Hostname: page-component-78c5997874-4rdpn Total loading time: 0 Render date: 2024-11-04T11:37:42.948Z Has data issue: false hasContentIssue false

Toward a Strategy to Involve Patients in Health Technology Assessment in Spain

Published online by Cambridge University Press:  14 March 2019

Ana Toledo-Chávarri*
Affiliation:
Fundación Canaria de Investigación Sanitaria (FUNCANIS) Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC) Instituto de Tecnologías Biomédicas (ITB), Universidad de La Laguna
Yolanda Alvarez-Perez
Affiliation:
Fundación Canaria de Investigación Sanitaria (FUNCANIS)
Yolanda Triñanes
Affiliation:
Unidad de Asesoramiento científico-técnico (Avalia-t); Axencia de Coñecemento en Saúde (ACIS), Servizo Galego de Saúde
Lilisbeth Perestelo-Pérez
Affiliation:
Servicio de Evaluación del Servicio Canario de la Salud (SESCS)
Mireia Espallargues
Affiliation:
Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC) Agència de Qualitat i Avaluació Sanitàries de Catalunya (AQuAS)
Matilde Palma
Affiliation:
Instituto de Salud Carlos III (ISCIII)
Pedro Serrano-Aguilar
Affiliation:
Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC) Servicio de Evaluación del Servicio Canario de la Salud (SESCS)
*
Author for correspondence: Ana Toledo-Chávarri, E-mail: anatoledochavarri@sescs.es

Abstract

Objectives

The aim of this study was to develop a feasible and effective strategy to involve patients in the Spanish Network of Agencies of Health Technology Assessment (RedETS).

Methods

The framework for patient involvement (PI) in the assessment activities and processes of RedETS were developed through a research project that included: (i) a systematic search of the international literature describing a strategy and/or a methodology linking health technology assessment (HTA) and PI; (ii) a qualitative study through interviews with RedETS members to analyze the perceptions of PI among HTA managers in the Spanish context; (iii) a Delphi consultation with three large platforms of patients, carers and consumer organizations in Spain about their perspectives of PI; (iv) a consensus process with the members of the RedETS Governing Council to define the final strategy.

Results

Three main themes were identified in the literature and Web site review: (i) PI methods for the different HTA phases; (ii) Participant definition and selection; (iii) Resources needed. A three-step implementation strategy was proposed: (i) short-term actions: piloting and testing patient participation in HTA and building patients' capacity; (ii) medium-term actions: broadening the participation of patients, and building internal capacity; (iii) long-term actions: consolidating and mainstreaming patient involvement

Conclusions

Patient participation can be incorporated into almost all the HTA phases and products with greater or lesser degrees of difficulty. However, a progressive implementation strategy is suggested for a feasible PI process.

