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参与者采用一种新的在线改良德尔菲法让患者和护理人员参与制定临床指南的体验。

Participant experiences with a new online modified-Delphi approach for engaging patients and caregivers in developing clinical guidelines.

作者信息

Armstrong Courtney, Grant Sean, Kinnett Kathi, Denger Brian, Martin Ann, Coulter Ian, Booth Marika, Khodyakov Dmitry

机构信息

Policy Analyst, RAND Health Care, RAND Corporation, San Francisco, CA, USA.

Assistant Professor, Department of Social & Behavioral Sciences, Indiana University Richard M. Fairbanks School of Public Health, Indianapolis, IN, USA; Adjunct Behavioral/Social Scientist, RAND Health Care, RAND Corporation, Santa Monica, CA, USA.

出版信息

Eur J Pers Cent Healthc. 2019;7(3):476-489.

Abstract

BACKGROUND

Patient engagement in clinical practice guideline (CPG) development has increased significantly in recent years. However, only a few patients and caregivers join CPG development groups.

OBJECTIVE

To describe participant experiences with a novel online, scalable approach for patient and caregiver engagement in CPG development.

DESIGN

We developed and tested the RAND/PPMD Patient-Centeredness Method (RPM), a novel online modified-Delphi approach to patient engagement in CPG development that consists of an optional idea generation round and two rating rounds interspersed with an online discussion round.

SETTING AND PARTICIPANTS

Using the online ExpertLens™ system, we ran 2 concurrent panels of patients and caregivers of individuals with Duchenne Muscular Dystrophy (DMD).

MAIN OUTCOME MEASURES

We surveyed all 95 panel participants about their participation and satisfaction with the process. We also conducted telephone interviews with 25 participants.

RESULTS

Participants expressed satisfaction with various ExpertLens™ features, noting that the system fostered lively interaction among them. Panelists also appreciated participating in an educational, interactive and convenient discussion forum that allowed them to share their opinions on the importance and acceptability of different recommendations. The RPM was viewed as empowering by patients and their caregivers who felt it would be useful for CPG developers.

DISCUSSION AND CONCLUSION

The results of our study show the overall participant satisfaction with a novel, scalable, online approach to engaging patients and caregivers in CPG development, which allows them to share their perspectives and lived experiences using a rigorous, systematic and iterative way that is similar to how clinicians provide their input.

摘要

背景

近年来,患者参与临床实践指南(CPG)制定的情况显著增加。然而,只有少数患者和照护者加入CPG制定小组。

目的

描述患者和照护者参与CPG制定的一种新型在线可扩展方法的参与者体验。

设计

我们开发并测试了兰德/PPMD以患者为中心的方法(RPM),这是一种用于患者参与CPG制定的新型在线改良德尔菲法,包括一轮可选的想法生成环节以及两轮评分环节,中间穿插一轮在线讨论环节。

背景与参与者

我们使用在线ExpertLens™系统,同时开展了两个由杜氏肌营养不良症(DMD)患者的患者和照护者组成的小组。

主要结局指标

我们调查了所有95名小组成员对参与过程的参与度和满意度。我们还对25名参与者进行了电话访谈。

结果

参与者对ExpertLens™的各种功能表示满意,指出该系统促进了他们之间的活跃互动。小组成员也很感激能参与一个有教育意义、互动性强且方便的讨论论坛,这个论坛让他们能够就不同建议的重要性和可接受性发表意见。患者及其照护者认为RPM具有赋权作用,觉得它对CPG开发者会很有用。

讨论与结论

我们的研究结果表明,总体而言,参与者对一种让患者和照护者参与CPG制定的新型、可扩展在线方法感到满意,这种方法使他们能够以一种严谨、系统且迭代的方式分享自己的观点和生活经历,类似于临床医生提供意见的方式。

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