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Zirnsak TM, Ng AH, Brasier C, Gray R. Public involvement in Australian clinical trials: A systematic review. Clin Trials 2024; 21:507-515. [PMID: 38408931 PMCID: PMC11304641 DOI: 10.1177/17407745231224533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/28/2024]
Abstract
BACKGROUND Public involvement enhances the relevance, quality, and impact of research. There is some evidence that public involvement in Australian research lags other countries, such as the United Kingdom. The purpose of the systematic review was to establish the rates and describe the characteristics of public involvement in Australian clinical trials. METHODS We reviewed evidence of public involvement in all Australian randomised controlled trials published in the first 6 months of 2021. To determine the quality of public involvement, we used the five-item short-form version of the Guidance of Reporting Involvement Patients and the Public, version 2. RESULTS In total, 325 randomised controlled trials were included, of which 17 (5%) reported any public involvement. Six trials reported public involvement in setting the research aim and seven in developing study methods. The authors of one study reflected on the overall role and influence of public involvement in the research. CONCLUSION Rate of public involvement in Australian clinical trials is seemingly substantially lower than those reported in countries with similar advanced public health care systems, notably the United Kingdom. Our observations may be explained by a lack of researcher skills in how to involve the public and the failure by major funding agencies in Australia to mandate public involvement when deciding on how to award grant funding.
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Affiliation(s)
- Tessa-May Zirnsak
- Social Work and Social Policy, La Trobe University, Melbourne, VIC, Australia
| | - Ashley H Ng
- Department of Dietetics, Human Nutrition and Sport, La Trobe University, Melbourne, VIC, Australia
- Monash Partners Academic Health Science Centre, Melbourne, VIC, Australia
| | - Catherine Brasier
- Social Work and Social Policy, La Trobe University, Melbourne, VIC, Australia
| | - Richard Gray
- School of Nursing and Midwifery, La Trobe University, Melbourne, VIC, Australia
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Idris MUBM, Jamil NB, Yi X, Su-Fee L, Yuh AS, Aloweni F, Towle RM. Keeping patients safe through medication review and management in the community. Br J Community Nurs 2024; 29:288-293. [PMID: 38814838 DOI: 10.12968/bjcn.2024.29.6.288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2024]
Abstract
BACKGROUND There are numerous publications on inpatient medication errors. However, little focus is given to medication errors that occur at home. AIMS To describe and analyse the types of medication errors among community-dwelling patients following their discharge from an acute care hospital in Singapore. METHOD This is a retrospective review of a 'good catch' reporting system from December 2018 to March 2022. Medication-related errors were extracted and analysed. FINDINGS A total of 73 reported medication-related error incidents were reviewed. The mean age of the patients was 78 years old (SD=9). Most patients managed their medications independently at home (45.2%, n=33). The majority of medications involved were cardiovascular medications (51.5%, n=50). Incorrect dosing (41.1%, n=39) was the most common medication error reported. Poor understanding of medication usage (35.6%, n=26) and lack of awareness of medication changes after discharge (24.7%, n=18) were the primary causes of the errors. CONCLUSION This study's findings provide valuable insights into reducing medication errors at home. More attention must be given to post-discharge care, especially to preventable medication errors. Medication administration and management education can be emphasised using teach-back methods.
