–years. Increased age, number of consultations, and number of medications were associated with increased risk of medication-related harm. Cardiovascular medications, antineoplastic and immunomodulatory agents, and anticoagulants caused most harm by frequency and severity. Conclusion Medication-related harm in general practice is common. This study adds to the evidence about the risk posed by medication in the real world. Findings can be used to inform decision making in general practice.
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17
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Morris RL, Ruddock A, Gallacher K, Rolfe C, Giles S, Campbell S. Developing a patient safety guide for primary care: A co-design approach involving patients, carers and clinicians. Health Expect 2021; 24:42-52. [PMID: 33142022 PMCID: PMC7879544 DOI: 10.1111/hex.13143] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Revised: 08/26/2020] [Accepted: 09/14/2020] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Patients and carers should be actively involved in patient safety and empowered to use person-centred approaches where they are asked to both identify safety concerns and partner in preventing them. OBJECTIVES The aim of this study was to co-design a patient safety guide for primary care (PSG-PC) to support patients and carers to address key patient safety questions and identify key points where they can make their care safer. The objectives were to i) identify when and how patients and carers can be involved in primary care patient safety, and ii) identify the relevant information to include in the PSG-PC. DESIGN An experience-based co-design approach. SETTING AND PARTICIPANTS We conducted three workshops with patients, carers, community pharmacists and general practitioners to develop and refine the PSG-PC. RESULTS Participants identified both explicit and implicit issues of primary care patient safety especially relating to technical and relational components of involving patients and carers. The importance of communication, understanding roles and responsibilities, and developing partnerships between patients and health-care providers were considered essential for actively involving patients in patient safety. Co-developing the PSG-PC provided insight to improve care to develop the PSG-PC. DISCUSSION The PSG-PC is the first guide to be developed for primary care, co-designed with patients, carers, general practitioners and pharmacists. The PSG-PC will support patients and carers to partner with health-care professionals to improve patient safety addressing international and national priorities to continuously improve patient safety.
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Affiliation(s)
- Rebecca L. Morris
- NIHR Greater Manchester Patient Safety Translational Research CentreFaculty of Biology, Medicine and HealthDivision of Population HealthHealth Services Research and Primary CareSchool of Health SciencesUniversity of ManchesterManchesterUnited Kingdom
| | - Angela Ruddock
- NIHR Greater Manchester Patient Safety Translational Research CentreFaculty of Biology, Medicine and HealthDivision of Population HealthHealth Services Research and Primary CareSchool of Health SciencesUniversity of ManchesterManchesterUnited Kingdom
| | - Kay Gallacher
- NIHR Greater Manchester Patient Safety Translational Research CentreFaculty of Biology, Medicine and HealthDivision of Population HealthHealth Services Research and Primary CareSchool of Health SciencesUniversity of ManchesterManchesterUnited Kingdom
| | - Carly Rolfe
- NIHR Greater Manchester Patient Safety Translational Research CentreFaculty of Biology, Medicine and HealthDivision of Population HealthHealth Services Research and Primary CareSchool of Health SciencesUniversity of ManchesterManchesterUnited Kingdom
| | - Sally Giles
- NIHR Greater Manchester Patient Safety Translational Research CentreFaculty of Biology, Medicine and HealthDivision of Population HealthHealth Services Research and Primary CareSchool of Health SciencesUniversity of ManchesterManchesterUnited Kingdom
| | - Stephen Campbell
- NIHR Greater Manchester Patient Safety Translational Research CentreFaculty of Biology, Medicine and HealthDivision of Population HealthHealth Services Research and Primary CareSchool of Health SciencesUniversity of ManchesterManchesterUnited Kingdom
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Boundouki G, Wilson R, Duxbury P, Henderson J, Ballance L, Wray J, Appanah V, Ibrahim I, Harvey J, Kirwan CC. Patient and public priorities for breast cancer research: a qualitative study in the UK. BMJ Open 2021; 11:e036072. [PMID: 33514570 PMCID: PMC7849895 DOI: 10.1136/bmjopen-2019-036072] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVE Internationally recognised specialist breast cancer scientists, clinicians and healthcare professionals have published breast cancer research gaps that are informing research funding priorities in the UK and worldwide. We aimed to determine the breast cancer research priorities of the public to compare with those identified by clinicians and scientists. DESIGN We conducted a qualitative study and thematic analysis using 