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      What do stakeholders expect from patient engagement: Are these expectations being met?

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          Abstract

          Background

          Meaningful patient engagement ( PE) in medicines development and during the life cycle of a product requires all stakeholders have a clear understanding of respective expectations.

          Objective

          A qualitative survey was undertaken to understand stakeholder expectations.

          Design

          The survey explored 4 themes from the perspective of each stakeholder group: meaning, views, expectations and priorities for PE. Participants were grouped into 7 categories: policymakers/regulators; health‐care professionals ( HCPs); research funders; payers/purchasers/ HTA; patients/patient representatives; pharmaceutical/life sciences industry; and academic researchers.

          Results

          Fifty‐nine interviews were conducted across a range of geographies, PE experience and job seniority/role. There was consensus across stakeholders on meaning of PE; importance of promoting PE to a higher level than currently; need for a more structured process and guidance. There was little consensus on stakeholder expectations and roles. Policymakers/regulators were expected by others to drive PE, create a framework and facilitate PE, provide guidelines of good practice and connect stakeholders, but this expectation was not shared by the policymakers/regulators group. HCPs were seen as the link between patients and other stakeholders, but HCPs did not necessarily share this view.

          Discussion and conclusions

          Despite broad stakeholder categories, clear themes emerged: there is no “leader”; no stakeholder has a clear view on how to meaningfully engage with patients; there are educational gaps; and a structure and guidance for PE is urgently required. Given the diversity of stakeholders, there needs to be multistakeholder collaborative leadership. Effective collaboration requires consensus on roles, responsibilities and expectations to synergize efforts to deliver meaningful PE in medicines life cycle.

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          Most cited references26

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          Evaluating patient and stakeholder engagement in research: moving from theory to practice.

          Despite the growing demand for research that engages stakeholders, there is limited evidence in the literature to demonstrate its value - or return on investment. This gap indicates a general lack of evaluation of engagement activities. To adequately inform engagement activities, we need to further investigate the dividends of engaged research, and how to evaluate these effects. This paper synthesizes the literature on hypothesized impacts of engagement, shares what has been evaluated and identifies steps needed to reduce the gap between engagement's promises and the underlying evidence supporting its practice. This assessment provides explicit guidance for better alignment of engagement's promised benefits with evaluation efforts and identifies specific areas for development of evaluative measures and better reporting processes.
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            Stakeholder participation in comparative effectiveness research: defining a framework for effective engagement.

            AIMS: Stakeholder engagement is fundamental to comparative effectiveness research (CER), but lacks consistent terminology. This paper aims to define stakeholder engagement and present a conceptual model for involving stakeholders in CER. MATERIALS #ENTITYSTARTX00026; METHODS: The definitions and model were developed from a literature search, expert input and experience with the Center for Comparative Effectiveness Research in Cancer Genomics, a proof-of-concept platform for stakeholder involvement in priority setting and CER study design. RESULTS: Definitions for stakeholder and stakeholder engagement reflect the target constituencies and their role in CER. The 'analytic-deliberative' conceptual model for stakeholder engagement illustrates the inputs, methods and outputs relevant to CER. The model differentiates methods at each stage of the project; depicts the relationship between components; and identifies outcome measures for evaluation of the process. CONCLUSION: While the definitions and model require testing before being broadly adopted, they are an important foundational step and will be useful for investigators, funders and stakeholder groups interested in contributing to CER.
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              Patient and Stakeholder Engagement in the PCORI Pilot Projects: Description and Lessons Learned

