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      Patients as partners in health research: A scoping review

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          Abstract

          Background

          The role of patient involvement in health research has evolved over the past decade. Despite efforts to engage patients as partners, the role is not well understood. We undertook this review to understand the engagement practices of patients who assume roles as partners in health research.

          Methods

          Using a recognized methodological approach, two academic databases (MEDLINE and EMBASE) and grey literature sources were searched. Findings were organized into one of the three higher levels of engagement, described by the Patient and Researcher Engagement framework developed by Manafo. We examined and quantified the supportive strategies used during involvement, used thematic analysis as described by Braun and Clarke and themed the purpose of engagement, and categorized the reported outcomes according to the CIHR Engagement Framework.

          Results

          Out of 6621 records, 119 sources were included in the review. Thematic analysis of the purpose of engagement revealed five themes: documenting and advancing PPI, relevance of research, co‐building, capacity building and impact on research. Improved research design was the most common reported outcome and the most common role for patient partners was as members of the research team, and the most commonly used strategy to support involvement was by meetings.

          Conclusion

          The evidence collected during this review advanced our understanding of the engagement of patients as research partners. As patient involvement becomes more mainstream, this knowledge will aid researchers and policy‐makers in the development of approaches and tools to support engagement.

          Patient/User Involvement

          Patients led and conducted the grey literature search, including the synthesis and interpretation of the findings.

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          Most cited references134

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          Scoping studies: towards a methodological framework

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            Scoping studies: advancing the methodology

            Background Scoping studies are an increasingly popular approach to reviewing health research evidence. In 2005, Arksey and O'Malley published the first methodological framework for conducting scoping studies. While this framework provides an excellent foundation for scoping study methodology, further clarifying and enhancing this framework will help support the consistency with which authors undertake and report scoping studies and may encourage researchers and clinicians to engage in this process. Discussion We build upon our experiences conducting three scoping studies using the Arksey and O'Malley methodology to propose recommendations that clarify and enhance each stage of the framework. Recommendations include: clarifying and linking the purpose and research question (stage one); balancing feasibility with breadth and comprehensiveness of the scoping process (stage two); using an iterative team approach to selecting studies (stage three) and extracting data (stage four); incorporating a numerical summary and qualitative thematic analysis, reporting results, and considering the implications of study findings to policy, practice, or research (stage five); and incorporating consultation with stakeholders as a required knowledge translation component of scoping study methodology (stage six). Lastly, we propose additional considerations for scoping study methodology in order to support the advancement, application and relevance of scoping studies in health research. Summary Specific recommendations to clarify and enhance this methodology are outlined for each stage of the Arksey and O'Malley framework. Continued debate and development about scoping study methodology will help to maximize the usefulness and rigor of scoping study findings within healthcare research and practice.
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              Patient engagement in research: a systematic review

              Background A compelling ethical rationale supports patient engagement in healthcare research. It is also assumed that patient engagement will lead to research findings that are more pertinent to patients’ concerns and dilemmas. However; it is unclear how to best conduct this process. In this systematic review we aimed to answer 4 key questions: what are the best ways to identify patient representatives? How to engage them in designing and conducting research? What are the observed benefits of patient engagement? What are the harms and barriers of patient engagement? Methods We searched MEDLINE, EMBASE, PsycInfo, Cochrane, EBSCO, CINAHL, SCOPUS, Web of Science, Business Search Premier, Academic Search Premier and Google Scholar. Included studies were published in English, of any size or design that described engaging patients or their surrogates in research design. We conducted an environmental scan of the grey literature and consulted with experts and patients. Data were analyzed using a non-quantitative, meta-narrative approach. Results We included 142 studies that described a spectrum of engagement. In general, engagement was feasible in most settings and most commonly done in the beginning of research (agenda setting and protocol development) and less commonly during the execution and translation of research. We found no comparative analytic studies to recommend a particular method. Patient engagement increased study enrollment rates and aided researchers in securing funding, designing study protocols and choosing relevant outcomes. The most commonly cited challenges were related to logistics (extra time and funding needed for engagement) and to an overarching worry of a tokenistic engagement. Conclusions Patient engagement in healthcare research is likely feasible in many settings. However, this engagement comes at a cost and can become tokenistic. Research dedicated to identifying the best methods to achieve engagement is lacking and clearly needed.
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                Author and article information

                Contributors
                mjsantan@ucalgary.ca
                mjsantan@ucalgary.ca
                Journal
                Health Expect
                Health Expect
                10.1111/(ISSN)1369-7625
                HEX
                Health Expectations : An International Journal of Public Participation in Health Care and Health Policy
                John Wiley and Sons Inc. (Hoboken )
                1369-6513
                1369-7625
                21 June 2021
                August 2021
                : 24
                : 4 ( doiID: 10.1111/hex.v24.4 )
                : 1378-1390
                Affiliations
                [ 1 ] The Department Community Health Sciences Calgary AB Canada
                [ 2 ] O’Brien Institute for Public Health Calgary AB Canada
                [ 3 ] Faculty of Nursing 3‐141 Edmonton Clinic Health Academy (ECHA) University of Alberta Edmonton AB Canada
                [ 4 ] Patient Partner Calgary AB Canada
                [ 5 ] The Department Psychology University of Calgary Calgary AB Canada
                [ 6 ] Alberta Health Services Calgary AB Canada
                [ 7 ] Faculty of Nursing University of Calgary Calgary AB Canada
                Author notes
                [*] [* ] Correspondence

                Maria Santana, Department of Community Health Sciences, Teaching Research and Wellness Building, 3280 Hospital Drive NW, Calgary, AB T2N 4N1, Canada.

                Email: mjsantan@ 123456ucalgary.ca

                Author information
                https://orcid.org/0000-0001-7242-1910
                https://orcid.org/0000-0002-0202-5952
                Article
                HEX13272
                10.1111/hex.13272
                8369093
                34153165
                577ac573-9aea-4df9-a9b1-53114853e75f
                © 2021 The Authors. Health Expectations published by John Wiley & Sons Ltd.

                This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

                History
                : 10 April 2021
                : 29 September 2020
                : 15 April 2021
                Page count
                Figures: 3, Tables: 3, Pages: 13, Words: 9734
                Funding
                Funded by: Alberta Health Services , doi 10.13039/100007582;
                Award ID: via Strategic Clinical Networks
                Funded by: Alberta Strategy for Patient Oriented Research Unit
                Categories
                Original Article
                Original Articles
                Custom metadata
                2.0
                August 2021
                Converter:WILEY_ML3GV2_TO_JATSPMC version:6.0.5 mode:remove_FC converted:17.08.2021

                Health & Social care
                co‐production,patient and public involvement,patient engagement,scoping review

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