'listening events' where patients with breast cancer and public representatives used a patient's breast cancer journey to identify research themes. PARTICIPANTS AND SETTING Female participants were recruited from attendees at participating hospitals and support groups in the northwest of England, including patients, their family and friends as well as staff at a local retail centre. INTERVENTION A framework approach was used to analyse transcribed discussions until thematic saturation was reached. MAIN OUTCOME MEASURES Breast cancer research priorities were identified from participant discussions and compared with the published gaps identified by scientists and healthcare professionals. RESULTS Thematic saturation was reached after 27 female participants participated in listening events. Our participants consistently focused on improved methods of dissemination of information and improving education on the signs and symptoms of breast cancer. This was not highlighted by scientists or healthcare professionals. There was strong emphasis on quality of life-related issues such as side effects of treatment. There was some agreement between the priorities deduced by our study and those of the professionals in the areas of screening, prevention and breast reconstruction. CONCLUSION Our study identified some research themes that were not identified by scientists and healthcare professionals in two earlier landmark studies. This highlights the importance of including patients and public representatives when setting research priorities. The results should be used to guide investigators when planning future studies and for funding bodies in allocating resources for future projects.
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Affiliation(s)
- George Boundouki
- The Nightingale Breast Cancer Unit, Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester, UK
| | - Rebecca Wilson
- The Nightingale Breast Cancer Unit, Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester, UK
| | - Paula Duxbury
- The Nightingale Breast Cancer Unit, Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester, UK
| | | | - Laura Ballance
- The Nightingale Breast Cancer Unit, Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester, UK
| | - Julie Wray
- Independent Patient Representative, Manchester, UK
| | | | - Ibrahim Ibrahim
- The Nightingale Breast Cancer Unit, Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester, UK
| | - James Harvey
- The Nightingale Breast Cancer Unit, Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester, UK
| | - Cliona Clare Kirwan
- The Nightingale Breast Cancer Unit, Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester, UK
- Division of Cancer Sciences, The University of Manchester, Manchester, UK
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Morris RL, Gallacher K, Hann M, Rolfe C, Small N, Giles SJ, Sanders C, Campbell SM. Protocol for a non-randomised feasibility study evaluating a codesigned patient safety guide in primary care. BMJ Open 2021; 11:e039752. [PMID: 33472773 PMCID: PMC7818830 DOI: 10.1136/bmjopen-2020-039752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Revised: 12/17/2020] [Accepted: 12/26/2020] [Indexed: 11/03/2022] Open
Abstract
INTRODUCTION Patients and carers should be active partners in patient safety with healthcare professionals and be empowered to use personalised approaches to identify safety concerns and work together to prevent them. This protocol paper details a study to examine the feasibility of a multicomponent intervention to involve patients and/or carers in patient safety in primary care in the UK. METHODS AND ANALYSIS This is a two-phase, non-randomised feasibility mixed methods pragmatic study of a patient safety guide for primary care (PSG-PC). 8 general practices will recruit 120 patient and/or carer participants. All patient and/or carer participants will receive the PSG-PC. It will examine the feasibility and acceptability of the PSG-PC in primary care settings in patients aged 18 years or older who attend appointments at general practice with health professionals four or more times per year as either patients or carers. It will identify secondary outcomes for improving patient safety, health status and patient empowerment, and reducing health service utilisation over 6 months between baseline and 6-month follow-ups. The findings will inform whether a main effectiveness trial is feasible and, if so, how it should be designed, and how many patients and practices will be needed. The study will be undertaken between January 2020 and September 2021. ETHICS AND DISSEMINATION Ethical approval was obtained from the National Health Service London-West London and Gene Therapy Advisory Committee Research Ethics Committee (reference: 19/LO/1289). Research findings will be disseminated with participating general practices and shared in a range of different ways to engage different audiences, including presenting at international and national conferences, publishing in open-access, peer-reviewed journals and facilitating dissemination workshops within local communities with patients, carers and healthcare professionals. TRIAL REGISTRATION NUMBER ISRCTN90222092.
