Skip to main content Accessibility help
×
Home

FRAMEWORK FOR USER INVOLVEMENT IN HEALTH TECHNOLOGY ASSESSMENT AT THE LOCAL LEVEL: VIEWS OF HEALTH MANAGERS, USER REPRESENTATIVES, AND CLINICIANS

  • Marie-Pierre Gagnon (a1), Marie Desmartis (a2), Johanne Gagnon (a3), Michèle St-Pierre (a4), Marc Rhainds (a5), Martin Coulombe (a5), Mylène Dipankui Tantchou (a2) and France Légaré (a6)...

Abstract

Objectives: The aim of this study was to explore stakeholders’ points of views regarding the applicability and relevance of a framework for user involvement in health technology assessment (HTA) at the local level. We tested this framework in the context of the assessment of alternative measures to restraint and seclusion among hospitalized adults and those living in long-term-care facilities.

Methods: Twenty stakeholders (health managers, user representatives, and clinicians) from seven regions of Quebec participated in a semi-structured interview. A thematic analysis of the transcribed interviews was performed.

Results: The findings highlighted the relevance and applicability of the framework to this specific HTA. According to interviewees, direct participation of users in the HTA process allows them to be part of the decision-making process. User consultation makes it possible to consider the views of a wide variety of people, such as marginalized and vulnerable groups, who do not necessarily meet the requirements for participating in HTA committees. However, some user representatives emphasized that user consultation should be integrated into a more holistic and participatory perspective. The most frequent barrier associated with user involvement in HTA was the top-down health system, which takes little account of the user's perspective.

Conclusions: The proposed framework was seen as a reference tool for making practitioners and health managers aware of the different mechanisms of user involvement in HTA and providing a structured way to classify and describe strategies. However, there is a need for more concrete instruments to guide practice and support decision making on specific strategies for user involvement in HTA at the local level.

Copyright

References

Hide All
1. Bridges, JF, Jones, C. Patient-based health technology assessment: A vision of the future. Int J Technol Assess Health Care. 2007;23:3035.
2. Coulter, A. Perspectives on health technology assessment: Response from the patient's perspective. Int J Technol Assess Health Care. 2004;20:9296.
3. Facey, K, Boivin, A, Gracia, J, et al. Patients’ perspectives in health technology assessment: A route to robust evidence and fair deliberation. Int J Technol Assess Health Care. 2010;26:334340.
4. Lehoux, P, Williams-Jones, B. Mapping the integration of social and ethical issues in health technology assessment. Int J Technol Assess Health Care. 2007;23:916.
5. Gagnon, MP, Desmartis, M, Lepage-Savary, D, et al. Introducing patients’ and the public's perspectives to health technology assessment: A systematic review of international experiences. Int J Technol Assess Health Care. 2011;27:3142.
6. Gagnon, MP, Desmartis, M, Gagnon, J, et al. Introducing the patient's perspective in hospital health technology assessment (HTA): The views of HTA producers, hospital managers and patients. Health Expect. 2014;17:888900.
7. Gauvin, FP, Abelson, J, Giacomini, M, Eyles, J, Lavis, JN. “It all depends”: Conceptualizing public involvement in the context of health technology assessment agencies. Soc Sci Med. 2010;70:15181526.
8. Oliver, SR, Rees, RW, Clarke-Jones, L, et al. A multidimensional conceptual framework for analysing public involvement in health services research. Health Expect. 2008;11:7284.
9. Rowe, G, Frewer, LJ. A typology of public engagement mechanisms. Sci Technol Hum Values. 2005;30:251–90.
10. Tritter, JQ. Revolution or evolution: The challenges of conceptualizing patient and public involvement in a consumerist world. Health Expect. 2009;12:275287.
11. Gagnon, MP, Gagnon, J, St-Pierre, M, et al. Involving patients in HTA activities at local level: A study protocol based on the collaboration between researchers and knowledge users. BMC Health Serv Res. 2012;12:14.
12. NVivo 8. NVivo qualitative data analysis software; QSR International Pty Ltd, NVivo 8, 2008.
13. Huberman, AM, Miles, MB. Qualitative data analysis: An expanded sourcebook (2nd ed.). Thousand Oaks, CA: Sage Publications; 1994.
14. Kelson, M, Akl, EA, Bastian, H, et al. Integrating values and consumer involvement in guidelines with the patient at the center: Article 8 in Integrating and coordinating efforts in COPD guideline development. An official ATS/ERS workshop report. Proc Am Thorac Soc. 2012;9:262268.
15. Entwistle, VA, Renfrew, MJ, Yearley, S, Forrester, J, Lamont, T. Lay perspectives: Advantages for health research. BMJ. 1998;316:463466.
16. Shalowitz, DI, Garrett-Mayer, E, Wendler, D. The accuracy of surrogate decision makers: A systematic review. Arch Intern Med. 2006;166:493497.
17. Nilsen, ES, Myrhaug, HT, Johansen, M, Oliver, S, Oxman, AD. Methods of consumer involvement in developing healthcare policy and research, clinical practice guidelines and patient information material. Cochrane Database Syst Rev. 2006:CD004563.
18. Craig, GM. Involving users in developing health services. BMJ. 2008;336:286287.
19. Fudge, N, Wolfe, CD, McKevitt, C. Assessing the promise of user involvement in health service development: Ethnographic study. BMJ. 2008;336:313317.

Keywords

Metrics

Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed