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Hughes A, Guha C, Sluiter A, Himmelfarb J, Jauré A. Patient-Centered Research and Innovation in Nephrology. ADVANCES IN KIDNEY DISEASE AND HEALTH 2024; 31:52-67. [PMID: 38403395 DOI: 10.1053/j.akdh.2023.12.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/06/2023] [Revised: 12/07/2023] [Accepted: 12/11/2023] [Indexed: 02/27/2024]
Abstract
Patient involvement in research can improve the relevance of research, consequently enhancing the recruitment, retention, and uptake of interventions and policies impacting patient outcomes. Despite this, patients are not often involved in the design and conduct of research. The research agenda and innovations are frequently determined by the interest of health and industry professionals rather than proactively aligning with the priorities of patients. It is now being encouraged and recommended to engage patients in research priority setting to ensure interventions and trials report outcomes valuable to patients, moving away from a history of overlooking the outcomes that reflect the feel and function of patients. Involving patients ensures constant innovative research in nephrology, as this broader depth of evidence fortifies reliability and validity through knowledge gained from lived experience. Findings from such research can enhance clinical practice and strengthen decision-making and policy to support better outcomes. We aim to outline principles and strategies for patient involvement in research, including setting research priorities, identifying and designing interventions, selecting outcomes, and disseminating and translating research. Principles and strategies including engagement, education and training, empowerment, and connection and community provide guidance in patient involvement. There are increasing efforts to involve patients across all stages of research including setting research priorities. Efforts are rising to involve patients across all stages of research including priority setting, identifying and designing interventions, selecting outcomes, and dissemination and translation. Patient involvement throughout the research cycle drives innovative investigations ensuring funding, efforts, and resources are directed toward priorities of patients, contributing to catalyst advancements in care and outcomes.
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Affiliation(s)
- Anastasia Hughes
- Sydney School of Public Health, The University of Sydney, Sydney, Australia; Centre for Kidney Research, The Children's Hospital at Westmead, Sydney, Australia.
| | - Chandana Guha
- Sydney School of Public Health, The University of Sydney, Sydney, Australia; Centre for Kidney Research, The Children's Hospital at Westmead, Sydney, Australia
| | - Amanda Sluiter
- Sydney School of Public Health, The University of Sydney, Sydney, Australia; Centre for Kidney Research, The Children's Hospital at Westmead, Sydney, Australia
| | - Jonathan Himmelfarb
- Division of Nephrology, Department of Medicine, University of Washington, Seattle, Washington; Kidney Research Institute, Seattle, WA
| | - Allison Jauré
- Sydney School of Public Health, The University of Sydney, Sydney, Australia; Centre for Kidney Research, The Children's Hospital at Westmead, Sydney, Australia
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Dong C, Liu R, Huang Z, Yang Y, Sun S, Li R. Effect of exercise interventions based on family management or self-management on glycaemic control in patients with type 2 diabetes mellitus: a systematic review and meta-analysis. Diabetol Metab Syndr 2023; 15:232. [PMID: 37957775 PMCID: PMC10644553 DOI: 10.1186/s13098-023-01209-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Accepted: 11/02/2023] [Indexed: 11/15/2023] Open
Abstract
BACKGROUND Most studies about exercise interventions for patients with type 2 diabetes mellitus (T2DM) have been conducted in hospitals or labs, but it is unclear whether study findings from this specific condition can be generalised to real-life T2DM communities. If patients with T2DM can exercise on their own or with family members, it may also reduce the need for patient supervision by medical staff, thereby reducing the burden of medical treatment and improving condition management's cost-effectiveness and practicability. Much of the current research on exercise interventions for T2DM was focused on the type of exercise and less on the mode of management, so we aimed to examine the effect of exercise interventions based on family management or self-management