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Affiliation(s)
- Rebecca L Morris
- NIHR Greater Manchester Patient Safety Translational Research Centre, The University of Manchester, Manchester, UK
| | | | - Mark Hann
- Centre for Biostatistics and Manchester Academic Health Science Centre, The University of Manchester, Manchester, UK
| | - Carly Rolfe
- NIHR Greater Manchester Patient Safety Translational Research Centre, The University of Manchester, Manchester, UK
| | | | - Sally J Giles
- NIHR Greater Manchester Patient Safety Translational Research Centre, The University of Manchester, Manchester, UK
| | - Caroline Sanders
- NIHR Greater Manchester Patient Safety Translational Research Centre, The University of Manchester, Manchester, UK
| | - Stephen M Campbell
- NIHR Greater Manchester Patient Safety Translational Research Centre, The University of Manchester, Manchester, UK
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Cheraghi-Sohi S, Panagioti M, Daker-White G, Giles S, Riste L, Kirk S, Ong BN, Poppleton A, Campbell S, Sanders C. Patient safety in marginalised groups: a narrative scoping review. Int J Equity Health 2020; 19:26. [PMID: 32050976 PMCID: PMC7014732 DOI: 10.1186/s12939-019-1103-2] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Accepted: 11/27/2019] [Indexed: 12/05/2022] Open
Abstract
Background Marginalised groups (‘populations outside of mainstream society’) experience severe health inequities, as well as increased risk of experiencing patient safety incidents. To date however no review exists to identify, map and analyse the literature in this area in order to understand 1) which marginalised groups have been studied in terms of patient safety research, 2) what the particular patient safety issues are for such groups and 3) what contributes to or is associated with these safety issues arising. Methods Scoping review. Systematic searches were performed across six electronic databases in September 2019. The time frame for searches of the respective databases was from the year 2000 until present day. Results The searches yielded 3346 articles, and 67 articles were included. Patient safety issues were identified for fourteen different marginalised patient groups across all studies, with 69% (n = 46) of the studies focused on four patient groups: ethnic minority groups, frail elderly populations, care home residents and low socio-economic status. Twelve separate patient safety issues were classified. Just over half of the studies focused on three issues represented in the patient safety literature, and in order of frequency were: medication safety, adverse outcomes and near misses. In total, 157 individual contributing or associated factors were identified and mapped to one of seven different factor types from the Framework of Contributory Factors Influencing Clinical Practice within the London Protocol. Patient safety issues were mostly multifactorial in origin including patient factors, health provider factors and health care system factors. Conclusions This review highlights that marginalised patient groups are vulnerable to experiencing a variety patient safety issues and points to a number of gaps. The findings indicate the need for further research to understand the intersectional nature of marginalisation and the multi-dimensional nature of patient safety issues, for groups that have been under-researched, including those with mental health problems, communication and cognitive impairments. Such understanding provides a basis for working collaboratively to co-design training, services and/or interventions designed to remove or at the very least minimise these increased risks. Trial registration Not applicable for a scoping review.
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Affiliation(s)
- Sudeh Cheraghi-Sohi
- NIHR Greater Manchester Patient Safety Translational Research Centre, The University of Manchester, Williamson Building, Oxford Rd, Manchester, M13 9PL,, England. .,Centre for Primary Care, The University of Manchester, Williamson Building, Oxford Rd, Manchester, M13 9PL, England.