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Affiliation(s)
| | | | - Xu Yi
- Assistant Director of Nursing; SingHealth, Singapore General Hospital
| | - Lim Su-Fee
- Clinical Assistant Professor; Singapore General Hospital, SingHealth Community Hospitals
| | - Ang Shin Yuh
- Clinical Assistant Professor; SingHealth, Singapore General Hospital
| | - Fazila Aloweni
- Clinical Assistant Professor; Singapore General Hospital
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Chang C, Sun J, Zhao X, Chen S, Song D, Wang L, Yang Y, Huang R, Zhang H, Du J. Clinical practice guidelines for the nutrition of colorectal cancer patients: a systematic review. Support Care Cancer 2024; 32:187. [PMID: 38396102 DOI: 10.1007/s00520-024-08394-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2023] [Accepted: 02/17/2024] [Indexed: 02/25/2024]
Abstract
PURPOSE The aim of this study is to rigorously assess the methodological quality of published clinical practice guidelines (CPGs) related to nutrition among colorectal cancer patients, to compile consensus recommendations, and to evaluate the quality of the included CPGs. METHODS The systematic search covered eight electronic databases, two relevant professional association websites, and six guideline websites from their inception up to January 22, 2023. The methodological quality of the eligible guidelines was evaluated using the Appraisal of Guidelines Research and Evaluation II (AGREE II) instrument, and then, consensus recommendations were synthesized. The scores for each domain were expressed as the mean ± standard deviation (SD). Using the mean score as the benchmark for comparison, they were subsequently ranked from highest to lowest. The included guidelines were then categorized as having "high," "moderate," or "low" quality based on their scores. RESULTS The literature search yielded ten guidelines. The findings indicated that the "Clarity of presentation" domain had the highest mean score (65.2 ± 7.7). This demonstrates how the guidelines effectively articulate recommendations. Additionally, the "Scope and purpose" domain achieved a mean score of 60.7 ± 10.9, followed by "Rigor of development" (51.7 ± 15.7), "Editorial independence" (51.1 ± 21), "Stakeholder involvement" (48 ± 16.8), and "Applicability" domains (47.5 ± 17.3). Two CPGs received an overall rating of "high quality" and were recommended; four CPGs received an overall rating of "moderate" and were recommended with modifications; and four CPGs received an overall rating of "low quality" and were not recommended. Furthermore, this study compiled twenty consensus recommendations related to nine distinct clinical issues. CONCLUSION This study identified disparities in the methodological quality of the included CPGs, particularly in the "Applicability" domain, thus emphasizing the need for advancement in clinical feasibility and implementation. Notably, there is few guidelines specifically targeting colorectal cancer nutrition. These synthesized findings provided an intuitive, convenient, and comprehensive reference for evaluating nutrition among colorectal cancer patients. When applying these results, users should make careful decisions based on their specific situations.
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Affiliation(s)
- Cheng Chang
- The First Hospital of Jilin University, No. 1 Xinmin Street, ChangchunJilin, 130021, China
| | - Jiao Sun
- School of Nursing, Jilin University, No.965 Xinjiang Street, ChangchunJilin, 130021, China
| | - Xiaosu Zhao
- The First Hospital of Jilin University, No. 1 Xinmin Street, ChangchunJilin, 130021, China.
| | - Si Chen
- The First Hospital of Jilin University, No. 1 Xinmin Street, ChangchunJilin, 130021, China
| | - Dongpo Song
- School of Nursing, Jilin University, No.965 Xinjiang Street, ChangchunJilin, 130021, China
| | - Lijie Wang
- The First Hospital of Jilin University, No. 1 Xinmin Street, ChangchunJilin, 130021, China
| | - Yang Yang
- The First Hospital of Jilin University, No. 1 Xinmin Street, ChangchunJilin, 130021, China
| | - Ruling Huang
- The First Hospital of Jilin University, No. 1 Xinmin Street, ChangchunJilin, 130021, China
| | - Haijia Zhang
- The First Hospital of Jilin University, No. 1 Xinmin Street, ChangchunJilin, 130021, China
| | - Jing Du
- The First Hospital of Jilin University, No. 1 Xinmin Street, ChangchunJilin, 130021, China
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Butler J, Petrie MC, Bains M, Bawtinheimer T, Code J, Levitch T, Malvolti E, Monteleone P, Stevens P, Vafeiadou J, Lam CSP. Challenges and opportunities for increasing patient involvement in heart failure self-care programs and self-care in the post-hospital discharge period. RESEARCH INVOLVEMENT AND ENGAGEMENT 2023; 9:23. [PMID: 37046357 PMCID: PMC10097448 DOI: 10.1186/s40900-023-00412-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Accepted: 01/25/2023] [Indexed: 06/19/2023]
Abstract