              BACKGROUND Patients and healthcare stakeholders are increasingly becoming engaged in the planning and conduct of biomedical research. However, limited research characterizes this process or its impact. OBJECTIVE We aimed to characterize patient and stakeholder engagement in the 50 Pilot Projects funded by the Patient-Centered Outcomes Research Institute (PCORI), and identify early contributions and lessons learned. DESIGN A self-report instrument was completed by researchers between 6 and 12 months following project initiation. PARTICIPANTS Forty-seven principal investigators or their designees (94 % response rate) participated in the study. MAIN MEASURES Self-report of types of stakeholders engaged, stages and levels of engagement, facilitators and barriers to engagement, lessons learned, and contributions from engagement were measured. KEY RESULTS Most (83 %) reported engaging more than one stakeholder in their project. Among those, the most commonly reported groups were patients (90 %), clinicians (87 %), health system representatives (44 %), caregivers (41 %), and advocacy organizations (41 %). Stakeholders were commonly involved in topic solicitation, question development, study design, and data collection. Many projects engaged stakeholders in data analysis, results interpretation, and dissemination. Commonly reported contributions included changes to project methods, outcomes or goals; improvement of measurement tools; and interpretation of qualitative data. Investigators often identified communication and shared leadership strategies as “critically important” facilitators (53 and 44 % respectively); lack of stakeholder time was the most commonly reported challenge (46 %). Most challenges were only partially resolved. Early lessons learned included the importance of continuous and genuine partnerships, strategic selection of stakeholders, and accommodation of stakeholders’ practical needs. CONCLUSIONS PCORI Pilot Projects investigators report engaging a variety of stakeholders across many stages of research, with specific changes to their research attributed to engagement. This study identifies early lessons and barriers that should be addressed to facilitate engagement. While this research suggests potential impact of stakeholder engagement, systematic characterization and evaluation of engagement at multiple stages of research is needed to build the evidence base. Electronic supplementary material The online version of this article (doi:10.1007/s11606-015-3450-z) contains supplementary material, which is available to authorized users.
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                Author and article information

                Contributors
                Role: Operations Manager
                Role: Executive Director Patient Perspectives
                Role: Consultant
                Role: Executive Director
                Role: Head of Medical
                Role: Chief Executive
                Role: Futures Group Chair
                Role: Scientific Editorify@thesynergist.org
                Journal
                Health Expect
                Health Expect
                10.1111/(ISSN)1369-7625
                HEX
                Health Expectations : An International Journal of Public Participation in Health Care and Health Policy
                John Wiley and Sons Inc. (Hoboken )
                1369-6513
                1369-7625
                01 June 2018
                December 2018
                : 21
                : 6 ( doiID: 10.1111/hex.2018.21.issue-6 )
                : 1035-1045
                Affiliations
                [ 1 ] EURORDIS Rare Diseases Europe Paris France
                [ 2 ] Merck Sharp & Dohme Ltd Hoddesdon UK
                [ 3 ] Neil Bertelsen Consulting Berlin Germany
                [ 4 ] The Synergist Brussels Belgium
                [ 5 ] Amgen (Europe) GmbH Zug Switzerland
                [ 6 ] National Health Council Washington DC USA
                [ 7 ] European Patients’ Academy on Therapeutic Innovation Brussels Belgium
                Author notes
                [*] [* ] Correspondence

                Ify Sargeant, The Synergist, Brussels, Belgium.

                Email: ify@ 123456thesynergist.org

                Author information
                http://orcid.org/0000-0003-4779-4007
                Article
                HEX12797
                10.1111/hex.12797
                6250871
                29858529
                d58adffe-cab9-4427-a961-dab36eba0c5f
                © 2018 The Authors. Health Expectations published by John Wiley & Sons Ltd.

                This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

                History
                : 07 April 2018
                Page count
                Figures: 5, Tables: 2, Pages: 11, Words: 5951
                Categories
                Original Research Paper
                Original Research Papers
                Custom metadata
                2.0
                hex12797
                December 2018
                Converter:WILEY_ML3GV2_TO_NLMPMC version:version=5.5.3 mode:remove_FC converted:23.11.2018

                Health & Social care
                alignment of expectations in patient engagement,collaborative leadership patient engagement,expectations patient engagement,leadership patient engagement,stakeholder expectations patient engagement

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