on glycaemic control in patients with T2DM. METHODS Articles were searched from eight Chinese and English databases. Randomized control trials (RCTs) published in English and Chinese, from inception to October 17, 2022, were included in this review. The methodological quality of the included studies was assessed using the RCT risk of bias assessment tool provided by the Cochrane Collaboration's tool. Meta-analysis was performed using Rev Man 5.4 and Stata 15.0 software. Heterogeneity was investigated using sensitivity analysis and subgroup analyses. Publication bias was tested by funnel plot and Egger's asymmetry tests. RESULTS A total of 10 studies with a total of 913 subjects were finally included in this review. The Meta-analysis showed that exercise interventions based on family management or self-management were more effective than control groups in reducing HbA1c (Z = 3.90; 95% CI MD = - 0.81; - 1.21 to - 0.40; P < 0.0001), fasting glucose (Z = 4.63; 95% CI MD = - 1.17; - 1.67 to - 0.68; P < 0.00001), 2-h plasma glucose (Z = 5.53; 95% CI MD = - 1.84; - 2.50 to - 1.19; P < 0.00001), and Low-density lipoproteins levels (Z = 3.73; 95% CI MD = - 0.38; - 0.58 to - 0.18; P = 0.0002). CONCLUSIONS Exercise interventions based on family management or self-management can significantly reduce glycosylated haemoglobin, fasting glucose, 2-h plasma glucose, and Low-density lipoproteins levels in patients with T2DM, which can effectively delay disease progression and reduce the risk of developing complications. In the future, for exercise interventions based on family or self-management, this review recommended that exercise intervention programmes should be formulated according to 30-60 min per session, more than three times per week, for more than six months of aerobic exercise or aerobic combined with resistance exercise.
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Affiliation(s)
- Chenyang Dong
- School of Sport Science, Beijing Sport University, 48 Xinxi Road, Haidian District, Beijing, China
| | - Ruoya Liu
- School of Sport Science, Beijing Sport University, 48 Xinxi Road, Haidian District, Beijing, China
| | - Zhiyang Huang
- School of Sport Science, Beijing Sport University, 48 Xinxi Road, Haidian District, Beijing, China
| | - Yang Yang
- School of Sport Science, Beijing Sport University, 48 Xinxi Road, Haidian District, Beijing, China
| | - Shiyuan Sun
- School of Sport Science, Beijing Sport University, 48 Xinxi Road, Haidian District, Beijing, China
| | - Ran Li
- School of Sport Science, Beijing Sport University, 48 Xinxi Road, Haidian District, Beijing, China.
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Nyarambi D, Osedeme F, Mamudu HM, Littleton MA, Poole AM, Blair C, Voigt C, Gregory R, Drozek D, Stewart DW, Weierbach FM, Paul TK, Flores EK, Wei H. Setting Patient-Centered Priorities for Cardiovascular Disease in Central Appalachia: Engaging Stakeholder Experts to Develop a Research Agenda. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:ijerph20095660. [PMID: 37174178 PMCID: PMC10178300 DOI: 10.3390/ijerph20095660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 03/30/2023] [Accepted: 04/18/2023] [Indexed: 05/15/2023]
Abstract
The disproportionate burden of cardiovascular diseases (CVD) and associated risk factors continues to exist in the Central Appalachian Region (CAR) of the United States. Previous studies to gather data about patient-centered care for CVD in the region were conducted through focus group discussions. There have not been any studies that used a collaborative framework where patients, providers, and community stakeholders were engaged as panelists. The objective of this study was to identify patient-centered research priorities for CVD in the CAR. We used a modified Delphi approach to administer questionnaires to forty-two stakeholder experts in six states representing the CAR between the fall of 2018 and the summer of 2019. Their responses were analyzed for rankings and derived priorities by research gaps. Six of the fifteen research priorities identified were patient-centered. These patient-centered priorities included shorter wait times for appointments; educating patients at their level; empowering patients to take responsibility for their health; access to quality providers; heart disease specialists for rural areas; and lifestyle changes. The participants' commitments to identify patient-centered research priorities indicate the potential to engage in community-based collaboration to address the burden of CVD in the CAR.
