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患者参与对癌症治疗后护理交接中患者安全的影响:系统评价和荟萃分析方案。

The impact of patient engagement on patient safety in care transitions after cancer treatment: Protocol for a systematic review and meta-analysis.

机构信息

Institute for Patient Safety (IfPS), Medical Faculty, University Hospital Bonn, Bonn, Germany.

Center for Integrated Oncology (CIO), Medical Faculty, University Hospital Bonn, Bonn, Germany.

出版信息

PLoS One. 2024 Aug 27;19(8):e0307831. doi: 10.1371/journal.pone.0307831. eCollection 2024.

Abstract

BACKGROUND

Transitions of care after cancer treatment pose a major challenge for patient safety as adverse events and unplanned healthcare utilization occur frequently. At this point, patient and family engagement (PFE) is particularly valuable since patients and their families experience various challenges along this pathway, such as changing roles and recurrent needs to navigate across structural gaps between different services. However, there is currently a lack of evidence on the impact of PFE on patient safety in transitions after cancer treatment.

OBJECTIVE

To systematically review and synthesize evidence on effects of different PFE interventions on patient safety in the transition of care after cancer treatment.

METHODS

This protocol for a systematic review with meta-analysis follows PRISMA-P guidelines. A comprehensive database search will be conducted in MEDLINE, EMBASE, CENTRAL, CINAHL, and APA PsycInfo. Trial registries and grey literature will be searched, forward and backward citation tracking will be performed. Trials with prospective, longitudinal, interventional study designs will be included if they evaluate PFE interventions on patient safety outcomes (primary outcomes: healthcare utilization, patient harm, adherence, patient experience; secondary: quality of life, distress); eligible studies need to survey patients with any oncological disease during or after transition following cancer treatment. Results will be synthesized narratively and meta-analytically using a random-effects model. Risk of bias will be assessed using the Cochrane RoB-2 and revised JBI critical appraisal tool. The certainty of evidence will be judged according to the GRADE approach.

DISCUSSION

Robust evidence of effectiveness is needed to establish PFE interventions for patient safety in care transitions for oncological patients. This review will allow evidence-based conclusions about types and effects of different PFE interventions for transitional safety in oncology care and inform stakeholders in designing sustainable PFE activities.

TRIAL REGISTRATION

PROSPERO (CRD42024546938), OSF (doi.org/10.17605/OSF.IO/9XAMU).

摘要

背景

癌症治疗后的医疗过渡期对患者安全构成了重大挑战,因为不良事件和非计划的医疗保健利用经常发生。在这一点上,患者和家属的参与(PFE)特别有价值,因为患者及其家属在这条道路上会遇到各种挑战,例如角色的转变和经常需要在不同服务之间的结构性差距中进行导航。然而,目前缺乏关于 PFE 对癌症治疗后过渡期患者安全影响的证据。

目的

系统回顾和综合评价不同 PFE 干预措施对癌症治疗后过渡期患者安全的影响。

方法

本系统综述和荟萃分析的方案遵循 PRISMA-P 指南。将在 MEDLINE、EMBASE、CENTRAL、CINAHL 和 APA PsycInfo 中进行全面的数据库搜索。将搜索试验登记处和灰色文献,并进行正向和反向引文追踪。如果前瞻性、纵向、干预性研究设计的试验评估了 PFE 干预措施对患者安全结果(主要结果:医疗保健利用、患者伤害、依从性、患者体验;次要结果:生活质量、痛苦)的影响,则将其纳入研究。合格的研究需要在癌症治疗后或过渡期间调查患有任何肿瘤疾病的患者。结果将采用随机效应模型进行叙述性和荟萃分析综合。使用 Cochrane RoB-2 和修订后的 JBI 批判性评估工具评估偏倚风险。将根据 GRADE 方法判断证据的确定性。

讨论

需要有强有力的有效性证据来确定 PFE 干预措施在肿瘤患者的护理过渡期的患者安全方面的作用。本综述将使我们能够根据不同的 PFE 干预措施在肿瘤护理过渡安全性方面的类型和效果得出基于证据的结论,并为设计可持续的 PFE 活动为利益相关者提供信息。

试验注册

PROSPERO(CRD42024546938),OSF(doi.org/10.17605/OSF.IO/9XAMU)。

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