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Bowdish DME, Chandran V, Hitchon CA, Kaplan GG, Avina-Zubieta JA, Fortin PR, Larché MJ, Boire G, Gingras AC, Dayam RM, Colmegna I, Lukusa L, Lee JLF, Richards DP, Pereira D, Watts TH, Silverberg MS, Bernstein CN, Lacaille D, Benoit J, Kim J, Lalonde N, Gunderson J, Allard-Chamard H, Roux S, Quan J, Hracs L, Turnbull E, Valerio V, Bernatsky S. When Should I Get My Next COVID Vaccine? Data from the SUrveillance of responses to COVID-19 vaCcines in systEmic immunE mediated inflammatory Diseases (SUCCEED)study. J Rheumatol 2024:jrheum.2023-1214. [PMID: 38621797 DOI: 10.3899/jrheum.2023-1214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/17/2024]
Abstract
OBJECTIVE To determine how serologic responses to COVID vaccination/infection in immunemediated inflammatory disease (IMID) are affected by time since last vaccination and other factors. METHODS Post-COVID-19 vaccination, data and dried blood spots/sera were collected from adults with rheumatoid arthritis, inflammatory bowel disease, systemic lupus, ankylosing spondylitis/spondylarthritis and psoriasis/psoriatic arthritis. First sample was at enrolment and then 2-4 weeks and 3, 6, and 12 months after latest vaccine dose. Multivariate generalized estimating equation regressions (including medications, demographics, and vaccination history) evaluated serologic response, based on log-transformed anti-RBD IgG titres; we also measured anti-nucleocapsid IgG. RESULTS Positive associations for log-transformed anti-RBD titres were seen with female sex, number of doses, and self-reported COVID infections in 2021-2023. Negative associations were seen with prednisone, anti-TNF agents, and rituximab.Over 2021-2023, most (94%) of anti-nucleocapsid positivity was associated with a self-reported infection in the 3 months prior. From March 2021 to Feb 2022, anti-nucleocapsid positivity was present in 5-15% of samples and was highest in the post-Omicron era, with anti-nucleocapsid positivity trending to 30-35% or higher as of March 2023. Anti-nucleocapsid positivity in IMID remained lower than Canada's general population seroprevalence (>50% in 2022 and >75% in 2023).Time since last vaccination was negatively associated with log-transformed anti-RBD titres, particularly after 210 days. CONCLUSION Ours is the first pan-Canadian IMID assessment of how vaccine history and other factors affect serologic COVID-19 vaccine responses. These findings may help individuals personalize vaccination decisions, including consideration of additional vaccination when >6 months has elapsed since last COVID vaccination/infection.
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Affiliation(s)
- Dawn M E Bowdish
- Dawn ME Bowdish PhD, Department of Medicine, McMaster University, 1280 Main St W, Hamilton, Ontario, Canada
| | - Vinod Chandran
- Vinod Chandran MD PhD, Schroeder Arthritis Institute, Krembil Research Institute, University Health Network, Toronto, Ontario, Canada; Division of Rheumatology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Carol A Hitchon
- Carol A Hitchon MD MSc, Department of Internal Medicine, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada
| | - Gilaad G Kaplan
- Gilaad G. Kaplan MD MPH, Division of Gastroenterology and Hepatology, Departments of Medicine and Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
| | - J Antonio Avina-Zubieta
- J. Antonio Avina-Zubieta MD PhD, Arthritis Research Canada and Division of Rheumatology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Paul R Fortin
- Paul R Fortin MD MPH, Centre de Recherche Arthrite, Division of Rheumatology, Department of Medicine, CHU de Québec - Université Laval, Québec City, Québec, Canada
| | - Maggie J Larché
- Maggie J. Larché MD PhD, Division of Rheumatology, Department of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Gilles Boire
- Gilles Boire MD MSc, Division of Rheumatology, Department of Medicine, Université de Sherbrooke, Sherbrooke, Québec, Canada
| | - Anne-Claude Gingras
- Anne-Claude Gingras PhD, Lunenfeld-Tanenbaum Research Institute at Mount Sinai Hospital, Sinai Health, Toronto, Ontario, Canada
| | - Roya M Dayam
- Roya M Dayam PhD, Lunenfeld-Tanenbaum Research Institute at Mount Sinai Hospital, Sinai Health, Toronto, Ontario, Canada
| | - Ines Colmegna
- Ines Colmegna MD, The Research Institute of the McGill University Health Centre, McGill University, Montreal, Quebec, Canada; Department of Medicine, Division of Rheumatology, McGill University, Montreal, Quebec, Canada
| | - Luck Lukusa
- Luck Lukusa MSc, The Research Institute of the McGill University Health Centre, McGill University, Montreal, Quebec, Canada
| | - Jennifer L F Lee
- Jennifer LF Lee BSc, The Research Institute of the McGill University Health Centre, McGill University, Montreal, Quebec, Canada
| | - Dawn P Richards
- Dawn P Richards PhD, Canadian Arthritis Patient Alliance, Toronto, Ontario, Canada
| | - Daniel Pereira
- Daniel Pereira BSc, Schroeder Arthritis Institute, Krembil Research Institute, University Health Network, Toronto, Ontario, Canada
| | - Tania H Watts
- Tania H Watts PhD, Department of Immunology, University of Toronto, Toronto, Ontario, Canada
| | - Mark S Silverberg
- Mark S Silverberg MD PhD, Lunenfeld-Tanenbaum Research Institute at Mount Sinai Hospital, Sinai Health, Toronto, Ontario, Canada; Zane Cohen Centre for Digestive Diseases, Division of Gastroenterology, Mount Sinai Hospital, Sinai Health, Ontario, Canada
| | - Charles N Bernstein
- Charles N Bernstein MD, Department of Internal Medicine, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada
| | - Diane Lacaille
- Diane Lacaille MD MHSc, Arthritis Research Canada and Division of Rheumatology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Jenna Benoit
- Jenna Benoit, Department of Medicine, McMaster University, 1280 Main St W, Hamilton, Ontario, Canada
| | - John Kim
- John Kim PhD, National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Manitoba, Canada
| | - Nadine Lalonde
- Nadine Lalonde BSc, Canadian Arthritis Patient Alliance, Toronto, Ontario, Canada
| | - Janet Gunderson
- Janet Gunderson BEd, Canadian Arthritis Patient Alliance, Toronto, Ontario, Canada
| | - Hugues Allard-Chamard
- Hugues Allard-Chamard MD PhD, Division of Rheumatology , Department of Medicine, Université de Sherbrooke, Sherbrooke, Québec, Canada
| | - Sophie Roux
- Sophie Roux MD PhD, Division of Rheumatology , Department of Medicine, Université de Sherbrooke, Sherbrooke, Québec, Canada
| | - Joshua Quan
- Joshua Quan MSc, Division of Gastroenterology and Hepatology, Departments of Medicine and Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
| | - Lindsay Hracs
- Lindsay Hracs PhD, Division of Gastroenterology and Hepatology, Departments of Medicine and Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
| | - Elizabeth Turnbull
- Elizabeth Turnbull RN, The Research Institute of the McGill University Health Centre, McGill University, Montreal, Quebec, Canada
| | - Valeria Valerio
- Valeria Valerio MD, The Research Institute of the McGill University Health Centre, McGill University, Montreal, Quebec, Canada
| | - Sasha Bernatsky
- Sasha Bernatsky MD PhD, The Research Institute of the McGill University Health Centre, McGill University, Montreal, Quebec, Canada; Department of Medicine, Division of Rheumatology, McGill University, Montreal, Quebec, Canada
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Maheswaranathan M, Akpabio A, Tomasella LA, Coler-Reilly A, Richards DP, Howard RA, Gore-Massy M, Ladone N, Sirotich E. Role of Creation of Plain Language Summaries to Disseminate COVID-19 Research Findings to Patients With Rheumatic Diseases. J Rheumatol 2024:jrheum.2023-0998. [PMID: 38224986 DOI: 10.3899/jrheum.2023-0998] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2024]
Abstract
Dissemination of accurate scientific and medical information was critical during the coronavirus disease 2019 (COVID-19) pandemic, particularly during the early phases when little was known about the disease. Unfortunately, poor science literacy is a serious public health problem, contributing to widespread difficulties in accurately interpreting information and scientific data during the ongoing COVID-19 infodemic.1,2.
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Affiliation(s)
- Mithu Maheswaranathan
- M. Maheswaranathan, MD, Duke University, Department of Internal Medicine, Division of Rheumatology and Immunology, Durham, North Carolina, USA
| | - Akpabio Akpabio
- A. Akpabio, FMCP, Rheumatology Department, Royal National Hospital for Rheumatic Diseases, Bath, UK
| | - Laura-Ann Tomasella
- L. Tomasella, MMBEC, Arthritis Kids South Africa, Johannesburg, South Africa
| | - Ariella Coler-Reilly
- A. Coler-Reilly, BA, Department of Internal Medicine, Division of Bone and Mineral Diseases, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Dawn P Richards
- D.P. Richards, PhD, Canadian Arthritis Patient Alliance, and Five02 Labs, Inc., Toronto, Ontario, Canada
| | - Richard A Howard
- R.A. Howard, MBA, Spondylitis Association of America, Encino, California, USA
| | | | - Nadine Ladone
- N. Ladone, BSc, Canadian Arthritis Patient Alliance and Patient Advisors Network, Toronto, Ontario, Canada
| | - Emily Sirotich
- E. Sirotich, PhD, Canadian Arthritis Patient Alliance, Toronto, Ontario, Canada, and Yale University School of Medicine, and COVID-19 Global Rheumatology Alliance, New Haven, Connecticut, USA, on behalf of the COVID-19 Global Rheumatology Alliance, C19-GRA Patient Directed Summaries Team
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Sayfi S, Charide R, Elliott SA, Hartling L, Munan M, Stallwood L, Butcher NJ, Richards DP, Mathew JL, Suvada J, Akl EA, Kredo T, Mbuagbaw L, Motilall A, Baba A, Scott SD, Falavigna M, Klugar M, Friessová T, Lotfi T, Stevens A, Offringa M, Schünemann HJ, Pottie K. A multimethods randomized trial found that plain language versions improved adults understanding of health recommendations. J Clin Epidemiol 2024; 165:111219. [PMID: 38008266 DOI: 10.1016/j.jclinepi.2023.11.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Revised: 10/17/2023] [Accepted: 11/17/2023] [Indexed: 11/28/2023]
Abstract
OBJECTIVES To make informed decisions, the general population should have access to accessible and understandable health recommendations. To compare understanding, accessibility, usability, satisfaction, intention to implement, and preference of adults provided with a digital "Plain Language Recommendation" (PLR) format vs. the original "Standard Language Version" (SLV). STUDY DESIGN AND SETTING An allocation-concealed, blinded, controlled superiority trial and a qualitative study to understand participant preferences. An international on-line survey. 488 adults with some English proficiency. 67.8% of participants identified as female, 62.3% were from the Americas, 70.1% identified as white, 32.2% had a bachelor's degree as their highest completed education, and 42% said they were very comfortable reading health information. In collaboration with patient partners, advisors, and the Cochrane Consumer Network, we developed a plain language format of guideline recommendations (PLRs) to compare their effectiveness vs. the original standard language versions (SLVs) as published in the source guideline. We selected two recommendations about COVID-19 vaccine, similar in their content, to compare our versions, one from the World Health Organization (WHO) and one from Centers for Disease Control and Prevention (CDC). The primary outcome was understanding, measured as the proportion of correct responses to seven comprehension questions. Secondary outcomes were accessibility, usability, satisfaction, preference, and intended behavior, measured on a 1-7 scale. RESULTS Participants randomized to the PLR group had a higher proportion of correct responses to the understanding questions for the WHO recommendation (mean difference [MD] of 19.8%, 95% confidence interval [CI] 14.7-24.9%; P < 0.001) but this difference was smaller and not statistically significant for the CDC recommendation (MD of 3.9%, 95% CI -0.7% to 8.3%; P = 0.096). However, regardless of the recommendation, participants found the PLRs more accessible, (MD of 1.2 on the seven-point scale, 95% CI 0.9-1.4%; P < 0.001) and more satisfying (MD of 1.2, 95% CI 0.9-1.4%; P < 0.001). They were also more likely to follow the recommendation if they had not already followed it (MD of 1.2, 95% CI 0.7-1.8%; P < 0.001) and share it with other people they know (MD of 1.9, 95% CI 0.5-1.2%; P < 0.001). There was no significant difference in the preference between the two formats (MD of -0.3, 95% CI -0.5% to 0.03%; P = 0.078). The qualitative interviews supported and contextualized these findings. CONCLUSION Health information provided in a PLR format improved understanding, accessibility, usability, and satisfaction and thereby has the potential to shape public decision-making behavior.
