Department of Clinical Epidemiology and Medical Technology Assessment, Maastricht University Medical Centre, P.O. Box 5800, 6202 AZ, Maastricht, the Netherlands.
Implement Sci. 2013 Jun 10;8:64. doi: 10.1186/1748-5908-8-64.
Despite a strong movement towards active patient involvement in healthcare policy decisions, systematic and explicit consideration of evidence of this research on patient preferences seems limited. Furthermore, little is known about the opinions of several stakeholders towards consideration of research evidence on patient preferences in healthcare policy decisions. This paper describes the protocol for an explorative study on the integration of research on patient preferences in healthcare policy decisions. The study questions: to what extent research evidence on patient preferences is considered in current procedures for healthcare policy decisions; opinions of stakeholders regarding the integration of this type of evidence in healthcare policy decisions; and what could be a decision framework for the integration of such research evidence in healthcare policy decisions.
METHODS/DESIGN: The study is divided in three sub-studies, predominantly using qualitative methods. The first sub-study is a scoping review in five European countries to investigate whether and how results of research on patient preferences are considered in current procedures for coverage decisions and clinical practice guideline development. The second sub-study is a qualitative study to explore the opinions of stakeholders with regard to the possibilities for integrating evidence on patient preferences in the process of healthcare decision-making in the Netherlands. The third sub-study is the development of a decision framework for research on patient preferences. The framework will consist of: a process description regarding the place of evidence on patient preferences in the decision-making process; and a taxonomy describing different terminologies and conceptualisations of 'preferences' and an overview of existing methodologies for investigating preferences. The concept framework will be presented to and discussed with experts.
This study will create awareness regarding the existence and potential value of research evidence on patient preferences for healthcare policy decision-making and provides insight in the methods for investigating patient preferences and the barriers and facilitators for integration of such research in healthcare policy decisions. Results of the study will be useful for researchers, clinical practice guideline developers, healthcare policy makers, and patient representatives.
尽管人们强烈主张让患者积极参与医疗保健政策决策,但系统和明确地考虑此类关于患者偏好的研究证据似乎有限。此外,对于几个利益攸关方对考虑将患者偏好研究证据纳入医疗保健政策决策的意见,我们知之甚少。本文介绍了一项关于将患者偏好研究纳入医疗保健政策决策的探索性研究的方案。该研究提出以下问题:当前医疗保健政策决策程序在多大程度上考虑了患者偏好研究证据;利益攸关方对将此类证据纳入医疗保健政策决策的意见;以及如何为将此类研究证据纳入医疗保健政策决策制定一个决策框架。
方法/设计:该研究分为三个子研究,主要采用定性方法。第一个子研究是在五个欧洲国家进行的范围界定审查,以调查关于患者偏好的研究结果是否以及如何在当前的覆盖范围决策程序和临床实践指南制定中得到考虑。第二个子研究是一项定性研究,旨在探讨利益攸关方对在荷兰医疗保健决策过程中整合患者偏好证据的可能性的意见。第三个子研究是为研究患者偏好制定决策框架。该框架将包括:描述证据在决策过程中关于患者偏好的位置的过程说明;以及描述不同术语和“偏好”概念化的分类法,并概述现有的研究偏好方法。将向专家介绍并讨论概念框架。
这项研究将使人们意识到关于患者偏好的研究证据对医疗保健政策决策的存在和潜在价值,并深入了解调查患者偏好的方法以及将此类研究纳入医疗保健政策决策的障碍和促进因素。研究结果将对研究人员、临床实践指南制定者、医疗保健政策制定者和患者代表有用。