scholarly journals Co-creation of practical “how-to guides” for patient engagement in key phases of medicines development—from theory to implementation

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
David Feldman ◽  
Paola Kruger ◽  
Laure Delbecque ◽  
Ashley Duenas ◽  
Oana Bernard-Poenaru ◽  
...  

Abstract Background The effective impact of patient engagement (PE) across the medicines development continuum is widely acknowledged across diverse health stakeholder groups, including health authorities; however, the practical applications of how to implement meaningful and consistent PE are not always addressed. Guidance for the practical implementation of PE requires granularity, and the need for such guidance has been identified as a priority. We describe the co-production and summarize the content of how-to guides that focus on PE in the early stages of medicines development. Methods Multi-stakeholder working groups (WGs) were established by Patient Focused Medicines Development (PFMD) for how-to guide development. How-to guides were co-produced with patients for PE activities identified as priorities through public consultation and by WGs. Guides were developed by applying PE quality guidance and associated quality criteria in an iterative process. How-to guides underwent internal review and validation by experts (ie, those with relevant experience in the particular PE activity or focus area) in specific focus groups and external review and validation through appropriate events and public consultation. Results Overall, 103 individual contributors from 38 organizations (representing eight stakeholder groups, including patients/patient organizations) and from 14 countries were organized into WGs and workstreams. Each WG comprised 15–30 contributors with PE experience relevant to the specific how-to guide. How-to guides were developed for PE in the early discovery and preclinical phases; PE in the development of a clinical outcomes assessment strategy; and PE in clinical trial protocol design. The how-to guides have a standardized format and structure to promote user familiarity. They provide detailed guidance and examples that are relevant to the individual PE activity and aim to facilitate the practical implementation of PE. Conclusions The how-to guides form a comprehensive series of actionable and stepwise resources that build from and integrate the PE quality criteria across the medicines continuum. They will be made freely available through PFMD’s Patient Engagement Management Suite (pemsuite.org) and shared widely to a variety of audiences in different settings, ensuring access to diverse patient populations. Implementation of these guides should advance the field of PE in bringing new medicines to the market and ultimately will benefit patients. Plain English summary Medicines are developed to help patients improve their health and lives. Many organizations and individuals want to ensure that medicines are developed to meet real patient needs and to address what is most important to patients. Finding out what patients need and what patients want requires good patient engagement, but knowing how to do patient engagement is not always clear. This is because medicines development is complicated, and a lot of different steps, people, and organizations are involved. Patient Focused Medicines Development (PFMD) was established in 2015 to connect individuals and organizations that are committed to making medicines not just for patients but with patients. To do this, PFMD brought together patients and other groups of people with relevant experience and good ideas on how to achieve patient engagement in the real-world setting. Together, PFMD has developed “how-to guides” for patient engagement that cover the main activities along the medicines development process. The guides are free to use and provide practical advice and examples that anyone can use in their patient engagement activities. The how-to guides will also help patients to understand medicines development and how best they can participate in this process to address their needs.

2019 ◽  
Vol 5 (1) ◽  
pp. 43-55 ◽  
Author(s):  
Katherine Deane ◽  
Laure Delbecque ◽  
Oleksandr Gorbenko ◽  
Anne Marie Hamoir ◽  
Anton Hoos ◽  
...  

IntroductionMeaningful patient engagement (PE) can enhance medicines’ development. However, the current PE landscape is fragmentary and lacking comprehensive guidance.MethodsWe systematically searched for PE initiatives (SYNaPsE database/publications). Multistakeholder groups integrated these with their own PE expertise to co-create draft PE Quality Guidance which was evaluated by public consultation. Projects exemplifying good PE practice were identified and assessed against PE Quality Criteria to create a Book of Good Practices (BOGP).ResultsSeventy-six participants from 51 organisations participated in nine multistakeholder meetings (2016–2018). A shortlist of 20relevant PE initiatives (from 170 screened) were identified. The co-created INVOLVE guidelines provided the main framework for PE Quality Guidance and was enriched with the analysis of the PE initiatives and the PE expertise of stakeholders. Seven key PE Quality Criteria were identified. Public consultation yielded 67 responses from diverse backgrounds. The PE Quality Guidance was agreed to be useful for achieving quality PE in practice, understandable, easy to use, and comprehensive. Overall, eight initiatives from the shortlist and from meeting participants were selected for inclusion in the BOGP based on demonstration of PE Quality Criteria and willingness of initiative owners to collaborate.DiscussionThe PE Quality Guidance and BOGP are practical resources which will be continually updated in response to user feedback. They are not prescriptive, but rather based on core principles, which can be applied according to the unique needs of each interaction and initiative. Implementation of the guidance will facilitate improved and systematic PE across the medicines’ development lifecycle.