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Affiliation(s)
- Shahab Sayfi
- Department of Biology, Faculty of Science, University of Ottawa, Ottawa, Ontario K1N 6N5, Canada; Schulich School of Medicine & Dentistry, Western University, London, Ontario N6A 5C1, Canada; Department of Health Research Methods, Evidence and Impact, Michael G. DeGroote Cochrane Canada and GRADE Centres, McMaster University, 1280 Main St. W., Hamilton, Ontario L8S 4K1, Canada
| | - Rana Charide
- Department of Health Research Methods, Evidence and Impact, Michael G. DeGroote Cochrane Canada and GRADE Centres, McMaster University, 1280 Main St. W., Hamilton, Ontario L8S 4K1, Canada
| | - Sarah A Elliott
- Department of Pediatrics, Faculty of Medicine and Dentistry, Alberta Research Center for Health Evidence, University of Alberta, Edmonton, Alberta, Canada; Cochrane Child Health, University of Alberta, Edmonton, Alberta, Canada
| | - Lisa Hartling
- Department of Pediatrics, Faculty of Medicine and Dentistry, Alberta Research Center for Health Evidence, University of Alberta, Edmonton, Alberta, Canada; Cochrane Child Health, University of Alberta, Edmonton, Alberta, Canada
| | - Matthew Munan
- Department of Pediatrics, Faculty of Medicine and Dentistry, Alberta Research Center for Health Evidence, University of Alberta, Edmonton, Alberta, Canada
| | - Lisa Stallwood
- Child Health Evaluative Sciences, The Hospital for Sick Children Research Institute, Toronto, Ontario M5G 0A4, Canada
| | - Nancy J Butcher
- Child Health Evaluative Sciences, The Hospital for Sick Children Research Institute, Toronto, Ontario M5G 0A4, Canada; Department of Psychiatry, University of Toronto, Toronto, Ontario M5T 1R8, Canada
| | | | - Joseph L Mathew
- Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Jozef Suvada
- National Evidence and Quality Platform, St. Elizabeth University of Public Health and Social Science, Research Dept., Nam. 1. Maja 1, 81000 Bratislava, Slovak Republic; Experts Consortium for COVID-19, Advisor to Government of Slovak Republic, Bratislava, Slovak Republic; WHO Executive Board, Geneva, Switzerland
| | - Elie A Akl
- Department of Health Research Methods, Evidence and Impact, Michael G. DeGroote Cochrane Canada and GRADE Centres, McMaster University, 1280 Main St. W., Hamilton, Ontario L8S 4K1, Canada; Department of Internal Medicine, American University of Beirut, Beirut, Lebanon
| | - Tamara Kredo
- Cochrane South Africa, South African Medical Research Council, Capetown, South Africa; Division of Epidemiology and Biostatistics, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa
| | - Lawrence Mbuagbaw
- Department of Health Research Methods, Evidence and Impact, Michael G. DeGroote Cochrane Canada and GRADE Centres, McMaster University, 1280 Main St. W., Hamilton, Ontario L8S 4K1, Canada; Department of Anesthesia, McMaster University, Hamilton, Ontario, Canada; Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada; Biostatistics Unit, Father Sean O'Sullivan Research Centre, St Joseph's Healthcare, Hamilton, Ontario, Canada; Centre for Development of Best Practices in Health (CDBPH), Yaoundé Central Hospital, Yaoundé, Cameroon; Division of Epidemiology and Biostatistics, Department of Global Health, Stellenbosch University, Cape Town, South Africa
| | - Ashley Motilall
- Department of Health Research Methods, Evidence and Impact, Michael G. DeGroote Cochrane Canada and GRADE Centres, McMaster University, 1280 Main St. W., Hamilton, Ontario L8S 4K1, Canada
| | - Ami Baba
- Child Health Evaluative Sciences, The Hospital for Sick Children Research Institute, Toronto, Ontario M5G 0A4, Canada
| | - Shannon D Scott
- Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
| | - Maicon Falavigna
- National Institute for Health Technology Assessment, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Miloslav Klugar
- Czech National Centre for Evidence-Based Healthcare and Knowledge Translation (Cochrane Czech Republic, Czech EBHC: JBI Centre of Excellence, Masaryk University GRADE Centre), Institute of Biostatistics and Analyses, Faculty of Medicine, Masaryk University, 625 00 Brno, Czech Republic; Institute of Health Information and Statistics of the Czech Republic, Prague, Czech Republic
| | - Tereza Friessová
- Department of Health Sciences, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Tamara Lotfi
- Department of Health Research Methods, Evidence and Impact, Michael G. DeGroote Cochrane Canada and GRADE Centres, McMaster University, 1280 Main St. W., Hamilton, Ontario L8S 4K1, Canada
| | - Adrienne Stevens
- Centre for Immunization Readiness, Public Health Agency of Canada, Ottawa, Ontario K1A 0K9, Canada
| | - Martin Offringa
- Child Health Evaluative Sciences, The Hospital for Sick Children Research Institute, Toronto, Ontario M5G 0A4, Canada; Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario M5T 3M6, Canada; Division of Neonatology, The Hospital for Sick Children, University of Toronto, Toronto, Ontario M5G 1X8, Canada
| | - Holger J Schünemann
- Department of Health Research Methods, Evidence and Impact, Michael G. DeGroote Cochrane Canada and GRADE Centres, McMaster University, 1280 Main St. W., Hamilton, Ontario L8S 4K1, Canada; Department of Biomedical Sciences, Humanitas University, Milan, Italy.
| | - Kevin Pottie
- Schulich School of Medicine & Dentistry, Western University, London, Ontario N6A 5C1, Canada; Department of Family Medicine, Western University, London, Ontario, Canada.
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Vanderhout S, Richards DP, Butcher N, Courtney K, Nicholls SG, Fergusson DA, Potter BK, Bhalla M, Nevins P, Fox G, Ly V, Taljaard M, Macarthur C. Prevalence of patient partner authorship and acknowledgment in child health research publications: an umbrella review. J Clin Epidemiol 2023; 164:35-44. [PMID: 37871836 DOI: 10.1016/j.jclinepi.2023.10.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 10/04/2023] [Accepted: 10/18/2023] [Indexed: 10/25/2023]
Abstract
OBJECTIVES Children and families are increasingly involved as equal partners in child health research, however, considerations around authorship have received little attention and there is limited guidance on the topic. Our objective was to determine the frequency and nature of patient partner authorship and/or acknowledgment among articles focused on patient engagement in child health research. STUDY DESIGN AND SETTING In this umbrella review, we searched MEDLINE, Embase, APA PsycINFO, Cochrane Database of Systematic Reviews, CINAHL, and Web of Science for systematic/scoping reviews on patient engagement in child health research. Individual articles included in eligible reviews comprised the sample of articles for analysis and were examined to identify patient partner authorship. Descriptive statistics were used to quantify patient partner authorship and/or acknowledgment and to summarize article characteristics. RESULTS Twelve systematic/scoping reviews met eligibility criteria, from which 230 individual articles were examined. In 16/230 (7%) articles, there was at least one patient partner author, and in 6/230 (3%) articles, patient partners were included as group authors. Within article Acknowledgments sections, patient partners were acknowledged by name in 41/230 (18%) articles, and anonymously or as a group in 98/230 (43%) articles. Patient partner authorship and/or acknowledgment was more frequent among articles published more recently (after 2015) and among articles where patient engagement was explicitly reported in the article. CONCLUSION Patient partners were more likely to be acknowledged than listed as an author on articles on patient engagement in child health research. Understanding patient partner preferences about authorship and acknowledgment, examination of the unique aspects of child and youth authorship and developing supports to empower patient partner authorship are needed.
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Affiliation(s)
- Shelley Vanderhout
- Institute for Better Health, Trillium Health Partners, 100 Queensway West, Mississauga, Ontario L5B 1B8, Canada.
| | - Dawn P Richards
- Patient Partner, Toronto, Ontario, Canada; Five02 Labs Inc., Toronto, Ontario, Canada
| | - Nancy Butcher
- Child Health Evaluative Sciences, Hospital for Sick Children Research Institute, 686 Bay Street, Toronto, Ontario M5G 0A4, Canada; Department of Psychiatry, Faculty of Medicine, University of Toronto, 250 College St, 8th floor, Toronto, Ontario M5T 1R8, Canada
| | - Kim Courtney
- Children's Hospital of Eastern Ontario Research Institute, 401 Smyth Rd, Ottawa, Ontario, Canada
| | - Stuart G Nicholls
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, 501 Smyth Road, Box 201B, Ottawa, Ontario K1H 8L6, Canada
| | - Dean A Fergusson
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, 501 Smyth Road, Box 201B, Ottawa, Ontario K1H 8L6, Canada; School of Epidemiology and Public Health, University of Ottawa, 600 Peter Morand Crescent, Room 101, Ottawa, Ontario K1G 5Z3, Canada
| | - Beth K Potter
- School of Epidemiology and Public Health, University of Ottawa, 600 Peter Morand Crescent, Room 101, Ottawa, Ontario K1G 5Z3, Canada
| | - Manav Bhalla
- University College Dublin School of Medicine, Health Sciences Centre, Belfield, Dublin, Ireland
| | - Pascale Nevins
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, 501 Smyth Road, Box 201B, Ottawa, Ontario K1H 8L6, Canada
| | - Grace Fox
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, 501 Smyth Road, Box 201B, Ottawa, Ontario K1H 8L6, Canada
| | - Valentina Ly
- University of Ottawa Library Services, 65 University Private, Ottawa, Ontario K1N 6N5, Canada
| | - Monica Taljaard
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, 501 Smyth Road, Box 201B, Ottawa, Ontario K1H 8L6, Canada; School of Epidemiology and Public Health, University of Ottawa, 600 Peter Morand Crescent, Room 101, Ottawa, Ontario K1G 5Z3, Canada
| | - Colin Macarthur
- Child Health Evaluative Sciences, Hospital for Sick Children Research Institute, 686 Bay Street, Toronto, Ontario M5G 0A4, Canada; Department of Paediatrics, University of Toronto, Toronto, Ontario M5S 1A1, Canada
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Yap C, Rekowski J, Ursino M, Solovyeva O, Patel D, Dimairo M, Weir CJ, Chan AW, Jaki T, Mander A, Evans TRJ, Peck R, Hayward KS, Calvert M, Rantell KR, Lee S, Kightley A, Hopewell S, Ashby D, Garrett-Mayer E, Isaacs J, Golub R, Kholmanskikh O, Richards DP, Boix O, Matcham J, Seymour L, Ivy SP, Marshall LV, Hommais A, Liu R, Tanaka Y, Berlin J, Espinasse A, de Bono J. Enhancing quality and impact of early phase dose-finding clinical trial protocols: SPIRIT Dose-finding Extension (SPIRIT-DEFINE) guidance. BMJ 2023; 383:e076386. [PMID: 37863491 DOI: 10.1136/bmj-2023-076386] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2023]
Affiliation(s)
| | - Jan Rekowski
- Institute of Cancer Research, London SM2 5NG, UK
| | - Moreno Ursino
- ReCAP/F CRIN, INSERM, Paris, France
- Unit of Clinical Epidemiology, University Hospital Centre Robert Debré, Reims, France
- INSERM Centre de Recherche des Cordeliers, Sorbonne University, Paris, France
- Health data and model driven approaches for Knowledge Acquisition team, Centre Inria, Paris, France
| | | | | | - Munyaradzi Dimairo
- Division of Population Health, Sheffield Centre for Health and Related Research, University of Sheffield, Sheffield, UK
| | - Christopher J Weir
- Edinburgh Clinical Trials Unit, Usher Institute, University of Edinburgh, Edinburgh, UK
| | - An-Wen Chan
- Department of Medicine, Women's College Research Institute, University of Toronto, Toronto, Canada
| | - Thomas Jaki
- MRC Biostatistics Unit, Cambridge University, Cambridge, UK
- Computational Statistics Group, University of Regensburg, Regensburg, Germany
| | - Adrian Mander
- Centre For Trials Research, Cardiff University, Cardiff, UK
| | - Thomas R Jeffry Evans
- Institute of Cancer Sciences, CR-UK Beatson Institute, University of Glasgow, Glasgow, UK
| | - Richard Peck
- Department of Pharmacology and Therapeutics, University of Liverpool, Liverpool, UK
- Hoffmann-La Roche, Basel, Switzerland
| | - Kathryn S Hayward
- Departments of Physiotherapy, and Medicine (Royal Melbourne Hospital), University of Melbourne, Parkville, VIC, Australia
- Florey Institute of Neuroscience and Mental Health, University of Melbourne, Parkville, VIC, Australia
| | - Melanie Calvert
- Centre for Patient Reported Outcomes Research, Institute of Applied Health Research, University of Birmingham, Birmingham, UK
- Birmingham Health Partners Centre for Regulatory Science and Innovation, University of Birmingham, Birmingham, UK
- National Institute for Health and Care Research Applied Research Collaboration West Midlands, University of Birmingham, Birmingham, UK
- National Institute for Health and Care Research Blood and Transplant Research Unit in Precision Transplant and Cellular Therapeutics, University of Birmingham, Birmingham, UK
- National Institute for Health and Care Research Birmingham Biomedical Research Centre, NIHR Birmingham Biomedical Research Centre, Institute of Translational Medicine, University Hospital NHS Foundation Trust, Birmingham, UK
| | | | - Shing Lee
- Columbia University Mailman School of Public Health, New York, NY, USA
| | | | - Sally Hopewell
- Oxford Clinical Research Unit, NDORMS, University of Oxford, Oxford, UK
| | - Deborah Ashby
- School of Public Health, Imperial College London, St Mary's Hospital, London, UK
| | - Elizabeth Garrett-Mayer
- Center for Research and Analytics, American Society of Clinical Oncology, Alexandria, VA, USA
| | - John Isaacs
- Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK
- Musculoskeletal Unit, Newcastle upon Tyne Hospitals NHS Foundation Trust, Freeman Hospital, Newcastle upon Tyne, UK
| | - Robert Golub
- Department of Medicine, Northwestern University Feinberg School of Medicine, Evanston, IL, USA
| | | | | | | | - James Matcham
- Strategic Consulting, Cytel (Australia), Perth, WA, Australia
| | - Lesley Seymour
- Investigational New Drug Programme, Canadian Cancer Trials Group, Cancer Research Institute, Queen's University, Kingston, ON, Canada
| | - S Percy Ivy
- Investigational Drug Branch, Cancer Therapy Evaluation Program, Division of Cancer Treatment and Diagnosis, National Institute of Health, Bethesda, MD, USA
| | - Lynley V Marshall
- Institute of Cancer Research, London SM2 5NG, UK
- Royal Marsden NHS Foundation Trust, London, UK
| | - Antoine Hommais
- Department of Clinical Research, National Cancer Institute, Boulogne-Billancourt, France
| | - Rong Liu
- Bristol Myers Squibb, New York, NY, USA
| | - Yoshiya Tanaka
- First Department of Internal Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan
| | | | | | - Johann de Bono
- Institute of Cancer Research, London SM2 5NG, UK
- Royal Marsden NHS Foundation Trust, London, UK
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Baba A, Richards DP, Smith M, Pallone N, Vanderhout S, Prebeg M, Elsman EBM, Potter BK, Offringa M, Butcher NJ. Youth and family involvement in the development of a plain language trial results communication tool: CommuniKIDS. Res Involv Engagem 2023; 9:88. [PMID: 37777802 PMCID: PMC10544151 DOI: 10.1186/s40900-023-00499-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Accepted: 09/25/2023] [Indexed: 10/02/2023]
Abstract
BACKGROUND Pediatric trials are possible through voluntary participation of children, youth (age ≤ 18 years), and their families. Despite important arguments for trialists to provide trial progress or results, and evidence that participants desire it, this information remains rarely shared with youth and their families. Little guidance exists on how trialists can best communicate trial results back to participants and their families. Guided by Liabo et al.'s framework, we describe how we developed a pediatric-specific, "plain language summary" clinical trial results template called CommuniKIDS with an adult patient partner, family partner (parent), youth advisors, and parent advisors, taking into account their unique knowledge needs and preferences. MAIN TEXT Patient and Public Involvement (PPI) was integrated in the development of the CommuniKIDS template. In collaboration with Clinical Trials Ontario, we used a generic trial results template as a starting point. The core project leadership team included a patient partner and a family partner from project inception to completion. Five youth (ages 13-18 years) and eight parent advisors were consulted at each point of the development process through three virtual workshops conducted separately; youth workshops were led by a youth facilitator. During these workshops, advisors agreed on the importance and value of sharing trial results, and expressed their preferences on content, format, and timing of sharing trial results. PPI-led improvements included the addition of three new sections to the CommuniKIDS template: "at a glance," "side effects," and "next steps." We reflect on our PPI strategy in the context of five "values" and six "practicalities" identified as good PPI principles, and summarize lessons learned when collaborating with youth and families from this project. CONCLUSION Involvement of a patient partner, a family partner, youth advisors, and parent advisors in the development of CommuniKIDS was critical to create a clinical trial results template that is useful and relevant to its end-users. To our knowledge, CommuniKIDS is the first to meaningfully engage youth and parents as advisors and partners in developing a plain language summary results template for pediatric trial participants and their families. Our experience of co-developing CommuniKIDS demonstrates that meaningful PPI can be achieved in trial results communication and knowledge translation practices. This report provides resources for those seeking to involve youth and families in their initiatives and in meaningfully sharing trial results.