BACKGROUND People living with heart failure (HF) are particularly vulnerable after hospital discharge. An alliance between patient authors, clinicians, industry, and co-developers of HF programs can represent an effective way to address the unique concerns and obstacles people living with HF face during this period. The aim of this narrative review article is to discuss challenges and opportunities of this approach, with the goal of improving participation and clinical outcomes of people living with HF. METHODS This article was co-authored by people living with HF, heart transplant recipients, patient advocacy representatives, cardiologists with expertise in HF care, and industry representatives specializing in patient engagement and cardiovascular medicine, and reviews opportunities and challenges for people living with HF in the post-hospital discharge period to be more integrally involved in their care. A literature search was conducted, and the authors collaborated through two virtual roundtables and via email to develop the content for this review article. RESULTS Numerous transitional-care programs exist to ease the transition from the hospital to the home and to provide needed education and support for people living with HF, to avoid rehospitalizations and other adverse outcomes. However, many programs have limitations and do not integrally involve patients in the design and co-development of the intervention. There are thus opportunities for improvement. This can enable patients to better care for themselves with less of the worry and fear that typically accompany the transition from the hospital. We discuss the importance of including people living with HF in the development of such programs and offer suggestions for strategies that can help achieve these goals. An underlying theme of the literature reviewed is that education and engagement of people living with HF after hospitalization are critical. However, while clinical trial evidence on existing approaches to transitions in HF care indicates numerous benefits, such approaches also have limitations. CONCLUSION Numerous challenges continue to affect people living with HF in the post-hospital discharge period. Strategies that involve patients are needed, and should be encouraged, to optimally address these challenges.
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Affiliation(s)
- Javed Butler
- Department of Medicine (L605), University of Mississippi Medical Center, 2500 North State Street, Jackson, MS, 39216, USA.
- Baylor Scott and White Research Institute, Dallas, TX, USA.
| | - Mark C Petrie
- Institute of Cardiovascular & Medical Sciences, University of Glasgow, Glasgow, Scotland
| | - Marc Bains
- HeartLife Foundation, Vancouver, BC, Canada
| | | | - Jillianne Code
- HeartLife Foundation, Vancouver, BC, Canada
- Faculty of Education, University of British Columbia, Vancouver, BC, Canada
| | | | - Elmas Malvolti
- Global Medical Affairs, BioPharmaceuticals Business Unit, AstraZeneca, Central Cambridge, UK
| | - Pasquale Monteleone
- Global Corporate Affairs, Biopharmaceuticals Business Unit, AstraZeneca, Cambridge, UK
| | - Petrina Stevens
- Global Medical Evidence, BioPharmaceuticals Business Unit, AstraZeneca, Cambridge, UK
| | - Jenny Vafeiadou
- Global Digital Health, Biopharmaceuticals Business Unit, AstraZeneca, Cambridge, UK
| | - Carolyn S P Lam
- National Heart Centre Singapore & Duke-NUS Medical School, Singapore, Singapore
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Taffere GR, Abebe HT, Zerihun Z, Mallen C, Price HP, Mulugeta A. Systematic review of community engagement approach in research: describing partnership approaches, challenges and benefits. J Public Health (Oxf) 2023. [DOI: 10.1007/s10389-022-01799-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
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Usher S, Denis JL. Exploring expectations and assumptions in the public and patient engagement literature: A meta-narrative review. PATIENT EDUCATION AND COUNSELING 2022; 105:2683-2692. [PMID: 35459528 DOI: 10.1016/j.pec.2022.04.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/02/2022] [Revised: 04/02/2022] [Accepted: 04/04/2022] [Indexed: 06/14/2023]
Abstract
OBJECTIVES Public and patient engagement (PPE) is increasingly recognized in policy statements as essential to achieving transformation towards patient-centred, value-based, integrated care. Despite extensive research over two decades, important gaps and questions remain around how the efforts invested in engagement drive the changes needed to meet these objectives. METHODS We conducted a meta-narrative review of systematic and scoping reviews to understand persistent difficulties and uncertainties in this research domain. Thirty-eight reviews looking at studies of PPE in care, healthcare organizations and systems were appraised. We synthesized the expectations of PPE that prompted each review, the guiding ideas about how PPE comes about, main findings and the questions and gaps they raise. RESULTS Four storylines are found in reviews: 1. Terminology is inconsistent and concepts are weak; 2. Outcomes of care can be improved 3. Influence on healthcare delivery and design is uncertain; 4. Characteristics of engagement efforts are consequential. DISCUSSION AND PRACTICE IMPLICATIONS Three assumptions underlie these storylines and appear as barriers to practice and research; alternative approaches based on collaborative governance and theories of change are proposed to understand and support engagement with transformative potential.