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Affiliation(s)
- Dumisa Nyarambi
- Department of Community and Behavioral Health, College of Public Health, East Tennessee State University, Johnson City, TN 37614, USA
| | - Fenose Osedeme
- Department of Community and Behavioral Health, College of Public Health, East Tennessee State University, Johnson City, TN 37614, USA
| | - Hadii M Mamudu
- Department of Health Services Management and Policy, College of Public Health, East Tennessee State University, Johnson City, TN 37614, USA
- Center for Cardiovascular Risk Research, East Tennessee State University, Johnson City, TN 37614, USA
| | - Mary A Littleton
- Department of Community and Behavioral Health, College of Public Health, East Tennessee State University, Johnson City, TN 37614, USA
| | - Amy M Poole
- Center for Cardiovascular Risk Research, East Tennessee State University, Johnson City, TN 37614, USA
| | - Cynthia Blair
- Center for Cardiovascular Risk Research, East Tennessee State University, Johnson City, TN 37614, USA
| | - Carl Voigt
- Center for Cardiovascular Risk Research, East Tennessee State University, Johnson City, TN 37614, USA
| | - Rob Gregory
- Karing Hearts Cardiology, Johnson City, TN 37604, USA
| | - David Drozek
- Heritage College of Osteopathic Medicine, Ohio University, Athens, OH 45701, USA
| | - David W Stewart
- Center for Cardiovascular Risk Research, East Tennessee State University, Johnson City, TN 37614, USA
- Department of Pharmacy Practice, Bill Gatton College of Pharmacy, East Tennessee State University, Johnson City, TN 37614, USA
| | - Florence M Weierbach
- Center for Cardiovascular Risk Research, East Tennessee State University, Johnson City, TN 37614, USA
- College of Nursing, East Tennessee State University, Johnson City, TN 37614, USA
| | - Timir K Paul
- Center for Cardiovascular Risk Research, East Tennessee State University, Johnson City, TN 37614, USA
- College of Medicine, Health Science Center, University of Tennessee-Nashville, Nashville, TN 37203, USA
| | - Emily K Flores
- Center for Cardiovascular Risk Research, East Tennessee State University, Johnson City, TN 37614, USA
- Department of Pharmacy Practice, Bill Gatton College of Pharmacy, East Tennessee State University, Johnson City, TN 37614, USA
| | - Holly Wei
- College of Nursing, East Tennessee State University, Johnson City, TN 37614, USA
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Arnold A, Rosenthal M, Salkar M, Patelb S, Harrell E, Aldridge H, Mancuso B. Patient Centered Studies Focused on Type 2 Diabetes Management, Education, and Family Support: A Scoping Review. Curr Diabetes Rev 2022; 18:e171121197989. [PMID: 34789134 DOI: 10.2174/1573399818666211117113026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Revised: 07/15/2021] [Accepted: 09/15/2021] [Indexed: 11/22/2022]
Abstract
BACKGROUND Although a large amount of research has been conducted in diabetes management, many of the articles do not focus on patient-centered questions and concerns. To address this shortcoming, patients and various other stakeholders from three northern Mississippi communities co-created research questions focused on Type 2 diabetes management. OBJECTIVE To identify the diabetes management literature pertaining to each of the six patient-developed research questions from March 2010 to July 2020. METHODS A scoping review was conducted via PubMed to identify research articles from March 2010 to July 2020 focused on patient-centered Type 2 diabetes studies relevant to the six research questions. RESULTS A total of 1,414 studies were identified via the search strategy and 34 were included for qualitative analysis following article exclusion. For one of the research questions, there were no articles included. For the remaining research questions, the number of articles identified ranged from two to eleven. After analysis of the included articles, it was found that these questions either lacked extensive data or had not been implemented in the practice of diabetes management. CONCLUSION Additional research is warranted for three of the five questions, as current evidence is either lacking or contradictory. In the remaining two questions, it seems that adequate current research exists to warrant transitioning to implementation focused studies wherein data may be generated to improve sustainability and scaling of current programming.
