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患者参与基层医疗会诊中共同决策系统评价的过程及影响

Process and impact of patient involvement in a systematic review of shared decision making in primary care consultations.

作者信息

Hyde Catherine, Dunn Kate M, Higginbottom Adele, Chew-Graham Carolyn A

机构信息

Research Institute for Primary Care & Health Sciences, Keele University, Keele, UK.

West Midlands Collaboration for Leadership in Applied Health Research and Care (CLAHRC), UK.

出版信息

Health Expect. 2017 Apr;20(2):298-308. doi: 10.1111/hex.12458. Epub 2016 May 12.

Abstract

BACKGROUND

Patient and public involvement and engagement (PPIE) in systematic reviews remains uncommon, despite the policy imperative for patient involvement in research. The aim of this study was to investigate the process and impact of collaborating with members of a patient Research User Group (RUG) on a systematic review about shared decision making around prescribing analgesia in primary care consultations.

METHODS

Five members of an established patient RUG collaborated with researchers undertaking a systematic review with narrative synthesis, through workshops held at three time-points. These addressed the following: designing the protocol, interpreting the results and planning dissemination. Support from a RUG coordinator and user support worker facilitated collaboration throughout the review process. Researchers reflected on how PPIE modified the review at each time-point.

RESULTS

RUG members identified factors important in shared decision making around analgesic prescribing additional to those initially proposed by the research team. Search terms and specific outcomes of interest were amended to reflect these additional factors. Thirty of the 39 patient-identified factors were absent in the published literature. The categories of factors identified were used as a framework for the narrative synthesis and for reporting results. RUG members prioritized options for disseminating the results.

CONCLUSION

PPIE collaboration throughout the systematic review impacted on the scope of the review, highlighting gaps in the literature that were important to patients. Impact on interpretation and dissemination of findings ensured the review directly reflected patient priorities. Challenges and strategies to facilitate PPIE involvement in systematic reviews and suggestions for future researchers are highlighted.

摘要

背景

尽管政策要求患者参与研究,但患者和公众参与及介入(PPIE)系统评价的情况仍不常见。本研究的目的是调查与患者研究用户组(RUG)成员合作开展一项关于基层医疗咨询中镇痛处方共享决策的系统评价的过程及影响。

方法

一个成熟的患者RUG的五名成员通过在三个时间点举办的研讨会,与进行叙事性综述的系统评价的研究人员合作。这些研讨会涉及以下方面:设计方案、解读结果和规划传播。RUG协调员和用户支持人员的支持促进了整个评价过程中的合作。研究人员反思了PPIE在每个时间点如何修改评价。

结果

RUG成员确定了在镇痛处方共享决策中除研究团队最初提出的因素之外的重要因素。检索词和感兴趣的具体结果被修改以反映这些额外因素。已发表文献中未出现39个由患者确定的因素中的30个。所确定的因素类别被用作叙事性综述和报告结果的框架。RUG成员对结果传播的选项进行了优先排序。

结论

在整个系统评价过程中的PPIE合作影响了评价的范围,突出了文献中对患者重要的空白。对结果解读和传播的影响确保了评价直接反映患者的优先事项。强调了促进PPIE参与系统评价的挑战和策略以及对未来研究人员的建议。

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