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Affiliation(s)
- Susan Usher
- École Nationale D'administration Publique, 4750 Henri Julien, Montréal, Québec H2T 2C8, Canada.
| | - Jean-Louis Denis
- École de Santé Publique, Université de Montréal, 7101 ave du Parc, Montréal, Québec H3N 1X9, Canada
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Integrating Care from Home to Hospital to Home: Using Participatory Design to Develop a Provincial Transitions in Care Guideline. Int J Integr Care 2022; 22:16. [PMID: 35634250 PMCID: PMC9122004 DOI: 10.5334/ijic.5674] [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] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Accepted: 05/03/2022] [Indexed: 12/04/2022] Open
Abstract
Introduction: Patients worldwide experience fragmented and uncoordinated care as they transition between primary and acute care. To improve system integration and outcomes for patients, in 2017/2018 Alberta Health Services (largest health services delivery organization in Canada) called for a coordinated approach to improve transitions in care (TiC). Healthcare leadership responded by initiating the development of a province-wide guideline outlining core components of effective transitions in care. This case study highlights the extensive design process used to develop this guideline, with a focus on the participatory design (PD) approach used throughout. Methods: An iterative, mixed methods PD approach was used to engage over 750 stakeholders through the following activities to establish Guideline content: i) learning collaborative; ii) design-team; iii) targeted online surveys; iv) primary care stakeholder consultation; v) modified Delphi panel; and vi) patient advisory committee. Results: The result was Alberta’s first guideline for supporting patients through TiC: “Alberta’s Home to Hospital to Home Transitions Guideline”. Conclusion: The extensive design process used to create the Guideline was instrumental in establishing content, encouraging system integration, and creating conditions to support provincial implementation. While intended to improve and standardize patient care in Alberta, the methods used and lessons learned throughout the development of the Guideline are applicable internationally.
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Mira JJ. How to reduce medication errors in patients over the age of 65? Expert Opin Pharmacother 2021; 22:2417-2421. [PMID: 34187264 DOI: 10.1080/14656566.2021.1947241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- José Joaquín Mira
- Health Psychology Department, Universidad Miguel Hernandez de Elche, Elche, Spain.,Alicante-Sant Joan Health District, Alicante, Spain
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Cadel L, Guilcher SJT, Kokorelias KM, Sutherland J, Glasby J, Kiran T, Kuluski K. Initiatives for improving delayed discharge from a hospital setting: a scoping review. BMJ Open 2021; 11:e044291. [PMID: 33574153 PMCID: PMC7880119 DOI: 10.1136/bmjopen-2020-044291] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
OBJECTIVE The overarching objective of the scoping review was to examine peer reviewed and grey literature for best practices that have been developed, implemented and/or evaluated for delayed discharge involving a hospital setting. Two specific objectives were to review what the delayed discharge initiatives entailed and identify gaps in the literature in order to inform future work. DESIGN Scoping review. METHODS Electronic databases and websites of government and healthcare organisations were searched for eligible articles. Articles were required to include an initiative that focused on delayed discharge, involve a hospital setting and be published between 1 January 2004 and 16 August 2019. Data were extracted using Microsoft Excel. Following extraction, a policy framework by Doern and Phidd was adapted to organise the included initiatives into categories: (1) information sharing; (2) tools and guidelines; (3) practice changes; (4) infrastructure and finance and (5) other. RESULTS Sixty-six articles were included in this review. The majority of initiatives were categorised as practice change (n=36), followed by information sharing (n=19) and tools and guidelines (n=19). Numerous initiatives incorporated multiple categories. The majority of initiatives were implemented by multidisciplinary teams and resulted in improved outcomes such as reduced length of stay and discharge delays. However, the experiences of patients and families were rarely reported. Included initiatives also lacked important contextual information, which is essential for replicating best practices and scaling up. CONCLUSIONS This scoping review identified a number of initiatives that have been implemented to target delayed discharges. While the majority of initiatives resulted in positive outcomes, delayed discharges remain an international problem. There are significant gaps and limitations in evidence and thus, future work is warranted to develop solutions that have a sustainable impact.