| | - Maria Panagioti
- NIHR Greater Manchester Patient Safety Translational Research Centre, The University of Manchester, Williamson Building, Oxford Rd, Manchester, M13 9PL,, England
| | - Gavin Daker-White
- NIHR Greater Manchester Patient Safety Translational Research Centre, The University of Manchester, Williamson Building, Oxford Rd, Manchester, M13 9PL,, England.,Centre for Primary Care, The University of Manchester, Williamson Building, Oxford Rd, Manchester, M13 9PL, England
| | - Sally Giles
- NIHR Greater Manchester Patient Safety Translational Research Centre, The University of Manchester, Williamson Building, Oxford Rd, Manchester, M13 9PL,, England.,Centre for Primary Care, The University of Manchester, Williamson Building, Oxford Rd, Manchester, M13 9PL, England
| | - Lisa Riste
- NIHR Greater Manchester Patient Safety Translational Research Centre, The University of Manchester, Williamson Building, Oxford Rd, Manchester, M13 9PL,, England
| | - Sue Kirk
- NIHR Greater Manchester Patient Safety Translational Research Centre, The University of Manchester, Williamson Building, Oxford Rd, Manchester, M13 9PL,, England
| | - Bie Nio Ong
- NIHR Greater Manchester Patient Safety Translational Research Centre, The University of Manchester, Williamson Building, Oxford Rd, Manchester, M13 9PL,, England.,Keele University, Citylabs, Nelson St, Manchester, M13 9NQ, England
| | - Aaron Poppleton
- NIHR Greater Manchester Patient Safety Translational Research Centre, The University of Manchester, Williamson Building, Oxford Rd, Manchester, M13 9PL,, England
| | - Stephen Campbell
- NIHR Greater Manchester Patient Safety Translational Research Centre, The University of Manchester, Williamson Building, Oxford Rd, Manchester, M13 9PL,, England.,Centre for Primary Care, The University of Manchester, Williamson Building, Oxford Rd, Manchester, M13 9PL, England
| | - Caroline Sanders
- NIHR Greater Manchester Patient Safety Translational Research Centre, The University of Manchester, Williamson Building, Oxford Rd, Manchester, M13 9PL,, England.,Centre for Primary Care, The University of Manchester, Williamson Building, Oxford Rd, Manchester, M13 9PL, England.,NIHR School for Primary Care Research, Citylabs, Nelson St, Manchester, M13 9NQ, England.,Health Innvoation Manchester, Citylabs, Nelson St, Manchester, M13 9NQ, England
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21
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Berzins K, Baker J, Louch G, Albutt A. A qualitative exploration of mental health service user and carer perspectives on safety issues in UK mental health services. Health Expect 2020; 23:549-561. [PMID: 32045094 PMCID: PMC7321733 DOI: 10.1111/hex.13025] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Revised: 10/21/2019] [Accepted: 12/17/2019] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Service user and carer perspectives on safety issues in mental health services are not well known and may be important in preventing and reducing harm. The development of the Yorkshire Contributory Factors Framework-Mental Health (YCFF-MH) provides a broad structure within which to explore these perspectives. OBJECTIVE To explore what service users of mental health services and their carers consider to be safety issues. DESIGN, SETTING AND PARTICIPANTS Qualitative interviews with 13 service users and 7 carers in the UK. Participants were asked about their experiences and perceptions of safety within mental health services. Perceived safety issues were identified using framework analysis, guided by the YCFF-MH. RESULTS Service users and carers identified a broad range of safety issues. These were categorized under 'safety culture' and included psychological concepts of safety and raising concerns; 'social environment' involved threatened violence and sexual abuse; 'individual service user and staff factors' dominated by not being listened to; 'management of staff and staffing levels' resulting in poor continuity of care; and 'service process' typified by difficulty accessing services during a crisis. Several examples of 'active failures' were also described. DISCUSSION AND CONCLUSIONS Safety issues appear broader than those recorded and reported by health services and inspectorates. Many safety issues have also been identified in other care settings supporting the notion that there are overlaps between service users and carers' perspectives of safety in mental health services and those of users in other settings. Areas for further research are suggested.