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Affiliation(s)
- Ami Baba
- Child Health Evaluative Sciences, The Hospital for Sick Children Research Institute, Toronto, ON, Canada
| | | | - Maureen Smith
- Canadian Organization for Rare Disorders, Ottawa, ON, Canada
| | - Nicole Pallone
- CanPKU and Parent of a Child with an Inherited Metabolic Disease, Sparwood, BC, Canada
| | - Shelley Vanderhout
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada
| | - Matthew Prebeg
- Department of Psychiatry, The Hospital for Sick Children, Toronto, ON, Canada
| | - Ellen B M Elsman
- Child Health Evaluative Sciences, The Hospital for Sick Children Research Institute, Toronto, ON, Canada
| | - Beth K Potter
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada
| | - Martin Offringa
- Child Health Evaluative Sciences, The Hospital for Sick Children Research Institute, Toronto, ON, Canada.
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada.
- Division of Neonatology, The Hospital for Sick Children, Toronto, ON, Canada.
- Peter Gilgan Centre for Research and Learning, The Hospital for Sick Children, 686 Bay Street, Toronto, ON, M5G 0A4, Canada.
| | - Nancy J Butcher
- Child Health Evaluative Sciences, The Hospital for Sick Children Research Institute, Toronto, ON, Canada.
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada.
- Peter Gilgan Centre for Research and Learning, The Hospital for Sick Children, 686 Bay Street, Toronto, ON, M5G 0A4, Canada.
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7
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Hazlewood GS, Akhavan P, Pardo JP, Agarwal A, Schieir O, Barber CEH, Proulx L, Richards DP, Bombardier C, Pope JE, Barnabe C, Tugwell P, Jamal S, Thorne JC, Nikolic RPA, Khraishi M, Bansback N, Legge A, Bykerk V, Taylor-Gjevre R. Canadian Rheumatology Association Living Guidelines for Rheumatoid Arthritis: Update #1. J Rheumatol 2023; 50:1198-1199. [PMID: 37527865 DOI: 10.3899/jrheum.2023-0625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/03/2023]
Affiliation(s)
- Glen S Hazlewood
- Departments of Medicine and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada;
- Arthritis Research Canada, Vancouver, British Columbia, Canada
| | - Pooneh Akhavan
- Division of Rheumatology, Mount Sinai Hospital, Toronto, Ontario, Canada
| | - Jordi Pardo Pardo
- Cochrane Musculoskeletal, University of Ottawa, Ottawa, Ontario, Canada
| | - Arnav Agarwal
- Division of General Internal Medicine, Department of Medicine, McMaster University, Hamilton, Ontario, Canada
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
- MAGIC Evidence Ecosystem Foundation, Oslo, Norway
| | - Orit Schieir
- Canadian Early Arthritis Cohort Study, Toronto, Ontario, Canada
| | - Claire E H Barber
- Departments of Medicine and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Arthritis Research Canada, Vancouver, British Columbia, Canada
| | - Laurie Proulx
- Canadian Arthritis Patient Alliance, Toronto, Ontario, Canada
| | - Dawn P Richards
- Canadian Arthritis Patient Alliance, Toronto, Ontario, Canada
| | - Claire Bombardier
- Toronto General Hospital Research Institute, University Health Network, Toronto, Ontario, Canada
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Janet E Pope
- Department of Medicine, Western University, Schulich School of Medicine & Dentistry, London, Ontario, Canada
| | - Cheryl Barnabe
- Departments of Medicine and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Arthritis Research Canada, Vancouver, British Columbia, Canada
| | - Peter Tugwell
- Department of Medicine and School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada
| | - Shahin Jamal
- Division of Rheumatology, University of British Columbia, Arthritis Research Canada, Vancouver, British Columbia, Canada
| | - J Carter Thorne
- The Arthritis Program Research Group, Newmarket, Ontario, Canada
| | - Roko P A Nikolic
- Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Majed Khraishi
- Department of Medicine, Memorial University of Newfoundland, St. John's, Newfoundland and Labrador, Canada
| | - Nick Bansback
- Arthritis Research Canada, Vancouver, British Columbia, Canada
- School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
| | - Alexandra Legge
- Arthritis Research Canada, Vancouver, British Columbia, Canada
- Department of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Vivian Bykerk
- Hospital for Special Surgery, Weill Cornell Medicine (Cornell University), New York, New York, USA
| | - Regina Taylor-Gjevre
- Division of Rheumatology, Department of Medicine, College of Medicine, University of Saskatchewan, Saskatchewan, Manitoba, Canada
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Elliott SA, Scott SD, Charide R, Patterson-Stallwood L, Sayfi S, Motilall A, Baba A, Lotfi T, Suvada J, Klugar M, Kredo T, Mathew JL, Richards DP, Butcher NJ, Offringa M, Pottie K, Schünemann HJ, Hartling L. A multimethods randomized trial found that plain language versions improved parents' understanding of health recommendations. J Clin Epidemiol 2023; 161:8-19. [PMID: 37421995 DOI: 10.1016/j.jclinepi.2023.06.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Revised: 06/02/2023] [Accepted: 06/23/2023] [Indexed: 07/10/2023]
Abstract
OBJECTIVES To assess the effectiveness of plain language compared with standard language versions of COVID-19 recommendations specific to child health. STUDY DESIGN AND SETTING Pragmatic, allocation-concealed, blinded, superiority randomized controlled trial with nested qualitative component. Trial was conducted online, internationally. Parents or legal guardians (≥18 years) of a child (<18 years) were eligible. Participants were randomized to receive a plain language recommendation (PLR) or standard (SLV) verison of a COVID-19 recommendation specific to child health. Primary outcome was understanding. Secondary outcomes included: preference, accessibility, usability, satisfaction, and intended behavior. Interviews explored perceptions and preferences for each format. RESULTS Between July and August 2022, 295 parents were randomized; 241 (81.7%) completed the study (intervention n = 121, control n = 120). Mean understanding scores were significantly different between groups (PLR 3.96 [standard deviation (SD) 2.02], SLV 3.33 [SD 1.88], P = 0.014). Overall participants preferred the PLR version: mean rating 5.05/7.00 (95% CI 4.81, 5.29). Interviews (n = 12 parents) highlighted their preference for the PLR and provided insight on elements to enhance future knowledge mobilization of health recommendations. CONCLUSION Compared to SLVs, parents preferred PLRs and better understood the recommendation. Guideline developers should strive to use plain language to increase understanding, uptake, and implementation of evidence by the public.
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Affiliation(s)
- Sarah A Elliott
- Alberta Research Centre for Health Evidence, Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada; Cochrane Child Health, Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada
| | - Shannon D Scott
- Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
| | - Rana Charide
- Departments of Health Research Methods, Evidence and Impact and of Medicine, McMaster University, Hamilton, Ontario, Canada; Michael G. DeGroote and GRADE Centres, McMaster University, Hamilton, Ontario, Canada; WHO Collaborating Center for Infectious Diseases, Research Methods and Recommendations, McMaster University, Hamilton, Ontario, Canada
| | - Lisa Patterson-Stallwood
- Child Health Evaluative Sciences, The Hospital for Sick Children Research Institute, Toronto, Ontario, Canada
| | - Shahab Sayfi
- Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada
| | - Ashley Motilall
- Departments of Health Research Methods, Evidence and Impact and of Medicine, McMaster University, Hamilton, Ontario, Canada; Michael G. DeGroote and GRADE Centres, McMaster University, Hamilton, Ontario, Canada; WHO Collaborating Center for Infectious Diseases, Research Methods and Recommendations, McMaster University, Hamilton, Ontario, Canada; Department of Biomedical Sciences, Humanitas University, Milan, Italy
| | - Ami Baba
- Child Health Evaluative Sciences, The Hospital for Sick Children Research Institute, Toronto, Ontario, Canada
| | - Tamara Lotfi
- Departments of Health Research Methods, Evidence and Impact and of Medicine, McMaster University, Hamilton, Ontario, Canada; Michael G. DeGroote and GRADE Centres, McMaster University, Hamilton, Ontario, Canada; WHO Collaborating Center for Infectious Diseases, Research Methods and Recommendations, McMaster University, Hamilton, Ontario, Canada; Department of Biomedical Sciences, Humanitas University, Milan, Italy
| | - Jozef Suvada
- Departments of Science and International Studies, St. Elizabeth University of Public Health and Social Science, Bratislava, Slovak Republic
| | - Miloslav Klugar
- Czech National Centre for Evidence-Based Healthcare and Knowledge Translation, Cochrane Czech Republic, Czech EBHC: JBI Centre of Excellence, Institute of Biostatistics and Analyses, Faculty of Medicine, Masaryk University, Brno-Bohunice, Czech Republic
| | - Tamara Kredo
- Cochrane South Africa, South African Medical Research Council, Cape Town, South Africa; Division of Clinical Pharmacology, Department of Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa; Division of Epidemiology and Biostatistics, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa
| | - Joseph L Mathew
- Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Dawn P Richards
- Five02 Labs Inc, Toronto, Ontario, Canada; Canadian Arthritis Patient Alliance, Toronto, Ontario, Canada
| | - Nancy J Butcher
- Child Health Evaluative Sciences, The Hospital for Sick Children Research Institute, Toronto, Ontario, Canada; Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Martin Offringa
- Child Health Evaluative Sciences, The Hospital for Sick Children Research Institute, Toronto, Ontario, Canada; Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada; Division of Neonatology, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Kevin Pottie
- Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada
| | - Holger J Schünemann
- Departments of Health Research Methods, Evidence and Impact and of Medicine, McMaster University, Hamilton, Ontario, Canada; Michael G. DeGroote and GRADE Centres, McMaster University, Hamilton, Ontario, Canada; WHO Collaborating Center for Infectious Diseases, Research Methods and Recommendations, McMaster University, Hamilton, Ontario, Canada; Department of Biomedical Sciences, Humanitas University, Milan, Italy
| | - Lisa Hartling
- Alberta Research Centre for Health Evidence, Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada; Cochrane Child Health, Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada.