Type
Method
Copyright
Copyright © Cambridge University Press 2019 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.Morrison, C, Dearden, A (2013) Beyond tokenistic participation: Using representational artefacts to enable meaningful public participation in health service design. Health Policy 112, 179186.10.1016/j.healthpol.2013.05.008Google Scholar
2.European Patients’ Forum (2015) Involvement in health technology assessment in Europe. Results of the EPF Survey. http://www.eu-patient.eu/globalassets/projects/hta/hta-epf-final-report2013.pdf.Google Scholar
3.OHTAC Public Engagement Subcommittee (2015) Public Engagement for Health Technology Assessment at Health Quality Ontario—Final Report From the Ontario Health Technology Advisory Committee Public Engagement Subcommittee. https://www.researchgate.net/publication/275890037_Public_Engagement_for_Health_Technology_Assessment_at_Health_Quality_Ontario-Final_Report_From_the_Ontario_Health_Technology_Advisory_Committee_Public_Engagement_Subcommittee.Google Scholar
4.Facey, K, Stafinski, T (2015) HTAi Interest Sub-Group for Patient/Citizen Involvement in HTA. In: G-I-N PUBLIC Toolkit Beyond Guidelines. G-I-N Public Working Group. https://www.g-i-n.net/working-groups/gin-public/toolkit (accessed February 16, 2019).Google Scholar
5.Ley 16/2003, de 28 de mayo, de Cohesión y Calidad del Sistema Nacional de Salud. BOE núm. 128, de 29 de mayo de 2003. Referencia: BOE-A-2003-10715. https://www.boe.es/buscar/act.php?id=BOE-A-2003-10715 (accessed February 17, 2019).Google Scholar
6.Ley 33/2011, de 4 de octubre, General de Salud Pública Jefatura del Estado «BOE» núm. 240, de 5 de octubre de 2011 Referencia: BOE-A-2011-15623. https://www.boe.es/eli/es/l/2011/10/04/33/con (accessed February 16, 2019).Google Scholar
7.Caron-Flinterman, JF, Broerse, JEW, Bunders, JFG (2007). Patient partnership in decision-making on biomedical research. Sci Technol Hum Values 32, 339368.10.1177/0162243906298354Google Scholar
8.Grupo de trabajo de implicación de pacientes en el desarrollo de GPC (2010) Implicación de Pacientes en el Desarrollo de Guías de Práctica Clínica: Manual Metodológico. Ministerio de Sanidad, Servicios Sociales e Igualdad. Instituto Aragonés de Ciencias de la Salud-IACS. Guías de Práctica Clínica en el SNS: IACS No 2010/01.Google Scholar
9.Perestelo-Pérez, L, Salcedo-Fernández, F, Toledo-Chávarri, A, et al. (2017) Desarrollo de herramientas de ayuda para la toma de decisiones compartida derivadas de las recomendaciones de las guías de práctica clínica. Ministerio de Sanidad, Servicios Sociales e Igualdad. Servicio de Evaluación del Servicio Canario de la Salud. Informes de Evaluación de Tecnologías Sanitarias.Google Scholar
10.Hermosilla-Gago, T, Grupo de Expertos de las Agencias de Evaluación de Tecnologías Sanitarias de España (2011) Manual para adaptar informes de evaluación de tecnologías sanitarias a los ciudadanos (MADETSCI). Sevilla: Agencia de Evaluación de Tecnologías Sanitarias de Andalucía. Consejería de Salud. Junta de Andalucía y Ministerio de Sanidad y Consumo.Google Scholar
11.Rodríguez, M, Espallargues, M (2014) Incorporación de pacientes, cuidadores y población en general en la evaluación de tecnologías sanitarias (ETS): experiencias de agencias y unidades de ETS en España. Barcelona: Agència de Qualitat i Avaluació Sanitàries de Catalunya.Google Scholar
12.Braun, V, Clarke, V (2006) Using thematic analysis in psychology. Qual Res Psychol 3, 77101.10.1191/1478088706qp063oaGoogle Scholar
13.Thomas, J, Harden, A (2008) Methods for the thematic synthesis of qualitative research in systematic reviews. BMC Med Res Methodol 8, 45.10.1186/1471-2288-8-45Google Scholar
14.Gauvin, F-P, Abelson, J, Giacomini, M, Eyles, J, Lavis, JN (2011) Moving cautiously: Public involvement and the health technology assessment community. Int J Technol Assess Health Care 27, 4349.10.1017/S0266462310001200Google Scholar
15.Menon, D (2011) Role of patient and public participation in health technology assessment and coverage decisions. Expert Rev Pharmacoeconomics Outcomes Res 11, 7589.10.1586/erp.10.82Google Scholar
16.Lopes, E, Carter, D, Street, J (2015) Power relations and contrasting conceptions of evidence in patient-involvement processes used to inform health funding decisions in Australia. Soc Sci Med 135, 8491.Google Scholar
17.Boivin, A, Green, J, van der Meulen, J, Légaré, F, Nolte, E (2009) Why consider patients’ preferences? A discourse analysis of clinical practice guideline developers. Med Care 47, 908915.10.1097/MLR.0b013e3181a81158Google Scholar
18.Wortley, S, Tong, A, Howard, K (2016) Preferences for engagement in health technology assessment decision-making: a nominal group technique with members of the public. BMJ Open 6, e010265.Google Scholar
19.Martin, GP (2008) ‘Ordinary people only’: Knowledge, representativeness, and the publics of public participation in healthcare. Sociol Health Illn 30, 3554.10.1111/j.1467-9566.2007.01027.xGoogle Scholar
20.Gauvin, F-P, Abelson, J, Lavis, JN (2014) Evidence Brief: Strengthening Public and Patient Engagement in Health Technology Assessment in Ontario. Hamilton, Canada: McMaster Health Forum.Google Scholar
21.Moran, R, Davidson, P (2011) An uneven spread: a review of public involvement in the National Institute of Health Research's Health Technology Assessment program. Int J Technol Assess Health Care 27, 343347.10.1017/S0266462311000559Google Scholar
22.Staniszewska, S, Brett, J, Mockford, C, Barber, R (2011) The GRIPP checklist: Strengthening the quality of patient and public involvement reporting in research. Int J Technol Assess Health Care 27, 391399.10.1017/S0266462311000481Google Scholar
23.Weeks, L, Polisena, J, Scott, AM, Holtorf, A-P, Staniszewska, S, Facey, K (2017) Evaluation of patient and public involvement initiatives in health technology assessment: A survey of international agencies. Int J Technol Assess Health Care 33, 715723.10.1017/S0266462317000976Google Scholar
24.Abelson, J, Wagner, F, DeJean, D, et al. (2016) Public and patient involvement in health technology assessment: a framework for action. Int J Technol Assess Health Care 32, 256264.10.1017/S0266462316000362Google Scholar
25.Mamzer, M-F, Dubois, S, Saout, C, et al. (2018) How to strengthen the presence of patients in health technology assessments conducted by the health authorities. Therapie 73, 95105.10.1016/j.therap.2017.11.004Google Scholar
26.Facey, K, Hansen, H, Single, A (2017) Patient Involvement in Health Technology Assesment. Singapore: Adis.10.1007/978-981-10-4068-9Google Scholar
27.Toledo-Chávarri, A, Perestelo-Pérez, L, Álvarez-Pérez, Y, et al. (2018) Participación de los pacientes en la Evaluación de Tecnologías Sanitarias: manual metodológico. Ministerio de Sanidad, Servicios Sociales e Igualdad. Servicio de Evaluación del Servicio Canario de la Salud, Informes de Evaluación de Tecnologías Sanitarias.Google Scholar
Supplementary material: File

Toledo-Chávarri et al. supplementary material

Toledo-Chávarri et al. supplementary material 1

Download Toledo-Chávarri et al. supplementary material(File)
File 62.8 KB