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STAKEHOLDER INVOLVEMENT THROUGHOUT HEALTH TECHNOLOGY ASSESSMENT: AN EXAMPLE FROM PALLIATIVE CARE

Published online by Cambridge University Press:  04 September 2017

Louise Brereton
Affiliation:
ScHARR, University of Sheffield College of Social Sciences, University of Lincolnlbrereton@lincoln.ac.uk
Philip Wahlster
Affiliation:
Department of Health Services Research, University of Bremen Center for General Practice, Medical Faculty, Saarland University
Kati Mozygemba
Affiliation:
Department of Health Services Research, University of Bremen
Kristin Bakke Lysdahl
Affiliation:
Centre for Medical Ethics, University of Oslo Faculty of Health Sciences, Oslo and Akershus University College of Applied Sciences
Jake Burns
Affiliation:
Institute for Medical Informatics, Biometry and Epidemiology, LMU Munich
Stephanie Polus
Affiliation:
Institute for Medical Informatics, Biometry and Epidemiology, LMU Munich
Marcia Tummers
Affiliation:
Radboud Institute for Health Sciences, Department for Health Evidence, Radboud University, Medical Center
Pietro Refolo
Affiliation:
Institute of Bioethics and Medical Humanities, Università Cattolica del Sacro Cuore
Dario Sacchini
Affiliation:
Institute of Bioethics and Medical Humanities, Università Cattolica del Sacro Cuore
Wojciech Leppert
Affiliation:
Department of Palliative Medicine, Poznan University of Medical Sciences Quality of Life Research Department, Medical University of Gdansk
James Chilcott
Affiliation:
ScHARR, University of Sheffield
Christine Ingleton
Affiliation:
School of Nursing & Midwifery, University of Sheffield
Clare Gardiner
Affiliation:
School of Nursing & Midwifery, University of Sheffield
Elizabeth Goyder
Affiliation:
ScHARR, University of Sheffield

Abstract

Objectives: Internationally, funders require stakeholder involvement throughout health technology assessment (HTA). We report successes, challenges, and lessons learned from extensive stakeholder involvement throughout a palliative care case study that demonstrates new concepts and methods for HTA.

Methods: A 5-step “INTEGRATE-HTA Model” developed within the INTEGRATE-HTA project guided the case study. Using convenience or purposive sampling or directly / indirectly identifying and approaching individuals / groups, stakeholders participated in qualitative research or consultation meetings. During scoping, 132 stakeholders, aged ≥ 18 years in seven countries (England, Italy, Germany, The Netherlands, Norway, Lithuania, and Poland), highlighted key issues in palliative care that assisted identification of the intervention and comparator. Subsequently stakeholders in four countries participated in face–face, telephone and / or video Skype meetings to inform evidence collection and / or review assessment results. An applicability assessment to identify contextual and implementation barriers and enablers for the case study findings involved twelve professionals in the three countries. Finally, thirteen stakeholders participated in a mock decision-making meeting in England.

Results: Views about the best methods of stakeholder involvement vary internationally. Stakeholders make valuable contributions in all stages of HTA; assisting decision making about interventions, comparators, research questions; providing evidence and insights into findings, gap analyses and applicability assessments. Key challenges exist regarding inclusivity, time, and resource use.

Conclusion: Stakeholder involvement is feasible and worthwhile throughout HTA, sometimes providing unique insights. Various methods can be used to include stakeholders, although challenges exist. Recognition of stakeholder expertise and further guidance about stakeholder consultation methods is needed.

Type
Theme Submissions
Copyright
Copyright © Cambridge University Press 2017 

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