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9
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Stallwood L, Sammy A, Prebeg M, Relihan J, Baba A, Charide R, Sayfi S, Elliott SA, Hartling L, Munan M, Richards DP, Mathew JL, Kredo T, Mbuagbaw L, Motilall A, Scott SD, Klugar M, Lotfi T, Stevens AL, Pottie K, Schünemann HJ, Butcher NJ, Offringa M. Plain Language vs Standard Format for Youth Understanding of COVID-19 Recommendations: A Randomized Clinical Trial. JAMA Pediatr 2023; 177:956-965. [PMID: 37548983 PMCID: PMC10407760 DOI: 10.1001/jamapediatrics.2023.2686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Accepted: 05/10/2023] [Indexed: 08/08/2023]
Abstract
Importance To ensure that youths can make informed decisions about their health, it is important that health recommendations be presented for understanding by youths. Objective To compare understanding, accessibility, usability, satisfaction, intention to implement, and preference of youths provided with a digital plain language recommendation (PLR) format vs the original standard language version (SLV) of a health recommendation. Design, Setting, and Participants This pragmatic, allocation-concealed, blinded, superiority randomized clinical trial included individuals from any country who were 15 to 24 years of age, had internet access, and could read and understand English. The trial was conducted from May 27 to July 6, 2022, and included a qualitative component. Interventions An online platform was used to randomize youths in a 1:1 ratio to an optimized digital PLR or SLV format of 1 of 2 health recommendations related to the COVID-19 vaccine; youth-friendly PLRs were developed in collaboration with youth partners and advisors. Main Outcomes and Measures The primary outcome was understanding, measured as the proportion of correct responses to 7 comprehension questions. Secondary outcomes were accessibility, usability, satisfaction, preference, and intended behavior. After completion of the survey, participants indicated their interest in completing a 1-on-1 semistructured interview to reflect on their preferred digital format (PLR or SLV) and their outcome assessment survey response. Results Of the 268 participants included in the final analysis, 137 were in the PLR group (48.4% female) and 131 were in the SLV group (53.4% female). Most participants (233 [86.9%]) were from North and South America. No significant difference was found in understanding scores between the PLR and SLV groups (mean difference, 5.2%; 95% CI, -1.2% to 11.6%; P = .11). Participants found the PLR to be more accessible and usable (mean difference, 0.34; 95% CI, 0.05-0.63) and satisfying (mean difference, 0.39; 95% CI, 0.06-0.73) and had a stronger preference toward the PLR (mean difference, 4.8; 95% CI, 4.5-5.1 [4.0 indicated a neutral response]) compared with the SLV. No significant difference was found in intended behavior (mean difference, 0.22 (95% CI, -0.20 to 0.74). Interviewees (n = 14) agreed that the PLR was easier to understand and generated constructive feedback to further improve the digital PLR. Conclusions and Relevance In this randomized clinical trial, compared with the SLV, the PLR did not produce statistically significant findings in terms of understanding scores. Youths ranked it higher in terms of accessibility, usability, and satisfaction, suggesting that the PLR may be preferred for communicating health recommendations to youths. The interviews provided suggestions for further improving PLR formats. Trial Registration ClinicalTrials.gov Identifier: NCT05358990.
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Affiliation(s)
- Lisa Stallwood
- Child Health Evaluative Sciences, The Hospital for Sick Children Research Institute, Toronto, Ontario, Canada
| | - Adrian Sammy
- Child Health Evaluative Sciences, The Hospital for Sick Children Research Institute, Toronto, Ontario, Canada
| | - Matthew Prebeg
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | | | - Ami Baba
- Child Health Evaluative Sciences, The Hospital for Sick Children Research Institute, Toronto, Ontario, Canada
| | - Rana Charide
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada
- Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada
- Grading of Recommendations Assessment, Development and Evaluation Centre, McMaster University, Hamilton, Ontario, Canada
- World Health Organization Collaborating Centre for Infectious Diseases, Research Methods and Recommendations, McMaster University, Hamilton, Ontario, Canada
| | - Shahab Sayfi
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
- Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
| | - Sarah A. Elliott
- Alberta Research Centre for Health Evidence, Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
- Cochrane Child Health, Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada
| | - Lisa Hartling
- Alberta Research Centre for Health Evidence, Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
- Cochrane Child Health, Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada
| | - Matthew Munan
- Alberta Research Centre for Health Evidence, Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Dawn P. Richards
- Five02 Labs Inc, Toronto, Ontario, Canada
- Canadian Arthritis Patient Alliance, Toronto, Ontario, Canada
| | - Joseph L. Mathew
- Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Tamara Kredo
- Cochrane South Africa, South African Medical Research Council, Cape Town, South Africa
- Division of Clinical Pharmacology, Department of Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa
- Division of Epidemiology and Biostatistics, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa
| | - Lawrence Mbuagbaw
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada
- Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada
- Grading of Recommendations Assessment, Development and Evaluation Centre, McMaster University, Hamilton, Ontario, Canada
- World Health Organization Collaborating Centre for Infectious Diseases, Research Methods and Recommendations, McMaster University, Hamilton, Ontario, Canada
- Division of Epidemiology and Biostatistics, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa
- Department of Anesthesia, McMaster University, Hamilton, Ontario, Canada
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
- Biostatistics Unit, Father Sean O’Sullivan Research Centre, St Joseph’s Healthcare, Hamilton, Ontario, Canada
- Centre for Development of Best Practices in Health, Yaoundé Central Hospital, Yaoundé, Cameroon
| | - Ashley Motilall
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada
- Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada
- Grading of Recommendations Assessment, Development and Evaluation Centre, McMaster University, Hamilton, Ontario, Canada
- World Health Organization Collaborating Centre for Infectious Diseases, Research Methods and Recommendations, McMaster University, Hamilton, Ontario, Canada
| | - Shannon D. Scott
- Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
| | - Miloslav Klugar
- Czech National Centre for Evidence-Based Healthcare and Knowledge Translation, Institute of Biostatistics and Analyses, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Tamara Lotfi
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada
- Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada
- Grading of Recommendations Assessment, Development and Evaluation Centre, McMaster University, Hamilton, Ontario, Canada
- World Health Organization Collaborating Centre for Infectious Diseases, Research Methods and Recommendations, McMaster University, Hamilton, Ontario, Canada
| | - Adrienne L. Stevens
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada
- Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada
- Grading of Recommendations Assessment, Development and Evaluation Centre, McMaster University, Hamilton, Ontario, Canada
- World Health Organization Collaborating Centre for Infectious Diseases, Research Methods and Recommendations, McMaster University, Hamilton, Ontario, Canada
- Centre for Immunization Readiness, Public Health Agency of Canada, Ottawa, Ontario, Canada
| | - Kevin Pottie
- Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
- Department of Family Medicine, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
| | - Holger J. Schünemann
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada
- Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada
- Grading of Recommendations Assessment, Development and Evaluation Centre, McMaster University, Hamilton, Ontario, Canada
- World Health Organization Collaborating Centre for Infectious Diseases, Research Methods and Recommendations, McMaster University, Hamilton, Ontario, Canada
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
| | - Nancy J. Butcher
- Child Health Evaluative Sciences, The Hospital for Sick Children Research Institute, Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Martin Offringa
- Child Health Evaluative Sciences, The Hospital for Sick Children Research Institute, Toronto, Ontario, Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
- Division of Neonatology, The Hospital for Sick Children, Toronto, Ontario, Canada
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Tripp L, Richards DP, Daly-Cyr J, Lane T, Linkiewich D, Begley KN, Buckley N, Hudspith M, Poulin P, Abelson J. Evaluating the impacts of patient engagement on a national health research network: results of a case study of the Chronic Pain Network. Res Involv Engagem 2023; 9:73. [PMID: 37649098 PMCID: PMC10466858 DOI: 10.1186/s40900-023-00491-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Accepted: 08/22/2023] [Indexed: 09/01/2023]
Abstract
BACKGROUND The Chronic Pain Network (CPN) is a pan-Canadian research network focused on innovating and improving the quality and delivery of pain prevention, assessment, management and research for all Canadians. An important focus of the CPN is to work in collaboration with patient partners. Patient partners, researchers and clinicians work together in all aspects of the research network including on funded research projects and in the governance of the Network. Given this focus, the CPN identified the importance of evaluating their patient engagement work to understand its functioning and impact. METHODS The objective of this exploratory evaluation case study was to understand the impacts of patient engagement on the CPN. The CPN worked with an external evaluation team which established an arms-length approach to the evaluation. Interviews were conducted with CPN members, including patient partners, leadership, funded researchers and committee co-chairs, at three discrete time points to trace the evolution of the patient engagement program within the Network. Key Network documents were also collected and reviewed. Data were analyzed following each set of interviews using content analysis guided by the principles of constant comparison and qualitative description. A final round of analysis was conducted using the Engage with Impact Toolkit, an impact measurement framework, to identify impacts of engagement. RESULTS Impacts of patient engagement were identified at the individual, network, funded research project and research community levels. These impacts were observed in the following areas: (1) building community; (2) developing knowledge, skills and resources; (3) increasing confidence; (4) influencing priorities and decisions; (5) enabling additional opportunities; (6) promoting culture change; and, (7) coping with experiences of living with chronic pain. CONCLUSIONS While not without challenges, the patient engagement efforts of the CPN demonstrates the impact engaging patient partners can have on a national research network and related policy activities. Understanding the approaches to, and impacts of, patient engagement on health research networks can illuminate the value of having patient partners engaged in all aspects of a research network and should serve as encouragement to others who look to take on similar work.
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Affiliation(s)
- Laura Tripp
- Public and Patient Engagement Collaborative, McMaster University, Hamilton, ON, Canada.
| | - Dawn P Richards
- Chronic Pain Network, McMaster University, Hamilton, ON, Canada
- Five02 Labs Inc, Toronto, ON, Canada
| | | | - Therese Lane
- Chronic Pain Network, McMaster University, Hamilton, ON, Canada
| | - Delane Linkiewich
- Chronic Pain Network, McMaster University, Hamilton, ON, Canada
- Department of Psychology, University of Guelph, Guelph, ON, Canada
| | | | - Norman Buckley
- Chronic Pain Network, McMaster University, Hamilton, ON, Canada
- Department of Anesthesia, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
| | - Maria Hudspith
- Chronic Pain Network, McMaster University, Hamilton, ON, Canada
- Pain BC, Vancouver, BC, Canada
| | - Patricia Poulin
- The Ottawa Hospital Pain Clinic, Ottawa, ON, Canada
- The Ottawa Hospital Research Institute, Ottawa, ON, Canada
- Department of Anesthesiology and Pain Medicine, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Julia Abelson
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada
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Richards DP, Poirier S, Mohabir V, Proulx L, Robins S, Smith J. Reflections on patient engagement by patient partners: how it can go wrong. Res Involv Engagem 2023; 9:41. [PMID: 37308922 DOI: 10.1186/s40900-023-00454-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Accepted: 06/09/2023] [Indexed: 06/14/2023]
Abstract
As six patient partners in Canada, we aim to contribute to learning and to provide an opportunity to reflect on patient engagement (PE) in research and healthcare environments. Patient engagement refers to "meaningful and active collaboration in governance, priority setting, conducting research and knowledge translation" with patient partners as members of teams, rather than participants in research or clinical care. While much has been written about the benefits of patient engagement, it is important to accurately document and share what we term 'patient engagement gone wrong.' These examples have been anonymized and presented as four statements: patient partners as a check mark, unconscious bias towards patient partners, lack of support to fully include patient partners, and lack of recognizing the vulnerability of patient partners. The examples provided are intended to demonstrate that patient engagement gone wrong is more common than discussed openly, and to simply bring this to light. This article is not intending to lay blame, rather to evolve and improve patient engagement initiatives. We ask those who interact with patient partners to reflect so we can all work towards improving patient engagement. Lean into the discomfort with these conversations as that is the only way to change these all too recognizable examples, and which will lead to better project outcomes and experiences for all team members.
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Affiliation(s)
- Dawn P Richards
- Canadian Institutes of Health Research Institute of Musculoskeletal Health and Arthritis, University of British Columbia, Vancouver, BC, Canada.
- Five02 Labs Inc., Toronto, ON, Canada.
- Patient Partner, Toronto, ON, Canada.
| | - Sabrina Poirier
- Patient Partner for Myalgic Encephalomyelitis Research, Halifax, NS, Canada
| | - Vina Mohabir
- Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, ON, Canada
| | - Laurie Proulx
- Canadian Arthritis Patient Alliance, Ottawa, ON, Canada
- Patient Partner, Ottawa, ON, Canada
| | - Sue Robins
- Bird Communications, Vancouver, BC, Canada
| | - Jeffery Smith
- Patient Partner for Myalgic Encephalomyelitis Research, Toronto, ON, Canada
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Schoemaker CG, Richards DP, de Wit M. Matching researchers' needs and patients' contributions: practical tips for meaningful patient engagement from the field of rheumatology. Ann Rheum Dis 2023; 82:312-315. [PMID: 36604151 PMCID: PMC9933154 DOI: 10.1136/ard-2022-223561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Accepted: 12/13/2022] [Indexed: 01/07/2023]
Abstract
There is an increasing recognition of the importance of patient engagement and involvement in health research, specifically within the field of rheumatology. In general, researchers in this specialty appreciate the value of patients as partners in research. In practice, however, the majority of researchers does not involve patients on their research teams. Many researchers find it difficult to match their needs for patient engagement and the potential contributions from individuals living with rheumatic disease. In this Viewpoint, we provide researchers and patients practical tips for matching 'supply and demand,' based on our own experiences as patient engagement consultants and trainers in rheumatology research. All authors started as a 'naïve' patient or caregiver, an identity that evolved through a process of 'adversarial growth': positive changes that are experienced as a result of the struggle with highly challenging life circumstances. Here, we introduce four stages of adversarial growth in the context of research. We submit that all types of patients have their own experiences, qualities and skills, and can add specific input to research. The recommendations for engagement are not strict directives. They are meant as starting points for discussion or interview. Regardless of individual qualities and knowledge, we believe that all patients engaged in research have a single goal in common: to contribute to research that ultimately will change the lives of many other patients.