2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
S Houwaart

Abstract End-user (e.g. patients or the public) testing of information material is becoming more common in the German public health care system. However, including the end-user (in this case patients) in an optimisation process and thus enabling a close collaboration while developing PIMs is still rare. This is surprising, given the fact that patients provide the exact perspective one is trying to address. Within the isPO project, a patient organization is included as a legal project partner to act as the patient representative and provide the patient's perspective. As such, the patient organization was included in the PHR approach as part of the PIM-optimisation team. During the optimisation process, the patients gave practical insights into the procedures of diagnosing and treating different types of cancer as well as into the patient's changing priorities and challenges at different time points. This was crucial information for the envisioned application of the individual PIMs and their hierarchical overview. Moreover, the developed PIM-checklist enabled the patients to give detailed feedback to the PIMs. With their experience of being in the exact situation in which the PIMs will be applied, their recommendations, especially on the wording and layout of the materials, have been a valuable contribution to the PIM optimisation process. In this part of the seminar, we will take a closer look at the following skill building aspects: What is gained from including patients as end-users in the development and optimization of PIM?How can we reach patients to contribute to a PIM optimization process? Which requirements and prerequisites do patients have to provide to successfully work on an optimisation team?How to compromise and weigh opinions when different ideas occur? Altogether, this part will construct a structured path of productive patient involvement and help to overcome uncertainties regarding a collaboration with patient organizations.


2017 ◽  
Vol 33 (S1) ◽  
pp. 224-225
Author(s):  
Elisabeth Oehrlein ◽  
Jason Harris ◽  
Nicole Labkoff ◽  
Eleanor Perfetto ◽  
Manal Ziadeh ◽  
...  

INTRODUCTION:Understanding the current landscape of patient engagement across value decision-making bodies internationally is a critical first step toward improving the patient centricity of Health Technology Assessment (HTA). This study assessed: (i) Terms and definitions used; (ii) Patient engagement opportunities; (iii) Evidence of patient engagement.METHODS:A sample of country-specific HTA's (HTA; n = 6), professional organizations (PO; n = 4), and collaborations/independent organizations (CO; n = 3) was selected for representativeness. Information was gathered through: (i) targeted web search and (ii) emailing organizations directly. Definitions, HTA methods documents, and the three most recent evaluations were identified, abstracted, and compared. Data were collected between September-October 2016.RESULTS:Numerous terms are used to describe patient engagement: patient input (HTA = 1, PO = 1), patient-group submitted information (HTA = 1), cooperation with patients/users (HTA = 1), public consultation (HTA = 1), patient perspectives (HTA = 1, PO = 1), involvement of people affected (HTA = 1), patient involvement (HTA = 2), patient and public involvement (HTA = 1), lay involvement (HTA = 1), inclusion of patient representative (PO = 3), patient reports (PO = 1), patient preference (PO = 2), public consultation (CO = 1), stakeholder consultation (CO = 1), open input (CO = 1), stakeholder engagement (CO = 1), and patient participation (CO = 1). Opportunities for patient engagement were described as: patient questionnaire (HTA = 2); comment period (HTA = 1; CO = 1); committee participation (HTA = 3; PO = 3); propose topics (HTA = 1); draft guidance (HTA = 1); general stakeholder forum (CO = 1). While organizations outline opportunities for patient engagement, not all organizations have clear evidence the practices are used or have impact. Recent evaluations demonstrate clear evidence of engagement (HTA = 2); Unclear or mixed evidence (HTA = 1; PO = 1; CO = 2); No evidence (HTA = 3; PO = 3; CO = 1).CONCLUSIONS:There is substantial heterogeneity in the terms used to describe patient engagement activities across organizations. While a variety of opportunities for patient engagement are described, lack of clear evidence to how patient engagement practices are consistently used may contribute to the perception that engagement by HTAs.


