Involvement of Patients in Health Technology Assessment: Further Perspectives for Informing Decision-Makers

Hailey, David

doi:10.15171/hpr.2017.16

Cited by 4 publications

(5 citation statements)

References 12 publications

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“…Despite restricted technical competencies in biomedicine and public health, lay people and civil society organizations (CSOs) have contributed to the priority-setting of health interventions based on their value judgments and direct experiences as insurance beneficiaries, service recipients, and caregivers (16). For some services, useful information and examples of lessons learned provided by these actors cannot be found in scientific literature (17). Nevertheless, universal health coverage experts maintain that public involvement in HTA and a transparent decision-making process are useful in communicating the value of specific health investments as well as gaining support from the government and other stakeholders for pro-poor policies, such as financial protection (11).…”

Section: Agenda Setting and Participatory Evidence-informed Health Tmentioning

confidence: 99%

Leaving No One Behind: Participatory Technology Appraisal as a Platform for Agenda Setting to Address Disparities in Access to Health Services in Thailand

Tantivess

Doungthipsirikul

2019

Int J Technol Assess Health Care

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ObjectivesThis article discusses how participatory technology appraisal as part of the Universal Coverage Scheme (UCS) in Thailand contributes to improving access to essential health services among vulnerable populations.MethodsDocument review was conducted on health technology appraisal approaches introduced by the UCS. The review involves health benefit proposals advanced by stakeholders and also meeting minutes of relevant working groups and committees published between 2010 and 2015.ResultsFrom the establishment of the UCS participatory technology appraisal mechanism in 2010 until 2015, a total of 133 health interventions have been nominated. Some nominations highlight problems in access to care among vulnerable populations. As policy advocates continue to be involved in the latter stages of coverage decisions, they have opportunities to persuade policy makers and other stakeholders to agree to the rationales of their proposals. Some interventions were rejected because they did not meet value for money, affordability, and feasibility criteria; however, topic nominations from stakeholders as well as relevant deliberation throughout the technology appraisal processes have a potential to improve accessibility of health care among the disadvantaged.ConclusionsThrough participation in the UCS policy-making processes, key stakeholders are able to direct the attention of decision makers to significant gaps in access to services among vulnerable citizens, a health system problem rarely brought to discussion by policy elites and experts. The Thai experience reaffirms participatory technology appraisal as a supportive measure to providing universal health coverage.

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Section: Agenda Setting and Participatory Evidence-informed Health Tmentioning

confidence: 99%

Leaving No One Behind: Participatory Technology Appraisal as a Platform for Agenda Setting to Address Disparities in Access to Health Services in Thailand

Tantivess

Doungthipsirikul

2019

Int J Technol Assess Health Care

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“…There is a growing body of literature that recognizes the importance of public engagement in health technology assessment (HTA) [ 1 , 2 ], whereby communities are involved in decision-making as well as the planning, design, governance and delivery of services [ 3 ]. Public engagement, such as patient-citizens [ 4 ], for example, can improve accountability, transparency, and social inclusion in addition to providing a real-world understanding of the benefits and adverse effects of using technology to manage the process [ 5 – 7 ]. Public involvement, such as any member of society, can ensure the participation of individuals without personal interests, a broader representation of society and add more impartiality in decision-making in HTA [ 8 ].…”

Section: Introductionmentioning

confidence: 99%

Public engagement in health technology assessment in Brazil: the case of the public consultation on National Clinical Guidelines for Care in Normal Birth

