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      Exploring Meaningful Patient Engagement in ADAPTABLE (Aspirin Dosing: A Patient-centric Trial Assessing Benefits and Long-term Effectiveness)

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          Abstract

          Background:

          Genuine patient engagement can improve research relevance, impact and is required for studies using the National Patient-Centered Clinical Research Network including major multicenter research projects. It is unclear, however, how best to integrate patients into governance of such projects.

          Methods:

          ADAPTABLE (Aspirin Dosing: A Patient-centric Trial Assessing Benefits and Long-term Effectiveness) is the first major multicenter research project to be conducted in National Patient-Centered Clinical Research Network. Here, we provide a description of how we implemented patient engagement in ADAPTABLE thus far, including a description of committee structures and composition, first-hand patient testimonials, specific contributions, and lessons learned during the planning and early implementation of ADAPTABLE.

          Results:

          We recruited 1 patient leader from 6 of the 7 enrolling networks to serve on a Patient Review Board for ADAPTABLE, supported the Board with an experienced patient engagement team including an “investigator-advocate” not otherwise involved in the trial, and facilitated bidirectional communication between the Board and ADAPTABLE Coordinating Center. The Board has reviewed and provided substantial input on the informed consent procedure, recruitment materials, patient portal design, and study policy including compensation of participants. Although it was “too late” for some suggested modifications, most modifications suggested by the patient leaders have been implemented, and they are enthusiastic about the study and their role. The patient leaders also attend Steering and Executive Committee calls; these experiences have been somewhat less productive.

          Conclusions:

          With adequate support, a cadre of committed patient leaders can provide substantial value to design and implementation of a major multicenter clinical trial.

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          Most cited references3

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          A systematic review of stakeholder engagement in comparative effectiveness and patient-centered outcomes research.

          We conducted a review of the peer-reviewed literature since 2003 to catalogue reported methods of stakeholder engagement in comparative effectiveness research and patient-centered outcomes research.
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            The Patient-Centered Outcomes Research Institute (PCORI) national priorities for research and initial research agenda.

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              How best to engage patients, doctors, and other stakeholders in designing comparative effectiveness studies.

              Having patients, doctors, health plan managers, hospital executives, and other stakeholders participate in the design of comparative effectiveness studies can ensure that this vital research focuses on the evidence gaps most relevant to health care decision makers. Through a qualitative assessment of case studies, we identify five key principles for the effective engagement of a broad coalition of participants in research intended to improve health care and control costs. Those principles are to ensure balance among the participating stakeholders; get participants to "buy in" to the process and understand their roles; provide neutral and expert facilitators for research discussions; establish connections among the participants; and keep the participants engaged throughout the research process.
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                Author and article information

                Journal
                Med Care
                Med Care
                MLR
                Medical Care
                Lippincott Williams & Wilkins
                0025-7079
                1537-1948
                October 2018
                13 September 2018
                : 56
                : 10 Suppl 1
                : S11-S15
                Affiliations
                [* ]Department of Epidemiology and Biostatistics, University of California, San Francisco, CA
                []Duke Clinical Research Institute, Durham, NC
                []Department of Medicine, Division of General Internal Medicine, University of California, San Francisco, CA
                Author notes
                Reprints: Madelaine Faulkner, MPH, Department of Epidemiology and Biostatistics, University of California, San Francisco, 550 16th Street, Second floor, San Francisco, CA 94158. E-mail: madelaine.faulkner@ 123456ucsf.edu .
                Article
                00007
                10.1097/MLR.0000000000000949
                6143214
                30074943
                99752e95-9315-4e2e-ac8e-869fb229b279
                Copyright © 2018 The Author(s). Published by Wolters Kluwer Health, Inc.

                This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. http://creativecommons.org/licenses/by-nc-nd/4.0/

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                patient-centered review board,patient engagement,adaptable,adaptors

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