Author(s):  
Duane Cottrell

One of the primary endeavors of choral conductors is the facilitation of good choral tone, which is largely dependent upon the vocal technique of the individual singers. This chapter examines principles of historical vocal pedagogy, discussing their correlation with modern scientific research, and present suggestions for practical implementation of specific techniques in choral rehearsals. The chapter discusses four primary areas of vocal pedagogy in choral rehearsals: first, the significance of laryngeal position in choral singing; second, principles of resonance in singing and their impact on the choral sound; third, a discussion of breath support in choral singing; and fourth, principles of phonation and vocal production for singers in a choral setting. Each of these four discussions contain practical suggestions for the application of specific practices and exercises that will strengthen the vocal technique of choral singers.


2020 ◽  
Vol 7 (1) ◽  
pp. 20
Author(s):  
Patricia Dobkin

There is a code of silence regarding addicted doctors in medicine. While the doctor is minimizing or denying the problem, often her or his co-workers look the other way. Colleagues may be concerned but hold back from “denouncing” one of their own. Yet, ethical and legal issues are real. Patient care may be compromised. This presentation will engage listeners by asking several reflective questions. The 4 C’s of addiction will be reviewed. Signs of addiction will be enumerated. Why doctors become entangled in substances will be examined. Is addiction different from burnout? If so, how? The adverse consequences of addiction will be reviewed. How can compassion be offered for a problem that triggers blame and shame?Impaired doctors are usually referred to Physician Health Programs. What do they offer? Can the Buddhist view of addiction contribute to Western therapies? Addiction recovery will be examined through a mindfulness lens.This, however, still puts the onus on the individual who struggles with addiction. What about the medical culture may contribute to the problem? Can this be changed? If so, how? Addicted doctors are not alone, and the problem is more than personal. Rather than simply review the literature, this presentation will engage the audience so that the taboo of addiction can be tackled. It is intended to break the silence such that upon return to work, participants may notice a colleague who shows signs of addiction and then open their hearts to offer support.


2021 ◽  
Author(s):  
Tadahiro Kuroda ◽  
Wai-Yeung Yip

Synthesising fifteen years of research, this authoritative text provides a comprehensive treatment of two major technologies for wireless chip and module interface design, covering technology fundamentals, design considerations and tradeoffs, practical implementation considerations, and discussion of practical applications in neural network, reconfigurable processors, and stacked SRAM. It explains the design principles and applications of two near-field wireless interface technologies for 2.5-3D IC and module integration respectively, and describes system-level performance benefits, making this an essential resource for researchers, professional engineers and graduate students performing research in next-generation wireless chip and module interface design.


Author(s):  
Oleh Turenko ◽  

The Foucault’s interpretation of the police, its theoretical substantiation, the range of powers and managerial tasks in modernist discourses. The French philosopher emphasized it should the modern concept of “police” does not coincide with its original theories of modern times. The doctrines of modern political scientists idealized the vocation of the police and identified it with the entire government, providing it with universal means of implementing the state interest. Considering the police from the perspective of “history of thought” Foucault notes that it is the unlimited nature of police functions gave the modern government to approve a disciplinary society, a new form of government - bio-power. This form of power totally controlled the individual, “took care of him” at all levels of biological life and, above all, the depths of consciousness - artificially created his authenticity. At the same time, in the theories of political scientists, the police received the status of a self-regulatory body, whose activities were not strictly controlled by state laws. In this case, the police, in the imaginary sense, is the living embodiment of state interest, morality and integrity, the formative and corrective body of state power. In order to form a disciplined and productive life, the police must direct individuals to regulation, to their temporal and hierarchical repetition. The a priori qualities of the police and its all-encompassing powers form the basis for the assertion of the idea of a “police state” and its radical form of panopticon. It is thanks to the idea of panopticon, its practical implementation by the police in modern society - the formation of disciplinary practice of continuous control in the social institutions of modernism.


