Does patient and public involvement impact public health decision-making? A 10 year retrospective analysis of public consultation in Brazil

Abstract

Background The aim of this work is to characterize the processes associated with patient and public involvement (PPI) in the form of public consultations (PC) during the first 10 years of operation of the National Committee for Health Technology Incorporation in the Unified Health System (Conitec) of Brazil, and to identify factors associated with changes in Conitec’s recommendations following these PC. Methods This cross-sectional study analysed all processes related to the adoption of technologies that took place in Brazil between 2012 and 2021 based on technical reports and self-reported information collected from PC participants. A multiple logistic regression model identified factors associated with changes in Conitec’s recommendations following PC. Results A total of 479 technical reports were published, of which 83% (n = 400) were submitted to PC. Demands were made mainly by applicants from the government (n = 262; 55%), regarding the adoption of medicines (n = 366; 76%), in which context neoplasms and infectious diseases were the most frequent indications (n = 66; 14% for each). A total of 264 (55%) processes resulted in a final recommendation in favour of introducing the technology. Over the period of 10 years, 196 483 contributions were received in response to PC. The largest volume of contributions was made by patients and their families or representatives (n = 99 082; 50%), females (122 895; 67%), white individuals (129 165; 71%) and individuals between the ages of 25 and 59 years (145 364; 80%). Alteration of the preliminary recommendation occurred in 13% (n = 53) of the PC, with a higher proportion of recommendations being altered from 2017 onwards. Increased participation by patients had a significant impact on the alteration of the preliminary recommendation (odds ratio 3.87, 95% CI 1.33–13.35, p = 0.02). Conclusions Increased engagement of patients and their families and caregivers in PC was associated with changing the preliminary recommendation of Conitec about the adoption of technologies into the public health system in Brazil.

Challenges for research uptake for health policymaking and practice in low- and middle-income countries: a scoping review

“…We identified key recommendations to improve research uptake for health policymaking in LMICs. Establishing evidence translation platforms, improving health policy research literacy and understanding the political dimension and context [171][172][173][174] are among the key recommendations to improve research uptake. Comprehensive evidence uptake approach is crucial [43,52,96,128], including strong monitoring, evaluation and learning strategy of evidence to policy translation [80,95,102,106,122,163], and evidence to policy intervention audit [62].…”

“…Stakeholder involvement will improve policy-maker confidence [58,66], result in greater trust of local partners [94], and enhance patient and public participation [172]. An evidence to policy platform [185] for capacity strengthening [173,186] of both evidence producers and users in implementation science will have a significant impact on research uptake [187].…”