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Affiliation(s)
| | - John Baker
- School of Healthcare, University of Leeds, Leeds, UK
| | - Gemma Louch
- NIHR Yorkshire and Humber Patient Safety Translational Research Centre, Bradford Royal Infirmary, Bradford Institute for Health Research, Bradford, UK
| | - Abigail Albutt
- NIHR Yorkshire and Humber Patient Safety Translational Research Centre, Bradford Royal Infirmary, Bradford Institute for Health Research, Bradford, UK
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22
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Vella-Baldacchino M, Perry DC, Roposch A, Nicolaou N, Cooke S, Ellis P, Theologis T. Research priorities in children requiring elective surgery for conditions affecting the lower limbs: a James Lind Alliance Priority Setting Partnership. BMJ Open 2019; 9:e033233. [PMID: 31892663 PMCID: PMC6955494 DOI: 10.1136/bmjopen-2019-033233] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVE To identify and prioritise research questions concerning the elective surgical management of children with conditions affecting the lower limb by engaging patients, carers and healthcare professionals. DESIGN A modified nominal group technique. SETTING UK. PARTICIPANTS 388 individuals (29 patients, 155 parents/carers, 204 healthcare professionals) were recruited through hospital clinics, patient charities and professional organisations and participated in the initial prioritisation survey; 234 individuals took part in the interim prioritisation survey. 33 individuals (3 patients, 9 parents/carers, 11 healthcare professionals, 7 individuals representing the project's steering group and 3 James Lind Alliance (JLA) facilitators) attended the final face-to-face workshop to rank the top 10 research priorities. INTERVENTIONS Surveys were distributed using various media resources such as newsletters, internet messaging boards and the 'Paediatric Lower Limb Surgery Priority Setting Partnership (PSP) website. Printed copies of the questionnaire were also made available to families in outpatient clinics. OUTCOME MEASURES Survey results, top 10 and top 26 priority rankings RESULTS: The process took 18 months to complete (July 2017-January 2019); 388 people generated 1023 questions; a total of 801 research questions were classified as true uncertainties. Following the JLA methodology, 75 uncertainties were developed from the initial 801 questions. Twenty six of those were selected through a second survey and were taken to the final face-to-face workshop where the top 10 research priorities were selected. The top10 priorities included questions on cerebral palsy, common hip conditions (ie, Perthes' disease and developmental dysplasia of the hip) as well as rehabilitation techniques and methods to improve shared decision-making between clinicians and patients/families. CONCLUSIONS This is the first JLA PSP in children's orthopaedic surgery, a particularly under-researched and underfunded area. We have identified important research topics which will guide researchers and funders and direct their efforts in future research.
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Affiliation(s)
- Martinique Vella-Baldacchino
- Nuffield Department of Orthopaedics Rheumatology and Musculoskeletal Science, Botnar Research Centre, Oxford, Oxfordshire, UK
| | - Daniel C Perry
- Nuffield Department of Orthopaedics Rheumatology and Musculoskeletal Science, Botnar Research Centre, Oxford, Oxfordshire, UK
| | - Andreas Roposch
- University College London Great Ormond Street Institute of Child Health Library, London, UK
| | - Nicholas Nicolaou
- Paediatric Orthopaedic Surgery, Sheffield Children's NHS Foundation Trust, Sheffield, UK
| | - Stephen Cooke
- Paediatric Orthopaedic Surgery, University Hospital Coventry, Coventry, UK
| | | | - Tim Theologis
- Paediatric Orthopaedic Surgery, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
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Clark KD, Capriotti MR, Obedin-Maliver J, Lunn MR, Lubensky ME, Flentje A. Supporting sexual and gender minority health: Research priorities from mental health professionals. JOURNAL OF GAY & LESBIAN MENTAL HEALTH 2019. [DOI: 10.1080/19359705.2019.1700865] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Kristen D. Clark
- Department of Community Health Systems in the School of Nursing, University of California San Francisco (UCSF), San Francisco, California, USA
| | | | - Juno Obedin-Maliver
- Ob/Gyn, Reproductive Science, Stanford University, Stanford, California, USA
| | - Mitchell R. Lunn
- Department of Medicine, Stanford University, Stanford, California, USA
| | - Micah E. Lubensky
- The PRIDE Study/PRIDEnet, University of California San Francisco (USCF), San Francisco, California, USA
| | - Annesa Flentje
- Department of Community Health Systems in the School of Nursing, University of California San Francisco (UCSF), San Francisco, California, USA
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The North East Multispecialty Delphi Project - Collaboration Between Trainee Research Networks. J Surg Res 2019; 247:115-120. [PMID: 31812338 DOI: 10.1016/j.jss.2019.10.035] [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: 04/07/2019] [Revised: 10/17/2019] [Accepted: 10/25/2019] [Indexed: 11/22/2022]
Abstract
Trainee research collaborative networks have revolutionized how trainees participate in clinical research. Three North East of England trainee-led research groups, the Intensive Care and Anesthesia Research Network of North East Trainees (INCARNNET), the Northern Surgical Trainees Research Association (NOSTRA) in General Surgery and the Collaborative Orthopedic Research Network (CORNET) in Trauma and Orthopedics have joined, creating a multispecialty collaborative. This multispecialty collaborative undertook a two-phase research Delphi, between November 2017 and June 2018, to identify key research questions. This Delphi identified three high priority research questions common to the three specialties: what is the impact of diabetes control on perioperative outcomes, what factors affect theater efficiency, and how to prevent postoperative chest infection following emergency surgery? These research questions will be developed into collaborative projects. The Delphi also identified specialty-specific questions to be taken forward as research projects by each network.