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Affiliation(s)
- Casper G Schoemaker
- Pediatric Rheumatology and Immunology, Wilhelmina Children's Hospital University Medical Centre, Utrecht, The Netherlands .,PGOsupport, Utrecht, The Netherlands
| | - Dawn P Richards
- Canadian Arthritis Patient Alliance, Toronto, Ontario, Canada,Five02 Labs Inc, Toronto, Ontario, Canada
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13
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Thomas M, Marshall DA, Sanchez AL, Bartlett SJ, Boonen A, Fraenkel L, Proulx L, Voshaar M, Bansback N, Buchbinder R, Guillemin F, Hiligsmann M, Richards DP, Richards P, Shea B, Tugwell P, Falahee M, Hazlewood GS. Exploring perceptions of using preference elicitation methods to inform clinical trial design in rheumatology: A qualitative study and OMERACT collaboration. Semin Arthritis Rheum 2023; 58:152112. [PMID: 36372015 DOI: 10.1016/j.semarthrit.2022.152112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Revised: 09/07/2022] [Accepted: 09/14/2022] [Indexed: 11/06/2022]
Abstract
BACKGROUND Clinical trial design requires value judgements and understanding patient preferences may help inform these judgements, for example when prioritizing treatment candidates, designing complex interventions, selecting appropriate outcomes, determining clinically important thresholds, or weighting composite outcomes. Preference elicitation methods are quantitative approaches that can estimate patients' preferences to quantify the absolute or relative importance of outcomes or other attributes relevant to the decision context. We aimed to explore stakeholder perceptions of using preference elicitation methods to inform judgements when designing clinical trials in rheumatology. METHODS We conducted 1-on-1 semi-structured interviews with patients with rheumatic diseases and rheumatology clinicians/researchers, recruited using purposive and snowball sampling. Participants were provided pre-interview materials, including a video and a document, to introduce the topic of preference elicitation methods and case examples of potential applications to clinical trials. Interviews were conducted via Zoom and were audio-recorded and transcribed. We used thematic analysis to analyze our data. RESULTS We interviewed 17 patients and 9 clinicians/researchers, until data and inductive thematic saturation were achieved within each group. Themes were grouped into overall perceptions, barriers, and facilitators. Patients and clinicians/researchers generally agreed that preference elicitation studies can improve clinical trial design, but that many considerations are required around preference heterogeneity and feasibility. A key barrier identified was the additional resources and expertise required to measure and incorporate preferences effectively in trial design. Key facilitators included developing guidance on how to use preference elicitation to inform trial design, as well as the role of external decision-makers in developing such guidance, and the need to leverage the movement towards patient engagement in research to encourage including patient preferences when designing trials. CONCLUSION Our findings allowed us to consider the potential applications of patient preferences in trial design according to stakeholders within rheumatology who are involved in the trial process. Future research should be conducted to develop comprehensive guidance on how to meaningfully include patient preferences when designing clinical trials in rheumatology. Doing so may have important downstream effects for shared decision-making, especially given the chronic nature of rheumatic diseases.
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Affiliation(s)
- Megan Thomas
- Department of Community Health Sciences, University of Calgary, Calgary, Canada
| | - Deborah A Marshall
- Department of Community Health Sciences, University of Calgary, Calgary, Canada; Department of Medicine, University of Calgary, Calgary, Canada
| | - Adalberto Loyola Sanchez
- Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Canada
| | - Susan J Bartlett
- Department of Medicine, McGill University, Montreal, Canada; Centre for Outcomes Research & Evaluation, Research Institute McGill University Health Centre, Montreal, Canada
| | - Annelies Boonen
- Department of Internal Medicine, Maastricht University Medical Center, Care and Public Health Research Institute, Maastricht, The Netherlands
| | - Liana Fraenkel
- Yale University School of Medicine, Section of Rheumatology, Connecticut, USA
| | - Laurie Proulx
- Patient research partner, Canadian Arthritis Patient Alliance, Ottawa, Canada
| | - Marieke Voshaar
- Patient research partner, Radboud University, Department of Pharmacy, Nijmegen, the Netherlands
| | - Nick Bansback
- School of Population and Public Health, Faculty of Medicine, University of British Columbia, Vancouver, Canada
| | - Rachelle Buchbinder
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University and Monash Department of Clinical Epidemiology, Cabrini Institute, Melbourne, Australia
| | | | - Mickaël Hiligsmann
- Department of Health Services Research CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht, the Netherlands
| | - Dawn P Richards
- Patient research partner, Canadian Arthritis Patient Alliance, Ottawa, Canada; Patient research partner, Canadian Arthritis Patient Alliance and Five02 Labs Inc., Toronto, Canada
| | - Pamela Richards
- Patient research partner, University Hospitals, Bristol NHS Trust, Bristol, UK
| | - Beverley Shea
- Department of Medicine, University of Ottawa, Ottawa, Canada
| | - Peter Tugwell
- Department of Medicine, University of Ottawa, Ottawa, Canada
| | - Marie Falahee
- Institute of Inflammation and Ageing, University of Birmingham, Birmingham, UK
| | - Glen S Hazlewood
- Department of Community Health Sciences, University of Calgary, Calgary, Canada; Department of Medicine, University of Calgary, Calgary, Canada.
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14
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Webster F, Connoy L, Longo R, Ahuja D, Amtmann D, Anderson A, Ashton-James CE, Boyd H, Chambers CT, Cook KF, Cowan P, Crombez G, Feinstein AB, Fuqua A, Gilam G, Jordan I, Mackey SC, Martins E, Martire LM, O'Sullivan P, Richards DP, Turner JA, Veasley C, Würtzen H, Yang SY, You DS, Ziadni M, Darnall BD. Patient Responses to the Term Pain Catastrophizing: Thematic Analysis of Cross-sectional International Data. J Pain 2023; 24:356-367. [PMID: 36241160 PMCID: PMC9898136 DOI: 10.1016/j.jpain.2022.10.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 09/03/2022] [Accepted: 10/04/2022] [Indexed: 11/12/2022]
Abstract
Pain catastrophizing is understood as a negative cognitive and emotional response to pain. Researchers, advocates and patients have reported stigmatizing effects of the term in clinical settings and the media. We conducted an international study to investigate patient perspectives on the term pain catastrophizing. Open-ended electronic patient and caregiver proxy surveys were promoted internationally by collaborator stakeholders and through social media. 3,521 surveys were received from 47 countries (77.3% from the U.S.). The sample was mainly female (82.1%), with a mean age of 41.62 (SD 12.03) years; 95% reported ongoing pain and pain duration > 10 years (68.4%). Forty-five percent (n = 1,295) had heard of the term pain catastrophizing; 12% (n = 349) reported being described as a 'pain catastrophizer' by a clinician with associated high levels of feeling blamed, judged, and dismissed. We present qualitative thematic data analytics for responses to open-ended questions, with 32% of responses highlighting the problematic nature of the term. We present the patients' perspective on the term pain catastrophizing, its material effect on clinical experiences, and associations with negative gender stereotypes. Use of patient-centered terminology may be important for favorably shaping the social context of patients' experience of pain and pain care. PERSPECTIVE: Our international patient survey found that 45% had heard of the term pain catastrophizing, about one-third spontaneously rated the term as problematic, and 12% reported the term was applied to them with most stating this was a negative experience. Clinician education on patient-centered terminology may improve care and reduce stigma.
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Affiliation(s)
- Fiona Webster
- Arthur Labatt Family School of Nursing, Western University, London, Ontario, Canada
| | - Laura Connoy
- Arthur Labatt Family School of Nursing, Western University, London, Ontario, Canada
| | - Riana Longo
- Arthur Labatt Family School of Nursing, Western University, London, Ontario, Canada
| | | | - Dagmar Amtmann
- University of Washington (UW), Department of Rehabilitation Medicine, UW Center on Outcomes Research in Rehabilitation (UWCORR), Seattle, Washington, USA
| | | | - Claire E Ashton-James
- Sydney Medical School, Kolling Institute, The University of Sydney, St Leonards, New South Wales, Australia
| | | | - Christine T Chambers
- Departments of Psychology and Neuroscience & Pediatrics, Dalhousie University; Centre for Pediatric Pain Research, IWK Health, Halifax, Nova Scotia
| | | | - Penney Cowan
- American Chronic Pain Association, World Patients Alliance
| | - Geert Crombez
- Psychology and Educational Sciences, Department of Experimental Clinical and Health Psychology, Ghent University, Gent, Belgium
| | - Amanda B Feinstein
- Stanford University School of Medicine/Stanford Children's Health, Menlo Park, California, USA
| | - Anne Fuqua
- University of Alabama Birmingham, Albama, USA
| | - Gadi Gilam
- The Institute of Biomedical and Oral Research, Hebrew University of Jerusalem, Jerusalem, Israel
| | | | - Sean C Mackey
- Division of Pain Medicine, Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University, Palo Alto, California, USA
| | - Eduarda Martins
- Centro Hospitalar Póvoa de Varzim/Vila do Conde, EPE, Portugal
| | - Lynn M Martire
- Penn State University, University Park, Pennsylvania, USA
| | - Peter O'Sullivan
- Curtin School of Allied Health, Curtin University, Perth, Western Australia, Australia
| | - Dawn P Richards
- Five02 Labs Inc and the Canadian Arthritis Patient Alliance, Toronto, Ontario, Canada
| | - Judith A Turner
- University of Washington School of Medicine, Seattle, Washington, USA
| | | | | | - Su-Yin Yang
- Tan Tock Seng Hospital, Department of Psychology, Tan Tock Seng Hospital, Singapore
| | - Dokyoung S You
- Division of Pain Medicine, Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University, Palo Alto, California, USA
| | - Maisa Ziadni
- Division of Pain Medicine, Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University, Palo Alto, California, USA
| | - Beth D Darnall
- Division of Pain Medicine, Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University, Palo Alto, California, USA.
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15
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Hazlewood GS, Colmegna I, Hitchon C, Fortin PR, Bernatsky S, Clarke AE, Mosher D, Wilson T, Thomas M, Barber CEH, Harrison M, Bansback N, Proulx L, Richards DP, Kaplan GG. Preferences for COVID-19 Vaccination in People With Chronic Immune-Mediated Inflammatory Diseases. J Rheumatol 2023:jrheum.220697. [PMID: 36642432 DOI: 10.3899/jrheum.220697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
OBJECTIVE To understand how people with chronic immune-mediated inflammatory diseases (IMIDs) trade off the benefits and risks of coronavirus disease 2019 (COVID-19) vaccine options. METHODS We conducted an online discrete-choice experiment in people with IMIDs to quantify the relative importance (RI) of attributes relevant to COVID-19 vaccination. Participants were recruited between May and August 2021 through patient groups and clinics in Canada, and completed 10 choices where they selected 1 of 2 hypothetical vaccine options or no vaccine. The RI of each attribute was estimated and heterogeneity was explored through latent class analysis. RESULTS The survey was completed by 551 people (89% female, mean age 46 yrs) with a range of IMIDs (inflammatory bowel disease [48%], rheumatoid arthritis [38%], systemic lupus erythematosus [16%]). Most had received 1 (94%) or 2 (64%) COVID-19 vaccinations. Across the ranges of levels considered, vaccine effectiveness was most important (RI = 66%), followed by disease flare (21%), rare but serious risks (9%), and number/timing of injections (4%). Patients would accept a risk of disease flare requiring a treatment change of ≤ 8.8% for a vaccine with a small absolute increase in effectiveness (10%). Of the 3 latent classes, the group with the greatest aversion to disease flare were more likely to be male and have lower incomes, but this group still valued effectiveness higher than other attributes. CONCLUSION Patients perceived the benefits of COVID-19 vaccination to outweigh rare serious risks and disease flare. This supports COVID-19 vaccine strategies that maximize effectiveness, while recognizing the heterogeneity in preferences that exists.
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Affiliation(s)
- Glen S Hazlewood
- G.S. Hazlewood, MD, PhD, Department of Medicine, and Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, and Arthritis Research Canada, Vancouver, British Columbia
| | - Ines Colmegna
- I. Colmegna, MD, The Research Institute of the McGill University Health Centre, McGill University, Montreal, Quebec
| | - Carol Hitchon
- C. Hitchon, MD, MSc, Department of Internal Medicine, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba
| | - Paul R Fortin
- P.R. Fortin, MD, Division de Rhumatologie, Departement de Medecine, CHU de Quebec, and Centre de Recherche ARThrite, Universite Laval, Quebec City, Quebec
| | - Sasha Bernatsky
- S. Bernatsky, MD, PhD, The Research Institute of the McGill University Health Centre, McGill University, Montreal, Quebec
| | - Ann E Clarke
- A.E. Clarke, MD, Department of Medicine, and Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, and Arthritis Research Canada, Vancouver, British Columbia
| | - Dianne Mosher
- D. Mosher, MD, Department of Medicine, and Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, and Arthritis Research Canada, Vancouver, British Columbia
| | - Todd Wilson
- T. Wilson, PhD, Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary
| | - Megan Thomas
- M. Thomas, MSc, Arthritis Research Canada, and Pharmaceutical Sciences, University of British Columbia, Vancouver, British Columbia
| | - Claire E H Barber
- C.E.H. Barber, MD, PhD, Department of Medicine, and Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, and Arthritis Research Canada, Vancouver, British Columbia
| | - Mark Harrison
- M. Harrison, PhD, Arthritis Research Canada, and Pharmaceutical Sciences, and School of Population and Public Health, University of British Columbia, and Centre for Health Evaluation and Outcome Sciences, St. Paul's Hospital, Vancouver, British Columbia
| | - Nick Bansback
- N. Bansback, PhD, Arthritis Research Canada, and School of Population and Public Health, University of British Columbia, and Centre for Health Evaluation and Outcome Sciences, St. Paul's Hospital, Vancouver, British Columbia
| | - Laurie Proulx
- L. Proulx, BCom, Canadian Arthritis Patient Alliance, Ontario
| | - Dawn P Richards
- D.P. Richards, PhD, Canadian Arthritis Patient Alliance, Ontario
| | - Gilaad G Kaplan
- G.G. Kaplan, MD, MPH, Department of Medicine, and Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
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16
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Charide R, Stallwood L, Munan M, Sayfi S, Hartling L, Butcher NJ, Offringa M, Elliott S, Richards DP, Mathew JL, Akl EA, Kredo T, Mbuagbaw L, Motillal A, Baba A, Prebeg M, Relihan J, Scott SD, Suvada J, Falavigna M, Klugar M, Lotfi T, Stevens A, Pottie K, Schünemann HJ. Knowledge mobilization activities to support decision-making by youth, parents, and adults using a systematic and living map of evidence and recommendations on COVID-19: protocol for three randomized controlled trials and qualitative user-experience studies. Trials 2023; 24:27. [PMID: 36641457 PMCID: PMC9840541 DOI: 10.1186/s13063-023-07067-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Accepted: 01/03/2023] [Indexed: 01/15/2023] Open
Abstract
INTRODUCTION The COVID-19 pandemic underlined that guidelines and recommendations must be made more accessible and more understandable to the general public to improve health outcomes. The objective of this study is to evaluate, quantify, and compare the public's understanding, usability, satisfaction, intention to implement, and preference for different ways of presenting COVID-19 health recommendations derived from the COVID-19 Living Map of Recommendations and Gateway to Contextualization (RecMap). METHODS AND ANALYSIS This is a protocol for a multi-method study. Through an online survey, we will conduct pragmatic allocation-concealed, blinded superiority randomized controlled trials (RCTs) in three populations to test alternative formats of presenting health recommendations: adults, parents, and youth, with at least 240 participants in each population. Prior to initiating the RCT, our interventions will have been refined with relevant stakeholder input. The intervention arm will receive a plain language recommendation (PLR) format while the control arm will receive the corresponding original recommendation format as originally published by the guideline organizations (standard language version). Our primary outcome is understanding, and our secondary outcomes are accessibility and usability, satisfaction, intended behavior, and preference for the recommendation formats. Each population's results will be analyzed separately. However, we are planning a meta-analysis of the results across populations. At the end of each survey, participants will be invited to participate in an optional one-on-one, virtual semi-structured interview to explore their user experience. All interviews will be transcribed and analyzed using the principles of thematic analysis and a hybrid inductive and deductive approach. ETHICS AND DISSEMINATION Through Clinical Trials Ontario, the Hamilton Integrated Research Ethics Board has reviewed and approved this protocol (Project ID: 3856). The University of Alberta has approved the parent portion of the trial (Project ID:00114894). Findings from this study will be disseminated through open-access publications in peer-reviewed journals and using social media. TRIAL REGISTRATION Clinicaltrials.gov NCT05358990 . Registered on May 3, 2022.