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Affiliation(s)
- Austin Arnold
- Department of Pharmacy Administration, School of Pharmacy, University of Mississippi, Oxford, MS 38677-1848, USA
| | - Meagen Rosenthal
- Department of Pharmacy Administration, School of Pharmacy, University of Mississippi, Oxford, MS 38677-1848, USA
| | - Monika Salkar
- Department of Pharmacy Administration, School of Pharmacy, University of Mississippi, Oxford, MS 38677-1848, USA
| | - Sahil Patelb
- School of Pharmacy, University of Mississippi, Oxford, MS 38677-1848, USA
| | - Emily Harrell
- School of Pharmacy, University of Mississippi, Oxford, MS 38677-1848, USA
| | - Harleigh Aldridge
- School of Pharmacy, University of Mississippi, Oxford, MS 38677-1848, USA
| | - Blake Mancuso
- School of Pharmacy, University of Mississippi, Oxford, MS 38677-1848, USA
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Patel NK, Masoud SS, Meyer K, Davila AV, Rivette S, Glassner AA, James D, White CL. Engaging multi-stakeholder perspectives to identify dementia care research priorities. J Patient Rep Outcomes 2021; 5:46. [PMID: 34156561 PMCID: PMC8218276 DOI: 10.1186/s41687-021-00325-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Accepted: 06/04/2021] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVES The purpose of this study was to partner with stakeholders to identify gaps in care for persons living with dementia and their family caregivers and from this list, identify priorities for dementia care research. METHODS Using a community-engaged research approach, a Stakeholder Advisory Council (SAC) consisting of diverse membership including persons living with dementia and family caregivers was convened. Through our work with the SAC, along with input from the wider network through a symposium, webinars, and an online learning community, gaps in dementia care and a list of topics for dementia care research was generated. This list was reduced to 46 topics for dementia care research and sent to stakeholders (persons living with dementia, family caregivers, and health/social care professionals in dementia care) to be prioritized by rating each of the 46 topics as "Not so important," "Important," or "Very important." Priorities for dementia care were summarized by frequencies and proportions. RESULTS A total of 186 participants completed the survey from August through October 2020, including 23 (12.4%) persons living with dementia, 101 (54.3%) family caregivers, and 62 (33.3%) health/social care professionals. Consistent across stakeholder groups was the focus on research on how best to support families following a diagnosis of dementia. Among persons living with dementia, research focused on support for continuing to live in their own homes was ranked as the highest priority, rated by 91.3% as "Very Important". High priority research areas for family caregivers included interventions to slow cognitive decline (76.3%) as well as non-pharmacological approaches to manage behavioral symptoms (74.7%). The highest priority research topics for health/social care professionals were focused on the diagnosis including benefits of an early diagnosis (71.4%), how best to deliver the diagnosis (70.9%), and supports needed following a diagnosis (78.6%). CONCLUSIONS This project draws on the strengths of its multi-stakeholder perspective to support patient-centered outcomes research. Findings are intended to inform those who conduct research and those who fund research about which research topics stakeholders believe are most important and thus have greatest potential to improve the quality of life among people living with dementia and their families.
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Affiliation(s)
- Neela K Patel
- Geriatrics and Supportive Care, Long School of Medicine, UT Health San Antonio, San Antonio, Texas, USA
- Glenn Biggs Institute for Alzheimer's and Neurodegenerative Diseases, UT Health San Antonio, San Antonio, Texas, USA
| | - Sara S Masoud
- Caring for the Caregiver Program, School of Nursing, UT Health San Antonio, San Antonio, Texas, USA
| | - Kylie Meyer
- Caring for the Caregiver Program, School of Nursing, UT Health San Antonio, San Antonio, Texas, USA
| | - Angelica V Davila
- Geriatrics and Supportive Care, Long School of Medicine, UT Health San Antonio, San Antonio, Texas, USA
- Glenn Biggs Institute for Alzheimer's and Neurodegenerative Diseases, UT Health San Antonio, San Antonio, Texas, USA
| | - Sheran Rivette
- Caring for the Caregiver Program, School of Nursing, UT Health San Antonio, San Antonio, Texas, USA
| | - Ashlie A Glassner
- Caring for the Caregiver Program, School of Nursing, UT Health San Antonio, San Antonio, Texas, USA
| | - Deborah James
- Caring for the Caregiver Program, School of Nursing, UT Health San Antonio, San Antonio, Texas, USA
| | - Carole L White
- Glenn Biggs Institute for Alzheimer's and Neurodegenerative Diseases, UT Health San Antonio, San Antonio, Texas, USA.