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Edwards L, Monro M, Butterfield Y, Johl R, Loftsgard KC, Pelletier H, McGavin C, Lavergne MR. What matters most to patients about primary healthcare: mixed-methods patient priority setting exercises within the PREFeR (PRioritiEs For Research) project. BMJ Open 2019; 9:e025954. [PMID: 31292175 PMCID: PMC6624027 DOI: 10.1136/bmjopen-2018-025954] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2018] [Revised: 04/05/2019] [Accepted: 06/03/2019] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES To identify patient-generated priority topics for future primary care research in British Columbia (BC), Canada within a diverse patient population. DESIGN Mixed-methods priority setting exercises framed by the dialogue model, using the nominal group technique (rank-ordered scoring) and province-wide online surveys capturing importance ratings of the top 10 primary healthcare topics from patients and primary care providers. SETTING BC, Canada. PARTICIPANTS Topic identification was completed by 10 patient partners (7 female, 3 male) from the BC Primary Health Care Research Network Patient Advisory; online surveys were completed by 464 patients and 173 primary care providers. RESULTS The 10 members recruited to the patient advisory provided over 80 experiences of what stood out for them in BC primary care, which were grouped thematically into 18 topics, 10 of which were retained in province-wide surveys. Top-rated survey topics for both patients (n=464) and providers (n=173) included being unable to find a regular family doctor/other primary healthcare provider, support for living with chronic conditions, mental health resources and information sharing, including electronic medical records. However, all 10 topics were rated important, on average, by both groups. CONCLUSIONS The current project activities demonstrate the feasibility of including patients in priority setting exercises for primary healthcare in general, rather than focusing on a condition-specific population or disease area. There was considerable overlap between patient-generated topics and topics previously identified by other stakeholders, but patients identified two additional topics (mental health resources, improve and strengthen patient-provider communication). More similarities than differences in topic importance between patients and providers emerged in the online surveys. The project activities that follow (rapid literature reviews, multistakeholder dialogue) will highlight under-researched topics and inform the development of specific research questions.