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Affiliation(s)
- Rana Charide
- grid.25073.330000 0004 1936 8227Michael G. DeGroote Cochrane Canada and McMaster GRADE Centres, Department of Health Research Methods, Evidence and Impact, McMaster University, 1280 Main St. W, Hamilton, Ontario L8S 4K1 Canada
| | - Lisa Stallwood
- grid.42327.300000 0004 0473 9646Child Health Evaluative Sciences, The Hospital for Sick Children Research Institute, Toronto, Ontario Canada
| | - Matthew Munan
- grid.17089.370000 0001 2190 316XAlberta Research Centre for Health Evidence, Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta Canada
| | - Shahab Sayfi
- grid.39381.300000 0004 1936 8884Schulich School of Medicine & Dentistry, Western University, London, Ontario Canada
| | - Lisa Hartling
- grid.17089.370000 0001 2190 316XAlberta Research Centre for Health Evidence, Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta Canada ,grid.17089.370000 0001 2190 316XCochrane Child Health, Department of Pediatrics, University of Alberta, Edmonton, Alberta Canada
| | - Nancy J. Butcher
- grid.42327.300000 0004 0473 9646Child Health Evaluative Sciences, The Hospital for Sick Children Research Institute, Toronto, Ontario Canada ,grid.17063.330000 0001 2157 2938Department of Psychiatry, University of Toronto, Toronto, Ontario Canada
| | - Martin Offringa
- grid.42327.300000 0004 0473 9646Child Health Evaluative Sciences, The Hospital for Sick Children Research Institute, Toronto, Ontario Canada ,grid.17063.330000 0001 2157 2938Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario Canada ,grid.42327.300000 0004 0473 9646Division of Neonatology, The Hospital for Sick Children, Toronto, Ontario Canada
| | - Sarah Elliott
- grid.17089.370000 0001 2190 316XAlberta Research Centre for Health Evidence, Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta Canada ,grid.17089.370000 0001 2190 316XCochrane Child Health, Department of Pediatrics, University of Alberta, Edmonton, Alberta Canada
| | - Dawn P. Richards
- Five02 Labs Inc, Toronto, Ontario Canada ,grid.498672.6Canadian Arthritis Patient Alliance, Toronto, Ontario Canada
| | - Joseph L. Mathew
- grid.415131.30000 0004 1767 2903Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Elie A. Akl
- grid.25073.330000 0004 1936 8227Michael G. DeGroote Cochrane Canada and McMaster GRADE Centres, Department of Health Research Methods, Evidence and Impact, McMaster University, 1280 Main St. W, Hamilton, Ontario L8S 4K1 Canada ,grid.22903.3a0000 0004 1936 9801Department of Internal Medicine, American University of Beirut, Beirut, Lebanon
| | - Tamara Kredo
- grid.415021.30000 0000 9155 0024Cochrane South Africa, South African Medical Research Council, Cape Town, South Africa ,grid.11956.3a0000 0001 2214 904XDivision of Clinical Pharmacology, Department of Medicine and Division of Epidemiology and Biostatistics, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa
| | - Lawrence Mbuagbaw
- grid.25073.330000 0004 1936 8227Michael G. DeGroote Cochrane Canada and McMaster GRADE Centres, Department of Health Research Methods, Evidence and Impact, McMaster University, 1280 Main St. W, Hamilton, Ontario L8S 4K1 Canada ,grid.25073.330000 0004 1936 8227Department of Anesthesia, McMaster University, Hamilton, Ontario Canada ,grid.25073.330000 0004 1936 8227Department of Pediatrics, McMaster University, Hamilton, Ontario Canada ,grid.416721.70000 0001 0742 7355Biostatistics Unit, Father Sean O’Sullivan Research Centre, St Joseph’s Healthcare, Hamilton, Ontario Canada ,grid.460723.40000 0004 0647 4688Centre for Development of Best Practices in Health (CDBPH), Yaoundé Central Hospital, Yaoundé, Cameroon ,grid.11956.3a0000 0001 2214 904XDivision of Epidemiology and Biostatistics, Department of Global Health, Stellenbosch University, Cape Town, South Africa
| | - Ashley Motillal
- grid.25073.330000 0004 1936 8227Michael G. DeGroote Cochrane Canada and McMaster GRADE Centres, Department of Health Research Methods, Evidence and Impact, McMaster University, 1280 Main St. W, Hamilton, Ontario L8S 4K1 Canada
| | - Ami Baba
- grid.42327.300000 0004 0473 9646Child Health Evaluative Sciences, The Hospital for Sick Children Research Institute, Toronto, Ontario Canada
| | - Matthew Prebeg
- grid.155956.b0000 0000 8793 5925Centre for Addiction and Mental Health, Toronto, Ontario Canada
| | - Jacqueline Relihan
- grid.155956.b0000 0000 8793 5925Centre for Addiction and Mental Health, Toronto, Ontario Canada
| | - Shannon D. Scott
- grid.17089.370000 0001 2190 316XFaculty of Nursing, University of Alberta, Edmonton, Alberta Canada
| | - Jozef Suvada
- Departments of Science and International Studies, St. Elizabeth University of Public Health and Social Science, Bratislava, Slovak Republic
| | - Maicon Falavigna
- grid.8532.c0000 0001 2200 7498National Institute for Health Technology Assessment, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Miloslav Klugar
- grid.10267.320000 0001 2194 0956Czech National Centre for Evidence-Based Healthcare and Knowledge Translation (Cochrane Czech Republic, Czech EBHC: JBI Centre of Excellence, Masaryk University GRADE Centre), Institute of Biostatistics and Analyses, Faculty of Medicine, Masaryk University, 625 00 Brno, Czech Republic
| | - Tamara Lotfi
- grid.25073.330000 0004 1936 8227Michael G. DeGroote Cochrane Canada and McMaster GRADE Centres, Department of Health Research Methods, Evidence and Impact, McMaster University, 1280 Main St. W, Hamilton, Ontario L8S 4K1 Canada
| | - Adrienne Stevens
- grid.415368.d0000 0001 0805 4386Centre for Immunization Readiness, Public Health Agency of Canada, Ottawa, Canada
| | - Kevin Pottie
- grid.39381.300000 0004 1936 8884Schulich School of Medicine & Dentistry, Western University, London, Ontario Canada ,grid.39381.300000 0004 1936 8884Department of Family Medicine, Western University, London, Ontario Canada
| | - Holger J. Schünemann
- grid.25073.330000 0004 1936 8227Michael G. DeGroote Cochrane Canada and McMaster GRADE Centres, Department of Health Research Methods, Evidence and Impact, McMaster University, 1280 Main St. W, Hamilton, Ontario L8S 4K1 Canada ,grid.452490.eDepartment of Biomedical Sciences, Humanitas University, Milan, Italy
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17
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Carroll K, Hudek N, Bénard A, Presseau J, Richards DP, Susan M, Fergusson DA, Graham ID, Mestre TA, Brehaut JC. Supporting Trial Participation in People with the Huntington's Gene: A Patient-Centered, Theory-Guided Survey of Barriers and Enablers. J Huntingtons Dis 2022; 11:421-434. [PMID: 36155526 DOI: 10.3233/jhd-220541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
BACKGROUND Under-recruitment regularly impedes clinical trials, leading to wasted resources and opportunity costs. Methods for designing trial participation strategies rarely consider behavior change theory. OBJECTIVE Informed by the Theoretical Domains Framework, we identified factors important to participating in Huntington's disease research and provide examples of how such a theory-informed approach can make specific suggestions about how to design targeted recruitment strategies. METHODS We identified a range of trial participation barriers and enablers based on interviews of key informants and implemented an online survey of members of the Huntington's disease community, asking them to rate the extent to which different factors would affect likelihood to participate in a generic Huntington's disease trial. RESULTS From 4,195 members, we received 323 responses and 243 completed surveys (323/4,195 or 8% participation, 243/323 or 75% completion). Respondents endorsed 9 barriers and 23 enablers relevant to trial participation. Most frequently endorsed barriers were travel to the study site (69%), worry about unknown side effects (65%), trial documents being difficult to understand (64%), and participation affecting other activities (49%). Enablers included optimism about likelihood of trial participation leading to a cure (98%), helping others (98%), contributing to science (97%), and having helpful people available to help with the participation decision (89%). CONCLUSION Our theory-informed survey to identify barriers to and enablers of Huntington's disease trial participation identified 32 factors, from 13 theoretical domains relevant to trial participation, and suggests effective approaches for improving trial participation and patient experience.
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Affiliation(s)
- Kelly Carroll
- Clinical Epidemiology Program, Ottawa Hospital Research Institute (OHRI), The Ottawa Hospital, Ottawa, ON, Canada
| | - Natasha Hudek
- Clinical Epidemiology Program, Ottawa Hospital Research Institute (OHRI), The Ottawa Hospital, Ottawa, ON, Canada
| | - Angèle Bénard
- Huntington Society of Canada (HSC), Waterloo, ON, Canada
| | - Justin Presseau
- Clinical Epidemiology Program, Ottawa Hospital Research Institute (OHRI), The Ottawa Hospital, Ottawa, ON, Canada.,School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada
| | | | - Marlin Susan
- Clinical Trials Ontario, MaRS Centre, Toronto, ON, Canada
| | - Dean A Fergusson
- Clinical Epidemiology Program, Ottawa Hospital Research Institute (OHRI), The Ottawa Hospital, Ottawa, ON, Canada.,School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada
| | - Ian D Graham
- Clinical Epidemiology Program, Ottawa Hospital Research Institute (OHRI), The Ottawa Hospital, Ottawa, ON, Canada.,School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada
| | - Tiago A Mestre
- Parkinson's Disease and Movement Disorders Centre, Division of Neurology, Department of Medicine, The Ottawa Hospital Research Institute, University of Ottawa Brain and Mind Research Institute, Ottawa, ON, Canada
| | - Jamie C Brehaut
- Clinical Epidemiology Program, Ottawa Hospital Research Institute (OHRI), The Ottawa Hospital, Ottawa, ON, Canada.,School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada
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18
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Hazlewood GS, Pardo JP, Barnabe C, Schieir O, Barber CEH, Proulx L, Richards DP, Tugwell P, Bansback N, Akhavan P, Bombardier C, Bykerk V, Jamal S, Khraishi M, Taylor-Gjevre R, Thorne JC, Agarwal A, Pope JE. Canadian Rheumatology Association Living Guidelines for the Pharmacological Management of Rheumatoid Arthritis With Disease-Modifying Antirheumatic Drugs. J Rheumatol 2022; 49:1092-1099. [PMID: 35840155 DOI: 10.3899/jrheum.220209] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/24/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVE To provide the initial installment of a living guideline that will provide up-to-date guidance on the pharmacological management of patients with rheumatoid arthritis (RA) in Canada. METHODS The Canadian Rheumatology Association (CRA) formed a multidisciplinary panel composed of rheumatologists, researchers, methodologists, and patients. In this first installment of our living guideline, the panel developed a recommendation for the tapering of biologic and targeted synthetic disease-modifying antirheumatic drug (b/ts DMARD) therapy in patients in sustained remission using the GRADE (Grading of Recommendations Assessment, Development, and Evaluation) approach, including a health equity framework developed for the Canadian RA population. The recommendation was adapted from a living guideline of the Australia & New Zealand Musculoskeletal Clinical Trials Network. RESULTS In people with RA who are in sustained low disease activity or remission for at least 6 months, we suggest offering stepwise reduction in the dose of b/tsDMARD without discontinuation, in the context of a shared decision, provided patients are able to rapidly access rheumatology care and reestablish their medications if needed. In patients where rapid access to care or reestablishing access to medications is challenging, we conditionally recommend against tapering. A patient decision aid was developed to complement the recommendation. CONCLUSION This living guideline will provide contemporary RA management recommendations for Canadian practice. New recommendations will be added over time and updated, with the latest recommendation, evidence summaries, and Evidence to Decision summaries available through the CRA website (www.rheum.ca).