- Caring for the Caregiver Program, School of Nursing, UT Health San Antonio, San Antonio, Texas, USA.
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Salkar M, Rosenthal M, Thakur T, Arnold A. Patient Centered Studies Focusing on Diabetes Self-Management: A Scoping Review. Curr Diabetes Rev 2020; 16:557-569. [PMID: 31886751 DOI: 10.2174/1573399816666191230112657] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Revised: 11/01/2019] [Accepted: 12/12/2019] [Indexed: 11/22/2022]
Abstract
BACKGROUND Type 2 diabetes continues to be a significant burden to patients and health systems globally. Addressing this condition from an alternative perspective, patients and various other stakeholders from three northern Mississippi communities co-created patient-centered research questions focused on type 2 diabetes management. OBJECTIVE The objective of this scoping review was to explore current literature focusing on nine patient- centered research questions to establish current knowledge and identify future research needs in the area of type 2 diabetes. METHODS A scoping review was conducted to obtain an overview of research related to the study purpose. The PubMed database was searched from March 2013 to March 2018 to identify patient-centered studies focused on type 2 diabetes and relevant to one of the nine research questions. RESULTS A total of 33 studies were identified and included. For five of the research questions, there was either no previous research literature or only "related" studies could be identified. These largely unexplored topics included how the understanding of guidelines by healthcare providers, specialty, and communication of medication side-effects impact patients' understanding and outcomes, the impact of improving patients' preparedness to communicate with providers, and whether younger patients require weight management programs that account for this populations' needs. CONCLUSION This lack of previous literature presents a unique opportunity to partner with patients to conduct this study and help improve the management of type 2 diabetes.
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Affiliation(s)
- Monika Salkar
- Department of Pharmacy Administration, School of Pharmacy, University of Mississippi, Oxford, MS, United States
| | - Meagen Rosenthal
- Department of Pharmacy Administration, School of Pharmacy, University of Mississippi, Oxford, MS, United States
| | - Tanvee Thakur
- Social and Administrative Science Division, School of Pharmacy, University of Wisconsin, Madison, WI, United States
| | - Austin Arnold
- Department of Pharmacy Administration, School of Pharmacy, University of Mississippi, Oxford, MS, United States
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Cheng C, Xin G, Xiaoli W, Chuanwei C, Xiaoming S, Yimin Z, Limei J, Ning C, Qian L, Hui W, Lan T, Zhaoxin W. Evaluation of the implementation and effect of the healthcare cloud information platform for diabetes self‐management: A case study in
Shanghai. Int J Health Plann Manage 2019; 34:986-997. [PMID: 31368129 DOI: 10.1002/hpm.2869] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Affiliation(s)
- Chen Cheng
- Business Division Department of Wonders Information Co., Ltd. Shanghai China
| | - Gong Xin
- Heart Failure Department of Shanghai East Hospital Affiliated to Tongji University Shanghai China
- School of MedicineTongji University Shanghai China
| | - Wang Xiaoli
- Pudong Institute for Health DevelopmentPudong Health Information Center Shanghai China
| | - Cao Chuanwei
- Business Division Department of Wonders Information Co., Ltd. Shanghai China
| | - Sun Xiaoming
- Pudong Institute for Health Development Shanghai China
| | - Zhang Yimin
- Pudong Institute for Health Development Shanghai China
| | - Jing Limei
- School of Public HealthShanghai University of Traditional Chinese Medicine Shanghai China
| | - Chen Ning
- School of MedicineTongji University Shanghai China
| | - Liu Qian
- School of MedicineTongji University Shanghai China
| | - Wang Hui
- School of Public HealthShanghai Jiao Tong University School of Medicine Shanghai China
| | - Tang Lan
- Weifang Community Health Service Center Shanghai China
| | - Wang Zhaoxin
- School of Public HealthShanghai Jiao Tong University School of Medicine Shanghai China
- General Practice CenterNanhai Hospital, Southern Medical University Guangdong China
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