Author(s):  
Nhan Phan-Thien ◽  
Sangtae Kim

Analytical solutions to a set of boundary integral equations are rare, even with simple geometries and boundary conditions. To make any reasonable progress, a numerical technique must be used. There are basically four issues that must be discussed in any numerical scheme dealing with integral equations. The first and most basic one is how numerical integration can be effected, together with an effective way of dealing with singular kernels of the type encountered in elastostatics. Numerical integration is usually termed numerical quadrature, meaning mathematical formulae for numerical integration. The second issue is the boundary discretization: when integration over the whole boundary is replaced by a sum of the integrations over the individual patches on the boundary. Each patch would be a finite element, or in our case, a boundary element on the surface. Obviously a high-order integration scheme can be devised for the whole domain, thus eliminating the need for boundary discretization. Such a scheme would be problem dependent and therefore would not be very useful to us. The third issue has to do with the fact that we are constrained by the very nature of the numerical approximation process to search for solutions within a certain subspace of L2, say the space of piecewise constant functions in which the unknowns are considered to be constant over a boundary element. It is the order of this subspace, together with the order and the nature of the interpolation of the geometry, that gives rise to the names of various boundary element schemes. Finally, one is faced with the task of solving a set of linear algebraic equations, which is usually dense (the system matrix is fully populated) and potentially ill-conditioned. A direct solver such as Gauss elimination may be very efficient for small- to medium-sized problems but will become stuck in a large-scale simulation, where the only feasible solution strategy is an iterative method. In fact, iterative solution strategies lead naturally to a parallel algorithm under a suitable parallel computing environment. This chapter will review various issues involved in the practical implementation of the CDL-BIEM on a serial computer and on a distributed computing environment.


Author(s):  
Stefano Triberti ◽  
Alice Chirico

Recent literature shows that new technologies can be used to promote patient engagement. The present contribution focuses on Virtual Worlds (VWs), namely virtual environments that multiple users can experience together thanks to the use of avatars. Indeed, VWs offer interesting opportunities for patient engagement interventions on two levels. On the individual level, customized avatars are known to have relationships with users' inner experience and Self-conception, so that they may constitute a peculiar additional tool for psychological assessment. Moreover, they are able to promote healthy behaviors thanks to a strong vicarious reinforcement (Proteus effect). On the collective level, VWs constitute an ideal platform to support the emergence of collective flow states (Networked Flow) which are related to the patients' creative activity and well-being. The present contribution deepens these phenomena, presenting VWs as an innovative and interesting tool for the patient engagement interventions of the future.


2019 ◽  
Vol 61 (7) ◽  
pp. 868-874
Author(s):  
Irene Tomoko Nakano ◽  
Gabriel Lucca de Oliveira Salvador ◽  
Hugo Reuters Schelin ◽  
Valeriy Denyak ◽  
Helen Jamil Khoury ◽  
...  

Background Appropriate mammary positioning is an important factor in optimizing image quality in mammography (MMG). Purpose To study the correlation of quality criteria and breast density classification proposed by the American College of Radiology (ACR) and European Guidelines and its influence to achieve a proper positioning, therefore an adequate MMG. Material and methods A total of 128 routine MMG examinations were reviewed for the definition of breast composition parenchyma and assessment of several quality criteria proposed by the ACR and European Guidelines to achieve an adequate MMG. Adequate MMG was defined as a difference between the posterior nipple line (PNL), difference of the mediolateral oblique (MLO) and craniocaudal (CC) incidences > 1 cm. The quality criteria were analyzed as a function of correlation coefficient in order to evaluate the individual impact of each factor and analysis of variance (ANOVA) for all criteria. Receiver operating characteristic (ROC) curves were plotted to evaluate the performance of the criteria on each type of parenchyma. Results Negative correlation of fatty breasts and visibility of the mammary angle, a greater number of skin folds and PNL > 1 cm (r < 0). Dense MMG presented less visibility of the lateral tissue compared with other categories. Area under the curve of ROC analysis revealed values of 53.1% and 54.7% for the right and left breasts, respectively. Conclusion Several factors influenced in the MMG process, but we find that breast parenchyma has a substantial role in affecting these criteria and therefore a correct position for diagnosis, which could compromise MMG diagnostic performance.


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