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      Innovation by patients with rare diseases and chronic needs

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          Abstract

          Abstract

          We provide the first empirical exploration of disease-related innovation by patients and their caregivers. Our aims were to explore to what degree do patients develop innovative solutions; how many of these are unique developments; and do these solutions have positive perceived impact on the patients’ overall quality of life? In addition, we explored the factors associated with patient innovation development, and sharing of the solutions that the patients developed.

          Methods

          We administered a questionnaire via telephone interviewing to a sample of 500 rare disease patients and caregivers. The solutions reported were pre-screened by the authors for their fit with the self-developed innovation aim of the study. All the reported solutions were then validated for their novelty by two medical professionals. Logistic regression models were used to test the relationships between our key variables, patient innovation and solution sharing.

          Results

          263 (53%) of our survey respondents reported developing and using a solution to improve management of their diseases. An initial screening removed 81 (16%) solutions for being an obvious misfit to the self-developed innovation aim of the study. This lowered the sample of potentially innovative solutions to 182 (36%). Assessment of novelty and usefulness of the solutions, conducted by two medical evaluators, confirmed that 40 solutions (8%) were indeed novel, while the remaining 142 (28%) were already known to medicine. The likelihood of patient innovation increased as the education level increased (OR 2, p < 0.05), and as their perception of limitations imposed by their disease increased (OR 1.3, p < 0.05). 55 individuals diffused their solutions to some degree, with 50 of these sharing via direct diffusion to other patients. There is a positive relationship between the impact of a solution on the respondents’ overall quality of life and likelihood of solution sharing.

          Conclusions

          Given that hundreds of millions of people worldwide are afflicted by rare diseases, patient and their caregivers can be a tremendous source of innovation for many who are similarly afflicted. Our findings suggest that many patients could be greatly assisted by improved diffusion of known solutions and best practices to and among patients and their caregivers.

          Electronic supplementary material

          The online version of this article (doi:10.1186/s13023-015-0257-2) contains supplementary material, which is available to authorized users.

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          Most cited references29

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          Development of the Patient Activation Measure (PAM): conceptualizing and measuring activation in patients and consumers.

          Controlling costs and achieving health care quality improvements require the participation of activated and informed consumers and patients. We describe a process for conceptualizing and operationalizing what it means to be "activated" and delineate the process we used to develop a measure for assessing "activation," and the psychometric properties of that measure. We used the convergence of the findings from a national expert consensus panel and patient focus groups to define the concept and identify the domains of activation. These domains were operationalized by constructing a large item pool. Items were pilot-tested and initial psychometric analysis performed using Rasch methodology. The third stage refined and extended the measure. The fourth stage used a national probability sample to assess the measure's psychometric performance overall and within different subpopulations. Convenience samples of patients with and without chronic illness, and a national probability sample (N=1,515) are included at different stages in the research. The Patient Activation Measure is a valid, highly reliable, unidimensional, probabilistic Guttman-like scale that reflects a developmental model of activation. Activation appears to involve four stages: (1) believing the patient role is important, (2) having the confidence and knowledge necessary to take action, (3) actually taking action to maintain and improve one's health, and (4) staying the course even under stress. The measure has good psychometric properties indicating that it can be used at the individual patient level to tailor intervention and assess changes.
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            Market Size in Innovation: Theory and Evidence from the Pharmaceutical Industry

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              User-innovators and “local” information: The case of mountain biking

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                Author and article information

                Contributors
                poliveira@ucp.pt
                leid.zejnilovic@cmu.edu
                hcanhao@medicina.ulisboa.pt
                evhippel@mit.edu
                Journal
                Orphanet J Rare Dis
                Orphanet J Rare Dis
                Orphanet Journal of Rare Diseases
                BioMed Central (London )
                1750-1172
                9 April 2015
                9 April 2015
                2015
                : 10
                : 41
                Affiliations
                [ ]UCP - Católica-Lisbon School of Business and Economics, Lisbon, Portugal
                [ ]Department of Engineering and Public Policy, Carnegie Mellon University, Pittsburgh, USA
                [ ]University of Lisbon School of Medicine and Santa Maria Hospital, Lisbon, Portugal
                [ ]MIT Sloan School of Management, Cambridge, MA USA
                Article
                257
                10.1186/s13023-015-0257-2
                4404234
                25887544
                69d883b2-8b8b-4121-99b5-641ac68b75e1
                © Oliveira et al.; licensee BioMed Central. 2015

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 25 November 2014
                : 20 March 2015
                Categories
                Research
                Custom metadata
                © The Author(s) 2015

                Infectious disease & Microbiology
                patient innovation,user innovation in health,diffusion of innovation,rare diseases

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