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Affiliation(s)
- Lauren Cadel
- Institute for Better Health, Trillium Health Partners, Mississauga, Ontario, Canada
- Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Ontario, Canada
| | - Sara J T Guilcher
- Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Ontario, Canada
- Rehabiliation Sciences Institute, University of Toronto, Toronto, Ontario, Canada
- Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Quality Division, Ontario Health, Toronto, Ontario, Canada
| | | | - Jason Sutherland
- Centre for Health Services and Policy Research, School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
| | - Jon Glasby
- School of Social Policy, University of Birmingham, Edgbaston, Birmingham, UK
| | - Tara Kiran
- Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Quality Division, Ontario Health, Toronto, Ontario, Canada
- Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada
- MAP Centre for Urban Health Solutions, St. Michael's Hospital, Toronto, Ontario, Canada
| | - Kerry Kuluski
- Institute for Better Health, Trillium Health Partners, Mississauga, Ontario, Canada
- Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
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Palmer JL, Siddle HJ, Redmond AC, Alcacer-Pitarch B. Implementation of podiatry telephone appointments for people with rheumatic and musculoskeletal diseases. J Foot Ankle Res 2021; 14:4. [PMID: 33413562 PMCID: PMC7790049 DOI: 10.1186/s13047-020-00441-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Accepted: 12/15/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Foot health problems are common in the general population, and particularly so in people with rheumatic and musculoskeletal disorders (RMD). Several clinical guidelines state that people with RMDs should have access to foot health services, although service capacity is often limited. The current COVID-19 pandemic has increased the need for alternative ways to provide patient care. The aim of this clinical audit was to review a newly implemented telephone follow-up appointment service conducted within the Rheumatology Podiatry Department in Leeds, UK. METHODS Fifty-eight patients attending the Rheumatology Podiatry Department at Leeds Teaching Hospitals NHS Trust were contacted by telephone approximately 6-8 weeks following initial intervention. During the telephone consultation, all patients were asked pre-defined questions relating to their symptoms, intervention efficacy, the need for further appointments and their preference for the type of consultation. To assess the cost of the telephone consultation the number of attempts needed in order to make successful contact, the duration of the call and the number of telephone follow-up appointments completed in a working day were also recorded. RESULTS Twenty-five patients (43%) were successfully contacted within the 6-8 weeks stipulated time frame and were included in the analysis. Of the 25 contacted, twelve (48%) patients were successfully contacted on the first attempt. Ten (40%) were successfully contacted on the second attempt. The remaining three patients (12%) required 3 or more attempts to make successful contact. Telephone consultations were estimated not to last longer than 10 min, including notes screening and documentation. Eleven patients (44%) reported an improvement in their symptoms, thirteen (52%) reported no change and one patient (4%) reported their symptoms to be worse. CONCLUSION Telephone follow-up consultations may be a potentially cost-effective alternative to face-to-face appointments when implemented in a Rheumatology Podiatry Department, and provide an alternative way of providing care, especially when capacity for face-to-face contact is limited. The potential cost saving and efficiency benefits of this service are likely to be enhanced when telephone consultations are pre-arranged with patients.
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Affiliation(s)
- J L Palmer
- College of Health, Wellbeing and Life Sciences, Sheffield Hallam University, Sheffield, UK.,First Contact Physiotherapy Practitioner, Primary Care Sheffield, Darnall Primary Care Centre, Sheffield, UK
| | - H J Siddle
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, 2nd Floor, Chapel Allerton Hospital, Leeds, LS7 4SA, UK.,Podiatry Department, Leeds Teaching Hospitals NHS Trust, Leeds, UK.,NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - A C Redmond
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, 2nd Floor, Chapel Allerton Hospital, Leeds, LS7 4SA, UK.,NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - B Alcacer-Pitarch
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, 2nd Floor, Chapel Allerton Hospital, Leeds, LS7 4SA, UK. .,Podiatry Department, Leeds Teaching Hospitals NHS Trust, Leeds, UK. .,NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals NHS Trust, Leeds, UK.
