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      Co-creation of patient engagement quality guidance for medicines development: an international multistakeholder initiative

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          Abstract

          Introduction

          Meaningful patient engagement (PE) can enhance medicines’ development. However, the current PE landscape is fragmentary and lacking comprehensive guidance.

          Methods

          We systematically searched for PE initiatives (SYNaPsE database/publications). Multistakeholder groups integrated these with their own PE expertise to co-create draft PE Quality Guidance which was evaluated by public consultation. Projects exemplifying good PE practice were identified and assessed against PE Quality Criteria to create a Book of Good Practices (BOGP).

          Results

          Seventy-six participants from 51 organisations participated in nine multistakeholder meetings (2016–2018). A shortlist of 20relevant PE initiatives (from 170 screened) were identified. The co-created INVOLVE guidelines provided the main framework for PE Quality Guidance and was enriched with the analysis of the PE initiatives and the PE expertise of stakeholders. Seven key PE Quality Criteria were identified. Public consultation yielded 67 responses from diverse backgrounds. The PE Quality Guidance was agreed to be useful for achieving quality PE in practice, understandable, easy to use, and comprehensive. Overall, eight initiatives from the shortlist and from meeting participants were selected for inclusion in the BOGP based on demonstration of PE Quality Criteria and willingness of initiative owners to collaborate.

          Discussion

          The PE Quality Guidance and BOGP are practical resources which will be continually updated in response to user feedback. They are not prescriptive, but rather based on core principles, which can be applied according to the unique needs of each interaction and initiative. Implementation of the guidance will facilitate improved and systematic PE across the medicines’ development lifecycle.

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          Most cited references12

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          When patient activation levels change, health outcomes and costs change, too.

          Patient engagement has become a major focus of health reform. However, there is limited evidence showing that increases in patient engagement are associated with improved health outcomes or lower costs. We examined the extent to which a single assessment of engagement, the Patient Activation Measure, was associated with health outcomes and costs over time, and whether changes in assessed activation were related to expected changes in outcomes and costs. We used data on adult primary care patients from a single large health care system where the Patient Activation Measure is routinely used. We found that results indicating higher activation in 2010 were associated with nine out of thirteen better health outcomes-including better clinical indicators, more healthy behaviors, and greater use of women's preventive screening tests-as well as with lower costs two years later. Changes in activation level were associated with changes in over half of the health outcomes examined, as well as costs, in the expected directions. These findings suggest that efforts to increase patient activation may help achieve key goals of health reform and that further research is warranted to examine whether the observed associations are causal.
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            Relation between agendas of the research community and the research consumer.

            Previous studies have suggested that research agendas can be biased. To determine whether there is a mismatch between available research evidence and the research preferences of consumers we examined research on interventions for the treatment of osteoarthritis of the knee joint. We searched published and unpublished studies on interventions in this condition to assess the structure of the evidence base. Focus groups and a postal survey of research consumers were then undertaken to examine their views and research priorities. Review of published and unpublished reports showed that the evidence base was dominated by studies of pharmaceutical (550, 59%) and surgical (238, 26%) interventions. 24 (36%) of 67 survey respondents ranked knee replacement as the highest priority for research, whereas 14 (21%) chose education and advice as their first choice. There is a mismatch between the amount of published work on different interventions, and the degree of interest of consumers. We suggest that broadening of the research agenda would be more in line with current treatment patterns and consumer views. If this mismatch is not addressed, then evidence-based medicine will not be representative of consumer needs.
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              The PCORI Engagement Rubric: Promising Practices for Partnering in Research

              Engaging patients, caregivers, and other health care stakeholders as partners in planning, conducting, and disseminating research is a promising way to improve clinical decision making and outcomes. Many researchers, patients, and other stakeholders, however, lack clarity about when and how to engage as partners within the clinical research process. To address the need for guidance on creating meaningful stakeholder partnerships in patient-centered clinical comparative effectiveness research, the Patient-Centered Outcomes Research Institute (PCORI) developed the PCORI Engagement Rubric (Rubric).
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                Author and article information

                Journal
                BMJ Innov
                BMJ Innov
                bmjinnov
                bmjinnov
                BMJ Innovations
                BMJ Publishing Group (BMA House, Tavistock Square, London, WC1H 9JR )
                2055-642X
                January 2019
                2 March 2019
                : 5
                : 1
                : 43-55
                Affiliations
                [1 ] School of Health Sciences, University of East Anglia , Norwich, UK
                [2 ] Patient Reported Outcomes, Pharmerit International , Rotterdam, Belgium
                [3 ] departmentChief Scientific and Medical Office – Patient Affairs , ViiV Healthcare , London, UK
                [4 ] Patient Focused Medicines Development , Brussels, Belgium
                [5 ] departmentPatient Engagement in Research , Institut de Recerca Sant Joan de Déu- Hospital Sant Joan de Déu , Esplugues de Llobregat, Spain
                [6 ] Clinical Trials Ontario , Toronto, Ontario, Canada
                [7 ] Steno Diabetes Centre North Denmark, Aalborg University Hospital , Aalborg, Denmark
                Author notes
                [Correspondence to ] Anne Marie Hamoir, Patient Focused Medicines Development, Brussels 1050, Belgium; am.hamoir@ 123456thesynergist.org
                Author information
                http://orcid.org/0000-0003-4779-4007
                Article
                bmjinnov-2018-000317
                10.1136/bmjinnov-2018-000317
                6792320
                31645992
                3ce479ac-6586-48a2-89d3-1ef9e37947e8
                © Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ

                This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

                History
                : 03 August 2018
                : 22 January 2019
                : 29 January 2019
                Categories
                Health IT, systems and process innovations
                1506
                2268
                Original article
                Custom metadata
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                patient engagement,quality guidance,multi-stakeholder initiative,patient engagement medicines

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