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Affiliation(s)
- Louisa Edwards
- Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada
- Centre for Clinical Epidemiology and Evaluation, Vancouver, British Columbia, Canada
| | - Melody Monro
- Fraser Health Authority, Surrey, British Columbia, Canada
| | - Yaron Butterfield
- BC Primary Health Care Research Network Patient Advisory, Vancouver, British Columbia, Canada
| | - Ravin Johl
- BC Primary Health Care Research Network Patient Advisory, Vancouver, British Columbia, Canada
| | - Kent Cadogan Loftsgard
- BC Primary Health Care Research Network Patient Advisory, Vancouver, British Columbia, Canada
| | - Hayley Pelletier
- BC Primary Health Care Research Network Patient Advisory, Vancouver, British Columbia, Canada
| | | | - M Ruth Lavergne
- Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada
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Synnot AJ, Tong A, Bragge P, Lowe D, Nunn JS, O’Sullivan M, Horvat L, Kay D, Ghersi D, McDonald S, Poole N, Bourke N, Lannin NA, Vadasz D, Oliver S, Carey K, Hill SJ. Selecting, refining and identifying priority Cochrane Reviews in health communication and participation in partnership with consumers and other stakeholders. Health Res Policy Syst 2019; 17:45. [PMID: 31036016 PMCID: PMC6489310 DOI: 10.1186/s12961-019-0444-z] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2018] [Accepted: 03/27/2019] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND Priority-setting partnerships between researchers and stakeholders (meaning consumers, health professionals and health decision-makers) may improve research relevance and value. The Cochrane Consumers and Communication Group (CCCG) publishes systematic reviews in 'health communication and participation', which includes concepts such as shared decision-making, patient-centred care and health literacy. We aimed to select and refine priority topics for systematic reviews in health communication and participation, and use these to identify five priority CCCG Cochrane Reviews. METHODS Twenty-eight participants (14 consumers, 14 health professionals/decision-makers) attended a 1-day workshop in Australia. Using large-group activities and voting, participants discussed, revised and then selected 12 priority topics from a list of 21 previously identified topics. In mixed small groups, participants refined these topics, exploring underlying problems, who they affect and potential solutions. Thematic analysis identified cross-cutting themes, in addition to key populations and potential interventions for future Cochrane Reviews. We mapped these against CCCG's existing review portfolio to identify five priority reviews. RESULTS Priority topics included poor understanding and implementation of patient-centred care by health services, the fact that health information can be a low priority for health professionals, communication and coordination breakdowns in health services, and inadequate consumer involvement in health service design. The four themes underpinning the topics were culture and organisational structures, health professional attitudes and assumptions, inconsistent experiences of care, and lack of shared understanding in the sector. Key populations for future reviews were described in terms of social health characteristics (e.g. people from indigenous or culturally and linguistically diverse backgrounds, elderly people, and people experiencing socioeconomic disadvantage) more than individual health characteristics. Potential interventions included health professional education, interventions to change health service/health professional culture and attitudes, and health service policies and standards. The resulting five priority Cochrane Reviews identified were improving end-of-life care communication, patient/family involvement in patient safety, improving future doctors' communication skills, consumer engagement strategies, and promoting patient-centred care. CONCLUSIONS Stakeholders identified priority topics for systematic reviews associated with structural and cultural challenges underlying health communication and participation, and were concerned that issues of equity be addressed. Priority-setting with stakeholders presents opportunities and challenges for review producers.
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Affiliation(s)
- Anneliese J. Synnot
- Centre for Health Communication and Participation, School of Psychology and Public Health, La Trobe University, Melbourne, Australia
- Cochrane Australia, School of Public Health and Preventive Medicine, Monash University, Melbourne, 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
| | - Peter Bragge
- BehaviourWorks Australia, Monash Sustainable Development Institute, Monash University, Melbourne, Australia
| | - Dianne Lowe
- Centre for Health Communication and Participation, School of Psychology and Public Health, La Trobe University, Melbourne, Australia
| | - Jack S. Nunn
- Centre for Health Communication and Participation, School of Psychology and Public Health, La Trobe University, Melbourne, Australia
| | | | | | - Debra Kay
- South Australian Health and Medical Research Institute, Adelaide, Australia
| | - Davina Ghersi
- NHMRC Clinical Trials Centre, Sydney Medical School, The University of Sydney, Sydney, NSW Australia
- National Health and Medical Research Council, Canberra, Australia
| | - Steve McDonald
- Cochrane Australia, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Naomi Poole
- Australian Commission on Safety and Quality in Healthcare, Sydney, Australia
| | | | - Natasha A. Lannin
- Alfred Health, Melbourne, Australia
