Hostname: page-component-586b7cd67f-dlnhk Total loading time: 0 Render date: 2024-11-28T18:16:06.943Z Has data issue: false hasContentIssue false
  • English
  • Français

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

Published online by Cambridge University Press:  04 September 2017

Louise Brereton ,
Philip Wahlster ,
Kati Mozygemba ,
Kristin Bakke Lysdahl ,
Jake Burns ,
Stephanie Polus ,
Marcia Tummers ,
Pietro Refolo ,
Dario Sacchini  and
Wojciech Leppert
...Show all authors
Louise Brereton
Affiliation:
ScHARR, University of Sheffield College of Social Sciences, University of [email protected]
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
Get access Rights & Permissions [Opens in a new window]

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.

Keywords

Stakeholder involvementHealth technology assessmentPalliative care
Type
Theme Submissions
Information
International Journal of Technology Assessment in Health Care , Volume 33 , Issue 5: Assessing Health Technologies in an Integrated Way-Results of the INTEGRATE-HTA Project , 2017 , pp. 552 - 561
Copyright
Copyright © Cambridge University Press 2017 

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

REFERENCES

1. Cicchetti, A, Iacopino, V, Carletto, A, Marchetti, M, Mennini, FS. Il ruolo degli stakeholder nel processo di HTA. Ital Health Technol Assess. 2011;4:69.CrossRefGoogle Scholar
2. Nielsen, CP, Lauritsen, SW, Kristensen, FB, et al. Involving stakeholders and developing a policy for stakeholder involvement in the European network for Health Technology Assessment, EUnetHTA. Int J Technol Assess Health Care. 2009;25:84–91.CrossRefGoogle ScholarPubMed
3. Yazdizadeh, B, Shahmoradi, S, Majdzadeh, R, et al. Stakeholder involvement in health technology assessment at national level: A study from Iran. Int J Technol Assess Health Care. 2016;32:181.CrossRefGoogle Scholar
4. OECD. The OECD Health Project: Health technology and decision making. Paris Organisation for Economic Co-operation and Development (OECD); 2005. http://www.oecd-ilibrary.org/ (accessed September 13, 2016).Google Scholar
5. 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
6. Daniels, N, van der Wilt, GJ. Health Technology Assessment, deliberative process, and ethically contested issues. Int J Technol Assess Health Care. 2016;32:10–15.CrossRefGoogle ScholarPubMed
7. INVOLVE Briefing notes for researchers: Involving the public in NHS, public health and social care research. 2012 INVOLVE, Eastleigh. http://www.invo.org.uk/posttypepublication/involve-briefing-notes-for-researchers (accessed October 3, 2016).Google Scholar
8. Popay, J, Collins, M. PiiAF: The public involvement impact assessment framework guidance. Lancaster: University of Lancaster; 2014.Google Scholar
9. Abelson, J, Giacomini, M, Lehoux, P, Gauvin, FP. Bringing ‘the public’ into health technology assessment and coverage policy decisions: From principles to practice. Health Policy. 2007;82:37–50.Google Scholar
10. Pizzo, E, Doyle, C, Matthews, R, Barlow, J. Patient and public involvement: How much do we spend and what are the benefits? Health Expect. 2015;18:1918–1926.Google Scholar
11. Brereton, L, Wahlster, P, Lysdahl, K, et al. Integrated assessment of home based palliative care with and without reinforced caregiver support: ‘A demonstration of INTEGRATE-HTA methodological guidances’–Executive Summary. 2016. http://www.integrate-hta.eu/downloads/ (accessed October 3, 2016).Google Scholar
12. Gomes, B, Calanzani, N, Curiale, V, McCrone, P, Higginson, IJ. Effectiveness and cost-effectiveness of home palliative care services for adults with advanced illness and their caregivers. Cochrane Database Syst Rev. 2013;6:CD007760.Google Scholar
13. Wahlster, P, Brereton, L, Burns, J, et al. Guidance on the integrated assessment of complex health technologies-The INTEGRATE-HTA Model. 2016. http://www.integrate-hta.eu/downloads/ (accessed October 3, 2016).Google Scholar
14. National Institute for Health and Care Excellence (NICE). Methods for the development of NICE public health guidance (3rd ed.) www.nice.org.uk (accessed December 12, 2014).Google Scholar
15. Brereton, L, Ingleton, C, Gardiner, C, et al. Lay and professional stakeholder involvement in scoping palliative care issues: Methods used in seven European countries. Palliat Med. 2017;31:181–192.Google Scholar
16. Lampe, K, Mäkelä, M. EUnetHTA WP4–HTA Core Model for Medical and Surgical Interventions–Version 1.0 2008. http://www.eunethta.eu/outputs/hta-core-model-medical-and-surgical-interventions-10r (accessed January 10, 2015).Google Scholar
17. Lysdahl, KB, Brereton, L, Oortwijn, W, et al, eds. Guidance for assessing effectiveness, economic aspects, ethical aspects, socio-cultural aspects and legal aspects in complex technologies 2016. http://www.integrate-hta.eu/downloads/ (accessed October 3, 2016).Google Scholar
18. Burns, J, Chilcott, JB, van Hoorn, R, Kievit, W, Rehfeuss, E. Guidance to assess effectiveness aspects. Guidance for assessing effectiveness, economic aspects, ethical aspects, socio-cultural aspects and legal aspects in complex technologies 2016. http://www.integrate-hta.eu/downloads/ (accessed October 3, 2016).Google Scholar
19. Rohwer, A, Pfadenhauer, L, Burns, J, et al. Logic models help make sense of complexity in systematic reviews and health technology assessments. J Clin Epidemiol. 2017;83:37–47.Google Scholar
20. Sampietro-Colom, L, Thomas, S. Rethinking stakeholder engagement and technology access in health technology assessment: Reactions to policy forum discussions. Int J Technol Assess Health Care. 2016;32: 200–202.CrossRefGoogle ScholarPubMed
21. Brandon, PR, Fukunaga, LL. The state of the empirical research literature on stakeholder involvement in program evaluation. Am J Eval. 2013;35:26–44.Google Scholar
22. Gomes, B, Higginson, IJ. Evidence on home palliative care: Charting past, present, and future at the Cicely Saunders Institute–WHO Collaborating Centre for Palliative Care, Policy and Rehabilitation. Prog Palliat Care. 2013;21:204–213.Google Scholar
23. Cavazza, M, Jommi, C. Stakeholders involvement by HTA Organisations: Why is so different?. Health Policy, 2012;105:236–245.CrossRefGoogle ScholarPubMed
24. Stephens, JM, Handke, B, Doshi, JA. International survey of methods used in health technology assessment (HTA): Does practice meet the principles proposed for good research. J Comp Eff Res. 2012;2:29–44.Google Scholar