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El-Harakeh A, Lotfi T, Ahmad A, Morsi RZ, Fadlallah R, Bou-Karroum L, Akl EA. The implementation of prioritization exercises in the development and update of health practice guidelines: A scoping review. PLoS One 2020; 15:e0229249. [PMID: 32196520 PMCID: PMC7083273 DOI: 10.1371/journal.pone.0229249] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2019] [Accepted: 02/02/2020] [Indexed: 02/07/2023] Open
Abstract
Background The development of trustworthy guidelines requires substantial investment of resources and time. This highlights the need to prioritize topics for guideline development and update. Objective To systematically identify and describe prioritization exercises that have been conducted for the purpose of the de novo development, update or adaptation of health practice guidelines. Methods We searched Medline and CINAHL electronic databases from inception to July 2019, supplemented by hand-searching Google Scholar and the reference lists of relevant studies. We included studies describing prioritization exercises that have been conducted during the de novo development, update or adaptation of guidelines addressing clinical, public health or health systems topics. Two reviewers worked independently and in duplicate to complete study selection and data extraction. We consolidated findings in a semi-quantitative and narrative way. Results Out of 33,339 identified citations, twelve studies met the eligibility criteria. All included studies focused on prioritizing topics; none on questions or outcomes. While three exercises focused on updating guidelines, nine were on de novo development. All included studies addressed clinical topics. We adopted a framework that categorizes prioritization into 11 steps clustered in three phases (pre-prioritization, prioritization and post-prioritization). Four studies covered more than half of the 11 prioritization steps across the three phases. The most frequently reported steps for generating initial list of topics were stakeholders’ input (n = 8) and literature review (n = 7). The application of criteria to determine research priorities was used in eight studies. We used and updated a common framework of 22 prioritization criteria, clustered in 6 domains. The most frequently reported criteria related to the health burden of disease (n = 9) and potential impact of the intervention on health outcomes (n = 5). All the studies involved health care providers in the prioritization exercises. Only one study involved patients. There was a variation in the number and type of the prioritization exercises’ outputs. Conclusions This review included 12 prioritization exercises that addressed different aspects of priority setting for guideline development and update that can guide the work of researchers, funders, and other stakeholders seeking to prioritize guideline topics.
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Affiliation(s)
- Amena El-Harakeh
- Center for Systematic Reviews on Health Policy and Systems Research (SPARK), American University of Beirut, Beirut, Lebanon
- Clinical Research Institute (CRI), American University of Beirut Medical Center, Beirut, Lebanon
| | - Tamara Lotfi
- Global Evidence Synthesis Initiative (GESI) Secretariat, American University of Beirut, Beirut, Lebanon
- Faculty of Medicine, American University of Beirut, Beirut, Lebanon
| | - Ali Ahmad
- Faculty of Medicine, American University of Beirut, Beirut, Lebanon
| | - Rami Z. Morsi
- Faculty of Medicine, American University of Beirut, Beirut, Lebanon
| | - Racha Fadlallah
- Center for Systematic Reviews on Health Policy and Systems Research (SPARK), American University of Beirut, Beirut, Lebanon
- Department of Health Management and Policy, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - Lama Bou-Karroum
- Center for Systematic Reviews on Health Policy and Systems Research (SPARK), American University of Beirut, Beirut, Lebanon
- Department of Health Management and Policy, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - Elie A. Akl
- Center for Systematic Reviews on Health Policy and Systems Research (SPARK), American University of Beirut, Beirut, Lebanon
- Clinical Research Institute (CRI), American University of Beirut Medical Center, Beirut, Lebanon
- Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon
- Department of Health Research Methods, Evidence, and Impact (HEI), McMaster University, Hamilton, Canada
- * E-mail:
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