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Affiliation(s)
- Glen S Hazlewood
- G.S. Hazlewood, MD, PhD, Associate Professor, C. Barnabe, MD, MSc, Professor, C.E.H. Barber, MD, PhD, Associate Professor, Departments of Medicine and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, and Arthritis Research Canada, Vancouver, British Columbia, Canada;
| | - Jordi Pardo Pardo
- J. Pardo Pardo, Ldo, Cochrane Musculoskeletal, University of Ottawa, Ottawa, Ontario, Canada
| | - Cheryl Barnabe
- G.S. Hazlewood, MD, PhD, Associate Professor, C. Barnabe, MD, MSc, Professor, C.E.H. Barber, MD, PhD, Associate Professor, Departments of Medicine and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, and Arthritis Research Canada, Vancouver, British Columbia, Canada
| | - Orit Schieir
- O. Schieir, PhD, Department of Medicine, McGill University, Montreal, Quebec, Canada
| | - Claire E H Barber
- G.S. Hazlewood, MD, PhD, Associate Professor, C. Barnabe, MD, MSc, Professor, C.E.H. Barber, MD, PhD, Associate Professor, Departments of Medicine and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, and Arthritis Research Canada, Vancouver, British Columbia, Canada
| | - Laurie Proulx
- L. Proulx, B.Com, D.P. Richards, PhD, Canadian Arthritis Patient Alliance, Toronto, Ontario, Canada
| | - Dawn P Richards
- L. Proulx, B.Com, D.P. Richards, PhD, Canadian Arthritis Patient Alliance, Toronto, Ontario, Canada
| | - Peter Tugwell
- P. Tugwell, MD, Professor, Department of Medicine and School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada
| | - Nick Bansback
- N. Bansback, PhD, Associate Professor, School of Population and Public Health, University of British Columbia, and Arthritis Research Canada, Vancouver, British Columbia, Canada
| | - Pooneh Akhavan
- P. Akhavan, MD, MSc, Division of Rheumatology, Mount Sinai Hospital, Toronto, Ontario, Canada
| | - Claire Bombardier
- C. Bombardier, MD, Professor, Division of Rheumatology, Mount Sinai Hospital, and Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Vivian Bykerk
- V. Bykerk, MD, Professor, Hospital for Special Surgery, New York, New York, USA
| | - Shahin Jamal
- S. Jamal, MD, MSc, Clinical Associate Professor, Division of Rheumatology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Majed Khraishi
- M. Khraishi, MD, Clinical Professor, Department of Medicine, Memorial University of Newfoundland, St. Johns, Newfoundland and Labrador, Canada
| | - Regina Taylor-Gjevre
- R. Taylor-Gjevre, MD, MSc, Professor, Division of Rheumatology, Department of Medicine, College of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - J Carter Thorne
- J.C. Thorne, MD, Assistant Professor, The Centre of Arthritis Excellence and The Arthritis Program Research Group, Newmarket, Ontario, Canada
| | - Arnav Agarwal
- A. Agarwal, MD, Division of General Internal Medicine, Department of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Janet E Pope
- J.E. Pope, MD, MPH, Professor, Dept of Medicine, Western University, Schulich School of Medicine & Dentistry, London, Ontario, Canada
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Vader K, Tutelman PR, Linkiewich D, Paré C, Wagenaar-Tison A, Birnie KA, Chambers CT, Eubanks K, Ghasemlou N, Gunderson J, Hudspith M, Lane T, Miller J, Richards DP. The state of patient engagement among pain research trainees in Canada: Results of a national web-based survey. Can J Pain 2022; 6:185-194. [DOI: 10.1080/24740527.2022.2115879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022] Open
Affiliation(s)
- Kyle Vader
- School of Rehabilitation Therapy, Queen’s University, Kingston, Ontario, Canada
| | - Perri R. Tutelman
- Department of Psychology & Neuroscience, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Delane Linkiewich
- Chronic Pain Network, McMaster University, Hamilton, Ontario, Canada
- Department of Psychology, University of Guelph, Guelph, Ontario, Canada
| | - Catherine Paré
- Department of Psychology, McGill University, Montréal, Québec, Canada
| | - Alice Wagenaar-Tison
- Department of Anatomy, Université du Québec à Trois-Rivières, Trois-Rivières, Québec, Canada
| | - Kathryn A. Birnie
- Department of Psychology & Neuroscience, Dalhousie University, Halifax, Nova Scotia, Canada
- Chronic Pain Network, McMaster University, Hamilton, Ontario, Canada
- Department of Anesthesiology, Perioperative and Pain Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Christine T. Chambers
- Department of Psychology & Neuroscience, Dalhousie University, Halifax, Nova Scotia, Canada
- Department of Pediatrics, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Kathleen Eubanks
- Chronic Pain Network, McMaster University, Hamilton, Ontario, Canada
| | - Nader Ghasemlou
- Chronic Pain Network, McMaster University, Hamilton, Ontario, Canada
- Departments of Anesthesiology & Perioperative Medicine and Biomedical & Molecular Sciences, Queen’s University, Kingston, Ontario, Canada
| | - Janet Gunderson
- Chronic Pain Network, McMaster University, Hamilton, Ontario, Canada
| | - Maria Hudspith
- Chronic Pain Network, McMaster University, Hamilton, Ontario, Canada
- Pain BC, Vancouver, British Columbia, Canada
| | - Therese Lane
- Chronic Pain Network, McMaster University, Hamilton, Ontario, Canada
| | - Jordan Miller
- School of Rehabilitation Therapy, Queen’s University, Kingston, Ontario, Canada
| | - Dawn P. Richards
- Chronic Pain Network, McMaster University, Hamilton, Ontario, Canada
- Five02 Labs Inc, Toronto, Ontario, Canada
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20
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Zvonareva O, Craveț C, Richards DP. Practices of patient engagement in drug development: a systematic scoping review. Res Involv Engagem 2022; 8:29. [PMID: 35768857 PMCID: PMC9243835 DOI: 10.1186/s40900-022-00364-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Accepted: 06/18/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND During the past decade, patient engagement (PE) has attracted significant attention in the field of drug development. Readiness to accept the central importance of patients' knowledge and contributions has become evident. This study aimed to synthesize evidence on the current state of PE in drug development: what is actually being done and how. METHODS A systematic scoping review was conducted based on a PRISMA-informed protocol. Search was performed in PubMed, EMBASE and Web of Science, covering the period between 2011 and 2021. For analysis of extracted data, we developed a framework for analyzing PE in Drug Development. The Framework distinguishes a number of different PE types that take place at different stages of drug development and are characterized by the different degrees of power patients have in the process. It allowed us to assess depth and intensity of PE initiatives included in this review. RESULTS Most included PE initiatives took place at the stage of designing studies (40 in total). At this stage drug development goals are already set, but the mode of reaching them has not yet been fully determined. PE initiatives on the finetuning details stage followed (16 in total). The finetuning details stage covers the last parts of the drug development trajectory, when only relatively minor issues are still open for patients' contributions. The least numerous were PE initiatives on the stage of setting up R&D program (13 in total). This stage refers to the early steps in drug development where PE has the potential to make the most impact on shaping the subsequent process. In terms of intensity of engagement, most PE initiatives included in this review align with consultation and involvement types, 26 and 30 initiatives, respectively. Partnership was less frequent in the published accounts of PE (13 initiatives). CONCLUSIONS This review delineated a contemporary landscape of PE in drug development. Although attention to PE in drug development is relatively recent, a wide range of PE practices has already been initiated. The results indicate the necessity of distinguishing between different types of PE in order to understand consequences of choices regarding depth and intensity of PE.
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Affiliation(s)
- Olga Zvonareva
- Department of Health, Ethics and Society, Maastricht University, Minderbroedersberg 4-6, 6211 LK, Maastricht, The Netherlands.
| | - Constanța Craveț
- Department of Health, Ethics and Society, Maastricht University, Minderbroedersberg 4-6, 6211 LK, Maastricht, The Netherlands
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21
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Parry M, Richards DP, Wells D, Najam A, Hemani S, Marlin S. Building Capacity for Patient-Oriented Research: Utilizing Decision Aids to Translate Evidence into Practice, Policy and Outcomes. Healthc Q 2022; 24:37-43. [PMID: 35467509 DOI: 10.12927/hcq.2022.26776] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
BACKGROUND The aim of this project was to engage with patient partners to translate knowledge about the decision aids and develop a scaling-up strategy for wider effects and reach. METHOD This project was guided by the World Health Organization and IDEAS (Integrate, Design, Assess and Share) frameworks for design thinking (e.g., ideating creative strategies), dissemination (e.g., sharing locally and widely) and scalability. RESULTS We engaged 132 stakeholders in six webinars, had 321 total page views of the decision aids and conducted 16 interviews to determine revisions to the design of the decision aids before scalability. CONCLUSION Patient-partner collaborations assisted with design thinking, dissemination and scalability.
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Affiliation(s)
- Monica Parry
- An associate professor at the Lawrence S. Bloomberg Faculty of Nursing at the University of Toronto in Toronto, ON. She can be contacted at
| | - Dawn P Richards
- The director of Patient and Public Engagement at Clinical Trials Ontario in Toronto, ON
| | - David Wells
- A patient partner with Diabetes Action Canada in Toronto, ON
| | - Adhiyat Najam
- A patient partner with Diabetes Action Canada in Toronto, ON
| | - Salima Hemani
- A trainee at the Lawrence S. Bloomberg Faculty of Nursing at the University of Toronto in Toronto, ON
| | - Susan Marlin
- The president and CEO at Clinical Trials Ontario in Toronto, ON
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22
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Zhang YQ, Jiao RM, Witt CM, Lao L, Liu JP, Thabane L, Sherman KJ, Cummings M, Richards DP, Kim EKA, Kim TH, Lee MS, Wechsler ME, Brinkhaus B, Mao JJ, Smith CA, Gang WJ, Liu BY, Liu ZS, Liu Y, Zheng H, Wu JN, Carrasco-Labra A, Bhandari M, Devereaux PJ, Jing XH, Guyatt G. How to design high quality acupuncture trials-a consensus informed by evidence. BMJ 2022; 376:e067476. [PMID: 35354583 PMCID: PMC8965655 DOI: 10.1136/bmj-2021-067476] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
An international panel including patients, clinicians, researchers, acupuncture and surgery trialists, statisticians, and experts in clinical epidemiology and methodology have developed new guidance for randomised controlled trials in acupuncture. It addresses the most prevalent and critical concerns of current acupuncture trials and will help funding agencies, trial registers, and journal editors to evaluate the relevance, importance, and quality of submitted trial proposals and completed trials
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Affiliation(s)
- Yu-Qing Zhang
- Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences, Beijing, China
- CEBIM (Center for Evidence-Based Integrative Medicine)-Clarity Collaboration, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
- Nottingham Ningbo GRADE Centre, University of Nottingham Ningbo, China
| | - Rui-Min Jiao
- Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences, Beijing, China
- China Center for Evidence-Based Traditional Chinese Medicine, China Academy of Chinese Medical Sciences, Beijing, China
| | - Claudia M Witt
- Institute for Complementary and Integrative Medicine, University Hospital Zurich and University of Zurich, Zurich, Switzerland
| | - Lixing Lao
- Virginia University of Integrative Medicine, Fairfax, VA, USA
| | - Jian-Ping Liu
- Center for Evidence-Based Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
- Institute for Excellence in Evidence-Based Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Lehana Thabane
- Department of Medicine, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
| | - Karen J Sherman
- Kaiser Permanente Washington Health Research Institute, Seattle WA, USA
- Department of Epidemiology, University of Washington, Seattle WA, USA
| | | | - Dawn P Richards
- Patient and Public Engagement, Clinical Trials Ontario, Toronto, ON, Canada
| | - Eun-Kyung Anna Kim
- Department of Western Medicine, Virginia University of Integrative Medicine, Fairfax, VA, USA
| | - Tae-Hun Kim
- Korean Medicine Clinical Trial Center, Seoul, Republic of Korea
- Korean Medicine Hospital, Seoul, Republic of Korea
- Kyung Hee University, Seoul, Republic of Korea
| | - Myeong Soo Lee
- Clinical Medicine Division, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
- Korean Convergence Medicine, University of Science and Technology, Daejeon, Republic of Korea
| | | | - Benno Brinkhaus
- Institute of Social Medicine, Epidemiology and Health Economics, Charité Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Jun J Mao
- Integrative Medicine Service, Memorial Sloan Kettering Cancer Center, Bendheim Integrative Medicine Center, New York, NY USA
| | - Caroline A Smith
- Translational Health Research Institute, Western Sydney University, Penrith, New South Wales, Australia
| | - Wei-Juan Gang
- Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences, Beijing, China
- China Center for Evidence-Based Traditional Chinese Medicine, China Academy of Chinese Medical Sciences, Beijing, China
| | - Bao-Yan Liu
- China Academy of Chinese Medical Sciences, Beijing, China
| | - Zhi-Shun Liu
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Yan Liu
- Key Laboratory of Chinese Internal Medicine of Ministry of Education, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Hui Zheng
- School of Acupuncture-Moxibustion and Tuina/The Third Affiliated Hospital, Chengdu University of Traditional Chinese Medicine, Sichuan, China
| | - Jia-Ni Wu
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Alonso Carrasco-Labra
- Center for Integrative Global Oral Health, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Mohit Bhandari
- Department of Medicine, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
| | - Philip J Devereaux
