Bradley Meaghan, Braverman Julia, Harrington Magdalena, Wicks Paul
PatientsLikeMe, Inc., 160 Second St., Cambridge, MA 02142 USA.
Res Involv Engagem. 2016 Dec 9;2:33. doi: 10.1186/s40900-016-0047-6. eCollection 2016.
PLM is an online platform that provides tools for individuals to track their health and connect with other patients and while PLM has invited patients to participate in various research projects throughout the years, an examination into what motivates patients to to get involved in clinical research has not been done. During our analysis of applications submitted by members of the PLM community, we looked for reasons patients want to participate in research and their overall beliefs about clinical research, in general. In addition, we analyzed obstacles and barriers toward patients' research participation. We observed the following:Patients are typically motivated by their individual needs and are most interested in research specific to their own condition.To get the most from patients' involvement and to enhance patients' contribution towards research goals, researchers should explain the research goal and requirements of each goal in clear and transparent terms, making it easy for patients to understand, thus avoiding any potential miscommunication.Future studies are needed to determine the best methods for involving patients in clinical research.
Historically, throughout the clinical and medical research arenas, patients have been perceived as passive "subjects" rather than as individuals who may have thoughts regarding research development, research plans, implementation of research studies, and data analysis. However, it is becoming more clear that patients increasingly want to have a more active role in clinical research studies and in the management of their own medical conditions as evidenced by a "no decision about us without us" stance, meaning patients want to make informed decisions about their health while working alongside their healthcare professionals. The central aim of this research study was to determine patients' motivations for being involved in research design and understand their perceptions of current research practices.
Two independent qualitative studies were conducted. In Study 1, we analyzed applications submitted by self-identified patients from within the PatientsLikeMe (PLM) community, for acceptance onto our advisory panel. The advisory panel was tasked with developing a best practice guide for how to involve patients in research. During the qualitative analysis, we identified major reasons for and topics of interest associated with PLM members' motivation to apply to the advisory panel. In Study 2, we analyzed applications from PLM community members and from patients outside the PLM community for a patient-led patient-reported-outcome (PRO) development project. Similar to Study 1, we identified themes associated with patients' motivations to participate in developing a new PRO.
PLM members are interested in being involved in medical research for various reasons, including facilitating provider-patient communication, improving comprehension of medical information, understanding their disease, and bringing a more individualized approach to health care in general.
Challenges in the process of appropriate involvement of patients in research are discussed. In both studies, the applicants shared their interests in being involved in research. However, in Study 2, many of the patients shared ideas that were not appropriate for the development of a PRO, which indicated limitations in how the invitation and application explained the project to patients. Future studies should contribute to determining the most appropriate method for involving patients in various settings.
PatientsLikeMe(PLM)是一个在线平台,为个人提供跟踪自身健康状况以及与其他患者建立联系的工具。多年来,PLM邀请患者参与各种研究项目,但尚未对促使患者参与临床研究的动机进行调查。在我们分析PLM社区成员提交的申请时,我们探寻了患者想要参与研究的原因以及他们对临床研究的总体看法。此外,我们分析了患者参与研究的障碍。我们观察到以下情况:患者通常受自身需求驱动,对针对自身病情的研究最感兴趣。为了充分利用患者的参与并增强患者对研究目标的贡献,研究人员应以清晰、透明的方式解释每个研究目标及其要求,使患者易于理解,从而避免任何潜在的误解。未来需要开展研究以确定让患者参与临床研究的最佳方法。
从历史上看,在整个临床和医学研究领域,患者一直被视为被动的“受试者”,而非可能对研究发展、研究计划、研究实施和数据分析有想法的个体。然而,越来越明显的是,患者越来越希望在临床研究以及自身医疗状况的管理中发挥更积极的作用,“没有我们的参与就没有关于我们的决策”这一立场就证明了这一点,即患者希望在与医疗保健专业人员合作的同时,对自己的健康做出明智的决策。本研究的核心目的是确定患者参与研究设计的动机,并了解他们对当前研究实践的看法。
进行了两项独立的定性研究。在研究1中,我们分析了PatientsLikeMe(PLM)社区中自我认定的患者提交的加入我们咨询小组的申请。该咨询小组的任务是制定一份关于如何让患者参与研究的最佳实践指南。在定性分析过程中,我们确定了与PLM成员申请加入咨询小组的动机相关的主要原因和感兴趣的话题。在研究2中,我们分析了PLM社区成员以及PLM社区之外的患者提交的参与一个由患者主导的患者报告结局(PRO)开发项目的申请。与研究1类似,我们确定了与患者参与开发新PRO的动机相关的主题。
PLM成员出于各种原因对参与医学研究感兴趣,包括促进医患沟通、提高对医学信息的理解、了解自己的疾病以及总体上为医疗保健带来更个性化的方法。
讨论了患者适当参与研究过程中的挑战。在两项研究中,申请人都分享了他们参与研究的兴趣。然而,在研究2中,许多患者分享的想法并不适合PRO的开发,这表明邀请和申请向患者解释项目的方式存在局限性。未来的研究应有助于确定在各种情况下让患者参与的最合适方法。