Health Technology and Policy Unit, School of Public Health, University of Alberta, Edmonton, AB, Canada.
School of Public Health, University of Adelaide, Adelaide, SA, Australia.
Patient. 2018 Jun;11(3):353-359. doi: 10.1007/s40271-017-0293-1.
Patient involvement is increasingly recognized as critical to the development, introduction and use (i.e. the lifecycle) of new and effective therapies, particularly those for rare diseases, where natural histories and the impact on patients and families are less well-understood than for common diseases. However, little is known about how patients and families would like to be involved during the lifecycle.
The aim of this study was to explore ways in which Canadian patients with rare diseases and their families would like to be involved in the lifecycle of therapies and identify their priorities for involvement.
Patients with rare diseases and their families were recruited to participate in two deliberative sessions, during which concepts related to decision-making uncertainty and the technology lifecycle were introduced before eliciting input around ways in which they could be involved. This was followed by a webinar, which was used to further identify opportunities for involvement. The data were then analyzed qualitatively using eclectic coding.
Patients and families identified opportunities that fell into three goals: (1) incorporation of their 'lived experience' in coverage decision making (i.e. decisions by governments on funding new therapies); (2) improved care for patients; and (3) greater awareness of rare diseases, with the first being a priority.
Opportunities for patients and families to contribute their 'lived experience' are needed throughout the orphan drug lifecycle, but the ideal mechanisms for providing this input have yet to be determined.
患者参与越来越被认为是新疗法和有效疗法(即生命周期)开发、引入和使用的关键,特别是对于罕见病而言,其自然病史以及对患者和家庭的影响不如常见病那样被充分了解。然而,对于患者和家庭在生命周期中希望如何参与,我们知之甚少。
本研究旨在探讨加拿大罕见病患者及其家属希望在治疗方法生命周期中参与的方式,并确定他们参与的优先事项。
招募了患有罕见病的患者及其家属参加了两次审议会议,在这些会议中,先介绍了与决策不确定性和技术生命周期相关的概念,然后征求他们在参与方面的意见。之后,举行了一次网络研讨会,用于进一步确定参与的机会。然后,使用折衷编码对数据进行定性分析。
患者和家属确定了三个目标的机会:(1)将他们的“生活经验”纳入覆盖范围决策制定(即政府对新疗法的资助决策);(2)改善患者护理;(3)提高对罕见病的认识,其中第一个是优先事项。
需要在孤儿药生命周期的各个阶段为患者和家属提供贡献其“生活经验”的机会,但提供这种投入的理想机制仍有待确定。