- School of Allied Health (Occupational Therapy), La Trobe University, Melbourne, Australia
| | | | - Sandy Oliver
- University College London, London, United Kingdom
- University of Johannesburg, Johannesburg, South Africa
| | - Karen Carey
- National Health and Medical Research Council, Canberra, Australia
| | - Sophie J. Hill
- Centre for Health Communication and Participation, School of Psychology and Public Health, La Trobe University, Melbourne, Australia
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27
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Synnot A, Bragge P, Lowe D, Nunn JS, O'Sullivan M, Horvat L, Tong A, Kay D, Ghersi D, McDonald S, Poole N, Bourke N, Lannin N, Vadasz D, Oliver S, Carey K, Hill SJ. Research priorities in health communication and participation: international survey of consumers and other stakeholders. BMJ Open 2018; 8:e019481. [PMID: 29739780 PMCID: PMC5942413 DOI: 10.1136/bmjopen-2017-019481] [Citation(s) in RCA: 48] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2017] [Revised: 03/28/2018] [Accepted: 03/29/2018] [Indexed: 01/07/2023] Open
Abstract
OBJECTIVE To identify research priorities of consumers and other stakeholders to inform Cochrane Reviews in 'health communication and participation' (including such concepts as patient experience, shared decision-making and health literacy). SETTING International. PARTICIPANTS We included anyone with an interest in health communication and participation. Up to 151 participants (18-80 years; 117 female) across 12 countries took part, including 48 consumers (patients, carers, consumer representatives) and 75 professionals (health professionals, policymakers, researchers) (plus 25 people who identified as both). DESIGN Survey. METHODS We invited people to submit their research ideas via an online survey open for 4 weeks. Using inductive thematic analysis, we generated priority research topics, then classified these into broader themes. RESULTS Participants submitted 200 research ideas, which we grouped into 21 priority topics. Key research priorities included: insufficient consumer involvement in research (19 responses), 'official' health information is contradictory and hard to understand (18 responses), communication/coordination breakdowns in health services (15 responses), health information provision a low priority for health professionals (15 responses), insufficient eliciting of patient preferences (14 responses), health services poorly understand/implement patient-centred care (14 responses), lack of holistic care impacting healthcare quality and safety (13 responses) and inadequate consumer involvement in service design (11 responses). These priorities encompassed acute and community health settings, with implications for policy and research. Priority populations of interest included people from diverse cultural and linguistic backgrounds, carers, and people with low educational attainment, or mental illness. Most frequently suggested interventions focused on training and cultural change activities for health services and health professionals. CONCLUSIONS Consumers and other stakeholders want research addressing structural and cultural challenges in health services (eg, lack of holistic, patient-centred, culturally safe care) and building health professionals' communication skills. Solutions should be devised in partnership with consumers, and focus on the needs of vulnerable groups.
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Affiliation(s)
- Anneliese Synnot
- Centre for Health Communication and Participation, School of Psychology and Public Health, La Trobe University, Melbourne, Victoria, Australia
- Cochrane Australia, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Peter Bragge
- BehaviourWorks Australia, Monash Sustainable Development Institute, Monash University, Melbourne, Victoria, Australia
| | - Dianne Lowe
- Centre for Health Communication and Participation, School of Psychology and Public Health, La Trobe University, Melbourne, Victoria, Australia
| | - Jack S Nunn
- Centre for Health Communication and Participation, School of Psychology and Public Health, La Trobe University, Melbourne, Victoria, Australia
| | - Molly O'Sullivan
- Murdoch Children's Research Institute, Melbourne, Victoria, Australia
| | - Lidia Horvat
- Safer Care Victoria, Melbourne, Victoria, Australia
| | - Allison Tong
- 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
| | - Debra Kay
- South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia
| | - Davina Ghersi
- NHMRC Clinical Trials Centre, Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia
- National Health and Medical Research Council, Canberra, New South Wales, Australia
| | - Steve McDonald
- Cochrane Australia, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Naomi Poole
- Australian Commission on Safety and Quality in Healthcare, Sydney, New South Wales, Australia
| | - Noni Bourke
- Bass Coast Health, Wonthaggi, Victoria, Australia
| | - Natasha Lannin
- Alfred Health, Melbourne, Victoria, Australia
- School of Allied Health (Occupational Therapy), La Trobe University, Melbourne, Victoria, Australia
| | - Danny Vadasz
- Health Issues Centre, Melbourne, Victoria, Australia
| | - Sandy Oliver
- University College London, London, UK
- Universityof Johannesburg, Johannesburg, South Africa
| | - Karen Carey
- Formerly of Consumers Health Forum, Canberra, Australia
| | - Sophie J Hill
- Centre for Health Communication and Participation, School of Psychology and Public Health, La Trobe University, Melbourne, Victoria, Australia
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