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混合方法评估公民健康倡导者关于医疗保健中财务利益冲突的研讨会。

Mixed methods evaluation of workshops for citizen health advocates about financial conflicts of interests in healthcare.

机构信息

Institute for Evidence-Based Healthcare, Bond University, Gold Coast, Queensland, Australia

Charles Perkins Centre and School of Pharmacy, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia.

出版信息

BMJ Open. 2020 May 10;10(5):e034195. doi: 10.1136/bmjopen-2019-034195.

Abstract

OBJECTIVES

To evaluate workshops delivered to citizen health advocates about financial conflicts of interest in healthcare, transparency databases which disclose industry payments in the USA and Australia and the pros and cons of advocacy groups accepting industry sponsorship.

DESIGN

Thematic analysis of workshop participant recorded discussions, and pre, post and 3-month follow-up questionnaires on confidence and knowledge about financial conflicts of interest, transparency databases and the merits of advocacy organisations accepting industry sponsorship.

PARTICIPANTS AND SETTING

48 citizen health advocates participated in a half-day workshop, held in four Australian cities, which ended with a 1-hour recorded discussion. Participants were recruited with assistance from leading state-based health advocacy organisations.

RESULTS

The thematic analysis of the recorded discussions revealed two major themes, (i) transparency and (ii) relationships with industry; and three minor themes: a lack of awareness about conflicts of interest and transparency, issues relating to trust and next steps in terms of potential reforms. In relation to transparency, participants felt strong support for transparency, strongly favouring the mandatory, extensive and accessible US Open Payments over the self-regulatory Australian model. Participants also noted that transparency had limitations, including the utility of disclosed information. In relation to industry sponsorship of advocacy groups, some participants expressed an openness to and support for accepting sponsorship, while many expressed a caution around potential downsides. Questionnaire results showed increases in both confidence and knowledge after the workshop, though only 23 of 48 participants returned the 3-month follow-up questionnaire.

CONCLUSIONS

Following a half-day workshop, citizen health advocates recruited by leading health advocacy organisations expressed strong support for tough transparency rules, and mixed feelings about advocacy groups accepting sponsorship from industry. Study limitations include a non-representative sample and a large drop-out at the 3-month post-workshop follow-up.

摘要

目的

评估向公民健康倡导者提供的关于医疗保健中财务利益冲突的培训课程、美国和澳大利亚披露行业支付情况的透明度数据库,以及倡导团体接受行业赞助的利弊。

设计

对工作坊参与者记录的讨论进行主题分析,并对信心和知识、财务利益冲突、透明度数据库和倡导组织接受行业赞助的优点进行会前、会后和 3 个月随访的问卷调查。

参与者和设置

48 名公民健康倡导者参加了在澳大利亚四个城市举行的为期半天的研讨会,研讨会结束时进行了 1 小时的录音讨论。参与者是在领先的州级健康倡导组织的协助下招募的。

结果

对记录讨论的主题分析揭示了两个主要主题,(i)透明度和(ii)与行业的关系;以及三个次要主题:对利益冲突和透明度缺乏认识、与信任相关的问题以及潜在改革方面的下一步措施。关于透明度,参与者强烈支持透明度,强烈赞成强制性、广泛和可访问的美国公开支付系统,而不是自我监管的澳大利亚模式。参与者还指出,透明度存在局限性,包括披露信息的效用。关于行业赞助倡导团体,一些参与者表示愿意并支持接受赞助,而许多人则对潜在的不利方面表示谨慎。问卷调查结果显示,参与者在研讨会后信心和知识均有所提高,但在 48 名参与者中只有 23 名返回了 3 个月随访问卷。

结论

在为期半天的研讨会之后,由领先的健康倡导组织招募的公民健康倡导者对严格的透明度规则表示强烈支持,对倡导团体接受行业赞助的态度喜忧参半。研究局限性包括代表性不足和 3 个月随访的参与者大量流失。

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