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

Part of: Special Collection - Methods

Published online by Cambridge University Press:  08 May 2015

Marie-Pierre Gagnon ,
Marie Desmartis ,
Johanne Gagnon ,
Michèle St-Pierre ,
Marc Rhainds ,
Martin Coulombe ,
Mylène Dipankui Tantchou  and
France Légaré
Marie-Pierre Gagnon
Affiliation:
Université Laval & CHU de Québec Research Center marie-pierre.gagnon@fsi.ulaval.ca
Marie Desmartis
Affiliation:
CHU de Québec Research Center
Johanne Gagnon
Affiliation:
Université Laval, Faculty of Nursing Sciences
Michèle St-Pierre
Affiliation:
Université Laval, Department of Management
Marc Rhainds
Affiliation:
CHU de Québec
Martin Coulombe
Affiliation:
CHU de Québec
Mylène Dipankui Tantchou
Affiliation:
CHU de Québec Research Center
France Légaré
Affiliation:
Université Laval, Department of Family Medicine; CHU de Québec Research Center
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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.

Keywords

CanadaHealth technology assessmentHospital-based HTAUser involvementMental healthElderly careInterviews
Type
Methods
Information
International Journal of Technology Assessment in Health Care , Volume 31 , Issue 1-2 , 2015 , pp. 68 - 77
Copyright
Copyright © Cambridge University Press 2015 

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References

REFERENCES

1. Bridges, JF, Jones, C. Patient-based health technology assessment: A vision of the future. Int J Technol Assess Health Care. 2007;23:30–35.CrossRefGoogle ScholarPubMed
2. Coulter, A. Perspectives on health technology assessment: Response from the patient's perspective. Int J Technol Assess Health Care. 2004;20:92–96.Google Scholar
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;26:334–340.Google Scholar
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;23:9–16.CrossRefGoogle ScholarPubMed
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;27:31–42.Google Scholar
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;17:888–900.Google Scholar
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;70:1518–1526.Google Scholar
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;11:72–84.Google Scholar
9. Rowe, G, Frewer, LJ. A typology of public engagement mechanisms. Sci Technol Hum Values. 2005;30:251–90.Google Scholar
10. Tritter, JQ. Revolution or evolution: The challenges of conceptualizing patient and public involvement in a consumerist world. Health Expect. 2009;12:275–287.Google Scholar
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.CrossRefGoogle Scholar
12. NVivo 8. NVivo qualitative data analysis software; QSR International Pty Ltd, NVivo 8, 2008.Google Scholar
13. Huberman, AM, Miles, MB. Qualitative data analysis: An expanded sourcebook (2nd ed.). Thousand Oaks, CA: Sage Publications; 1994.Google Scholar
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;9:262–268.CrossRefGoogle Scholar
15. Entwistle, VA, Renfrew, MJ, Yearley, S, Forrester, J, Lamont, T. Lay perspectives: Advantages for health research. BMJ. 1998;316:463–466.Google Scholar
16. Shalowitz, DI, Garrett-Mayer, E, Wendler, D. The accuracy of surrogate decision makers: A systematic review. Arch Intern Med. 2006;166:493–497.Google Scholar
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.Google Scholar
18. Craig, GM. Involving users in developing health services. BMJ. 2008;336:286–287.Google Scholar
19. Fudge, N, Wolfe, CD, McKevitt, C. Assessing the promise of user involvement in health service development: Ethnographic study. BMJ. 2008;336:313–317.Google Scholar