Carvalho¹,

Silva²,

Barreto

2021

BMC Public Health

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Background There is a growing body of literature that recognizes the importance of public engagement in health technology assessment. However, there is still uncertainty regarding how the results should be recorded, analyzed, and used by decision makers. Objective Synthesize the contributions of the Brazilian public (women, health professionals, managers, educational institutions, and companies) about the implementation of the National Clinical Guidelines for Care in Normal Birth from the public consultation carried out in Brazil. Method IRaMuTeQ software was used to organize and summarize the corpus based on three types of analysis: descriptive statistics; descending hierarchical classification; and specificities analysis. The public consultation was conducted in 2016 by the National Committee for Health Technology Incorporation (CONITEC) in the Brazilian public health system as part of the guideline development process. Results The corpus consisted of 303 texts, separated into 1233 text segments, 1081 of which were used, corresponding to retention of 87.67%. Five classes emerged from our analyses: mandatory presence of an obstetrician during labor and delivery in hospital settings; barriers and facilitators for guideline implementation; use of evidence—based practices by health professionals; progression of labor and delivery and women’s rights; and mobilization to promote the guideline For each class, the most frequent words and sentences with the highest chi-squared scores were presented. Barriers were associated with lack of financial resources, training and professional motivation, and facilitators with training to change the practices of health professionals. Obstetric nurses emerged as an alternative for supervising normal births as well as the mandatory presence of an obstetrician during childbirth in hospital settings. Conclusion Our findings summarize the contributions provided by the Brazilian public and shed some light on the barriers and facilitators of clinical guidelines for care in normal birth. These topics are not typically explored by quantitative studies. Including this information in the decision-making process would not only increase public engagement, but provide greater evidence for implementing the clinical guidelines nationwide.

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“…The number of initiatives promoting social engagement in health technology assessment (HTA) has grown in recent years, [1–3] largely due to efforts by patient organizations and the HTA community [4, 5]. Fostering public engagement (on the part of users or interested citizens) can contribute to encouraging social responsibility, participatory democracy and transparency [4, 6]. Patients can provide unique additional perspectives for decision making, with experience-based insight on the benefits and disadvantages of using certain health technologies [4, 7].…”

Section: Introductionmentioning

confidence: 99%

“…Fostering public engagement (on the part of users or interested citizens) can contribute to encouraging social responsibility, participatory democracy and transparency [4, 6]. Patients can provide unique additional perspectives for decision making, with experience-based insight on the benefits and disadvantages of using certain health technologies [4, 7].…”

Section: Introductionmentioning

confidence: 99%

“…The outcomes of determining and assessing patient engagement in HTA can be difficult to identify, quantify and qualify because of the social participation strategies implemented by HTA agencies [4]. However, assessment methods developed by these agencies to incorporate these social contributions remain unclear, making it difficult to determine how and when these contributions effectively explain the decision-making process in HTA [8].…”

Section: Introductionmentioning

confidence: 99%

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Public engagement in health technology assessment in Brazil: the case of the Trastuzumab public consultation

Carvalho

Sousa

Barreto

et al. 2019

BMC Health Serv Res

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BackgroundPublic engagement in health technology assessment (HTA) is increasing worldwide. There are several forms of public engagement and it is not always possible to determine which stakeholders participate in the HTA process and how they contribute. Our objective was to investigate which types of social representatives contributed to the public consultation on the incorporation of Trastuzumab for early-stage breast cancer treatment within the public health system in Brazil, held in 2012 by the National Committee for Health Technology Incorporation (CONITEC).MethodsA mixed methods approach was used to analyze social representativeness and the composition of the corpus from the public consultation, which consisted of 127 contributions. Three types of analysis were performed using IRaMuTeQ software: classic lexical analysis, descending hierarchical classification and specificities analysis. The contributions were clustered according to the main categories of discourse observed, into four social representation categories: 1) patient representation/advocacy; 2) pharmaceutical industry/advocacy; 3) healthcare professionals; and 4) individual contributions.ResultsCategory 1 contained words related to increased survival due to use of the drug and a low score for words pertaining to studies on Trastuzumab. The word “safety” obtained a positive score only in category 2, which was also the only category that exhibited a negative score for the word “risk”. Category 3 displayed the lowest scores for “diagnosis” and “safety”. The word “efficacy” had a negative score only in category 4.ConclusionsEach category exhibited different results for words related to health systems and to key concepts linked to HTA. Our analysis enabled the identification of the most prominent contributions for each category. Despite the promising results obtained, further research is needed to validate this software for use in analyzing public contributions.

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Involvement of Patients in Health Technology Assessment: Further Perspectives for Informing Decision-Makers

Cited by 4 publications

References 12 publications

Leaving No One Behind: Participatory Technology Appraisal as a Platform for Agenda Setting to Address Disparities in Access to Health Services in Thailand

Leaving No One Behind: Participatory Technology Appraisal as a Platform for Agenda Setting to Address Disparities in Access to Health Services in Thailand

Public engagement in health technology assessment in Brazil: the case of the public consultation on National Clinical Guidelines for Care in Normal Birth

Public engagement in health technology assessment in Brazil: the case of the Trastuzumab public consultation

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