Abstract
BackgroundPriority-setting partnerships between researchers and stakeholders (meaning consumers, health professionals and health decision-makers) may improve research relevance and value. The Cochrane Consumers and Communication Group (CCCG) publishes systematic reviews in ‘health communication and participation’, which includes concepts such as shared decision-making, patient-centred care and health literacy. We aimed to select and refine priority topics for systematic reviews in health communication and participation, and use these to identify five priority CCCG Cochrane Reviews.MethodsTwenty-eight participants (14 consumers, 14 health professionals/decision-makers) attended a 1-day workshop in Australia. Using large-group activities and voting, participants discussed, revised and then selected 12 priority topics from a list of 21 previously identified topics. In mixed small groups, participants refined these topics, exploring underlying problems, who they affect and potential solutions. Thematic analysis identified cross-cutting themes, in addition to key populations and potential interventions for future Cochrane Reviews. We mapped these against CCCG’s existing review portfolio to identify five priority reviews.ResultsPriority topics included poor understanding and implementation of patient-centred care by health services, the fact that health information can be a low priority for health professionals, communication and coordination breakdowns in health services, and inadequate consumer involvement in health service design. The four themes underpinning the topics were culture and organisational structures, health professional attitudes and assumptions, inconsistent experiences of care, and lack of shared understanding in the sector. Key populations for future reviews were described in terms of social health characteristics (e.g. people from indigenous or culturally and linguistically diverse backgrounds, elderly people, and people experiencing socioeconomic disadvantage) more than individual health characteristics. Potential interventions included health professional education, interventions to change health service/health professional culture and attitudes, and health service policies and standards. The resulting five priority Cochrane Reviews identified were improving end-of-life care communication, patient/family involvement in patient safety, improving future doctors’ communication skills, consumer engagement strategies, and promoting patient-centred care.ConclusionsStakeholders identified priority topics for systematic reviews associated with structural and cultural challenges underlying health communication and participation, and were concerned that issues of equity be addressed. Priority-setting with stakeholders presents opportunities and challenges for review producers.
Highlights
Priority-setting partnerships between researchers and stakeholders may improve research relevance and value
We considered the project to be international in scope but, for feasibility, we conducted the workshop component in Australia
For the intervention conceptual code, we applied the categories of the Consumers and Communication Group (CCCG) intervention taxonomy [37] as the sub-codes
Summary
Priority-setting partnerships between researchers and stakeholders (meaning consumers, health professionals and health decision-makers) may improve research relevance and value. The health research agenda has largely been set by researchers and funders with little input from the end users of research [1], including consumers (patients and their families or carers, and the general public) [2] and other stakeholders (health professionals, health policy-makers and decision-makers). This has been shown to result in a mismatch between the priorities of the users of research and the research that is conducted [3, 4]. Systematic reviews, as summaries of multiple studies on a topic, are an appropriate and reliable source of evidence to inform health decision-making [11]
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