- Department of Medicine, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
| | - Xiang-Hong Jing
- Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences, Beijing, China
- China Center for Evidence-Based Traditional Chinese Medicine, China Academy of Chinese Medical Sciences, Beijing, China
| | - Gordon Guyatt
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
- Department of Medicine, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
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23
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MacKenzie NE, Chambers CT, Parker JA, Aubrey E, Jordan I, Richards DP, Marianayagam J, Ali S, Campbell F, Finley GA, Gruenwoldt E, Stevens B, Stinson J, Birnie KA. Bridging the gap: Identifying diverse stakeholder needs and barriers to accessing evidence and resources for children’s pain. Can J Pain 2022; 6:48-64. [PMID: 35603313 PMCID: PMC9116405 DOI: 10.1080/24740527.2022.2045192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Affiliation(s)
- Nicole E. MacKenzie
- Dalhousie University, Department of Psychology and Neuroscience, Halifax, Nova Scotia; IWK Health, Centre for Pediatric Pain Research, Halifax, Nova Scotia
| | - Christine T. Chambers
- Dalhousie University, Department of Psychology and Neuroscience, Halifax, Nova Scotia; IWK Health, Centre for Pediatric Pain Research, Halifax, Nova Scotia; Dalhousie University, Department of Pediatrics, Halifax, Nova Scotia
| | | | - Erin Aubrey
- Solutions for Kids in Pain, Halifax, Nova Scotia
| | - Isabel Jordan
- Patient and Family Partner, Squamish, British Columbia
| | | | | | - Samina Ali
- University of Alberta, Department of Pediatrics, Women and Children’s Health Research Institute, Faculty of Medicine & Dentistry, Edmonton, Alberta
| | - Fiona Campbell
- Department of Anesthesia and Pain Medicine, Hospital for Sick Children, University of Toronto, Toronto, Ontario
| | - G. Allen Finley
- Dalhousie University, Department of Anesthesia, Halifax, Nova Scotia; IWK Health Centre, Centre for Pediatric Pain Research, Halifax, Nova Scotia
| | | | - Bonnie Stevens
- The Hospital for Sick Children and Lawrence S. Bloomberg Faculty of Nursing, Toronto, Ontario
| | - Jennifer Stinson
- The Hospital for Sick Children and Lawrence S. Bloomberg Faculty of Nursing, Toronto, Ontario
| | - Kathryn A. Birnie
- University of Calgary, Department of Anesthesiology, Perioperative and Pain Medicine, Calgary, Alberta
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24
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Richards DP, Cobey KD, Proulx L, Dawson S, de Wit M, Toupin-April K. Identifying potential barriers and solutions to patient partner compensation (payment) in research. Res Involv Engagem 2022; 8:7. [PMID: 35197113 PMCID: PMC8867631 DOI: 10.1186/s40900-022-00341-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Accepted: 02/11/2022] [Indexed: 06/14/2023]
Abstract
Research that engages patients on the research team is often supported by grant funding from different organizations and, in some cases, principal investigators (who control the grant funding) provide patient partners with compensation (or payment) for their contributions. However, we have noted a gap in resources that identify and address barriers to compensating patient partners (no matter the size, degree or length of their engagement). In this paper, we present thoughts and experiences related to barriers to compensating patient partners with the goal of helping individuals identify and find solutions to these obstacles. Based on our experiences as individuals who live with chronic conditions and are patient partners, and those who are researchers who engage patient partners, we have identified eight barriers to compensating patient partners. We discuss each of these barriers: lack of awareness about patient partnership, institutional inflexibility, policy guidance from funders, compensation not prioritized in research budgets, leadership hesitancy to create a new system, culture of research teams, preconceived beliefs about the skills and abilities of patient partners, and expectations placed on patient partners. We demonstrate these barriers with real life examples and we offer some solutions. To further demonstrate these barriers, we ask readers to reflect on some scenarios that present realistic parallel situations to those that patient partners face. The intention is to illustrate, through empathy or putting yourself in someone else's shoes, how we might all do better with respect to institutional barriers related to patient partner compensation. Last, we issue a call to action to share resources and identify actions to overcome these barriers from which we will create an online resource repository.
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Affiliation(s)
- Dawn P Richards
- Five02 Labs Inc, Toronto, ON, Canada.
- Canadian Institutes of Health Research Institute of Musculoskeletal Health and Arthritis, University of British Columbia, Vancouver, BC, Canada.
- Canadian Arthritis Patient Alliance, Ottawa, ON, Canada.
- Patient Research Partner, Toronto, ON, Canada.
| | - Kelly D Cobey
- Meta-Research and Open Science Program, University of Ottawa Heart Institute, Ottawa, ON, Canada
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada
| | - Laurie Proulx
- Canadian Arthritis Patient Alliance, Ottawa, ON, Canada
- Patient Research Partner, Ottawa, ON, Canada
| | - Shoba Dawson
- Bristol Medical School, University of Bristol, Bristol, UK
| | | | - Karine Toupin-April
- School of Rehabilitation Sciences, University of Ottawa, Ottawa, ON, Canada
- Department of Pediatrics, University of Ottawa, Ottawa, ON, Canada
- Children's Hospital of Eastern Ontario Research Institute, Ottawa, ON, Canada
- Institut du Savoir Montfort, Ottawa, ON, Canada
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25
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Parry M, Ceroni T, Wells D, Richards DP, Toupin-April K, Ansari H, Bjørnnes AK, Burnside H, Cavallo S, Day A, Ellis A, Feldman D, Gilron I, Najam A, Zulfiqar Z, Marlin S. Patient engagement partnerships in clinical trials (PEP-CT): protocol for the systematic development and testing of patient partner and investigator decision aids. BMJ Open 2022; 12:e060267. [PMID: 35190448 PMCID: PMC8862478 DOI: 10.1136/bmjopen-2021-060267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
INTRODUCTION Building capacity to improve sex/gender knowledge and strengthen patient engagement in clinical trials requires training and support. The overall goal of this 2-year project is to refine, translate and evaluate two web-based open-access patient and investigator decision aids aimed to improve patient engagement partnerships in clinical trials. METHODS AND ANALYSIS Two decision aids were designed in Phase 1 of this programme of research and this protocol describes a subsequent sequential phased approach to refine/translate (Phase 2A) and conduct alpha/usability (Phase 2B) and beta/field (Phase 3) testing. Decision aid development is guided by the International Patient Decision Aid Standards, User-Centred Design, Ottawa Decision-Support Framework and the Ottawa Model of Research Use. We have integrated patient-oriented research methods by engaging patient partners across all phases of our programme of research. Decision aids will first be refined and then translated to French (Phase 2A). Eight iterative cycles of semistructured interviews with 40 participants (20 patient partners and 20 investigators) will be conducted to determine usability (Phase 2B). A pragmatic pre/post pilot study design will then be implemented for field/beta testing using another purposive sample of 80 English-speaking and French-speaking participants (40 patients and 40 investigators). The samples are purposive to ensure an equal representation of English-speaking and French-speaking participants and an equal representation of men and women. Since sex and/or gender differences in utilisation and effectiveness of decision aids have not been previously reported, Phase 3 outcomes will be reported for the total sample and separately for men and women. ETHICS AND DISSEMINATION Ethics approval has been granted from the University of Toronto (41109, 28 September 2021). Informed consent will be obtained from participants. Dissemination will include co-authored publications, conference presentations, educational national public forums, fact sheets/newsletters, social media sharing and videos/webinars.
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Affiliation(s)
- Monica Parry
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada
| | - Tina Ceroni
- Clinical Trials Ontario, Toronto, Ontario, Canada
| | - David Wells
- Diabetes Action Canada, Toronto, Ontario, Canada
| | | | - Karine Toupin-April
- School of Rehabilitation Sciences, University of Ottawa, Ottawa, Ontario, Canada
- Research Institute, Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada
- Institut du Savoir Montfort, Ottawa, Ontario, Canada
| | - Hafsa Ansari
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada
| | - Ann Kristin Bjørnnes
- Department of Nursing and Health Promotion, Oslo Metropolitan University, Oslo, Norway
| | - Heather Burnside
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada
| | - Sabrina Cavallo
- School of Rehabilitation, Faculty of Medicine, Université de Montréal, Montreal, Quebec, Canada
| | - Andrew Day
- Department of Community Health and Epidemiology and CERU, Queen's Unversity, Kingston, Ontario, Canada
| | - Anne Ellis
- Department of Medicine, Queen's University, Kingston, Ontario, Canada
| | - Debbie Feldman
- School of Rehabilitation, Faculty of Medicine, Université de Montréal, Montreal, Quebec, Canada
| | - Ian Gilron
- Departments of Anesthesiology and Perioperative Medicine, Biomedical and Molecular Sciences and School of Policy Studies, Queen's University, Kingston, Ontario, Canada
| | | | - Zoya Zulfiqar
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada
| | - Susan Marlin
- Clinical Trials Ontario, Toronto, Ontario, Canada
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26
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Hazlewood GS, Bombardier C, Li X, Movahedi M, Choquette D, Coupal L, Bykerk V, Schieir O, Mosher D, Marshall DA, Bernatsky S, Spencer N, Richards DP, Proulx L, Barber CEH. Heterogeneity in patient characteristics and differences in treatment across four Canadian rheumatoid arthritis cohorts. J Rheumatol 2021; 49:16-25. [PMID: 34334357 DOI: 10.3899/jrheum.201688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/16/2021] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To compare clinical characteristics and treatment of patients with rheumatoid arthritis (RA) across 4 Canadian cohorts. METHODS The four longitudinal cohorts included: The Canadian Early Arthritis Cohort (CATCH) (n=2878); Ontario Best Practices Research Initiative (OBRI) (n=3734); RHUMADATA® (Quebec, n=2890), and the Rheum4U Precision Health Registry (Calgary, n=709). Data were from cohort inception (range 1998-2016) to 2020. Clinical characteristics and drug treatments were summarized descriptively. RESULTS 10,211 patients with RA were included. The percentage of patients who entered the cohort with early RA ( ≤ 2 years of disease at enrolment) ranged from 29% (Rheum4U) to 100% (CATCH). Mean age (55 years), sex (74% female) and seropositivity (69%) were similar between cohorts. At the time of initial disease modifying anti-rheumatic drug (DMARD) use, median disease activity scores (DAS-28) varied, ranging from 2.99 (Rheum4U) to 5.19 (CATCH), but were more similar at the time of the first DMARD switch (range:3.57-5.03), first biologic or targeted synthetic DMARD (bDAMRD, tsDMARD) use (range:4.01-4.67) and second bDAMRD or tsDMARD (range:3.71-4.39). The initial DMARD was most commonly methotrexate, either in monotherapy (32%, range:18%-40%) or dual therapy (34%, range:29%- 42%). The first DMARD switch was to another DMARD monotherapy in 20% (range:10%- 32%), dual therapy in 49% (range:39%-56%), and bDMARD or tsDMARD in 24% (range:15%- 28%). The first bDMARD was an anti-TNF in 79% (range:78%-85%). CONCLUSION Canadian RA cohorts demonstrate some heterogeneity in treatment which could reflect differences in inclusion criteria, calendar year, or regional differences. This project is a first step towards conducting harmonized analyses across Canadian RA cohorts.
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Affiliation(s)
- Glen S Hazlewood
- Department of Medicine, University of Calgary; Department of Community Health Sciences, University of Calgary; Arthritis Research Canada; McCaig Institute for Bone and Joint Health; Department of Medicine University of Toronto; Toronto General Research Institute; Ontario Best Practices Research Initiative (OBRI); Institute of Health Policy, Management and Evaluation, University of Toronto; Université de Montréal, CHUM; RHUMADATA®; Hospital for Special Surgery, Weill Cornell Medical College; Canadian Early Arthritis Cohort (CATCH); Department of Medicine, McGill University; Canadian Arthritis Patient Alliance. Funding: This project was funded by an Arthritis Alliance of Canada Legacy Award. GSH is supported by a Canadian Institutes of Health Research New Investigator Award. CEHB has an Arthritis Stars Career Development Award, funded by the Canadian Institutes of Health Research-Institute of Musculoskeletal Health and Arthritis STAR-19-0611/CIHR SI2-169745. DAMar is supported by the Arthur J.E. Child Chair in Rheumatology and a Canada Research Chair in Health Systems and Services Research (2008-2018). The CATCH study was designed and implemented by the investigators and financially supported through unrestricted research grants from: Amgen and Pfizer Canada - Founding sponsors since January 2007; AbbVie Corporation and Hoffmann-LaRoche since 2011; Medexus Inc. since 2013; Eli Lilly Canada since 2016, Merck Canada since 2017, Sandoz Canada, Biopharmaceuticals since 2019 and Gilead Sciences Canada since 2020. Previously funded by Janssen Biotech from 2011-2016, UCB Canada and Bristol-Myers Squibb Canada from 2011-2018, and Sanofi Genzyme from 2016-2017. OBRI was funded by peer reviewed grants from CIHR (Canadian Institute for Health Research), Ontario Ministry of Health and Long-Term Care (MOHLTC ), Canadian Arthritis Network (CAN) and unrestricted grants from: Abbvie, Amgen, Celgene, Hospira, Janssen, Lilly, Merck, Novartis, Pfizer, Roche, Sanofi, & UCB. The Rheum4U Program is supported by unrestricted educational grants from the following pharmaceutical companies: AbbVie; Amgen; Bristol-Myers Squibb (BMS); Celgene; Janssen; Merck; Novartis; Pfizer;Roche; Sanofi; Sandoz; Swedish Orphan Biovitrum AB (publ) (Sobi); and Union Chimique Belge (UCB). Rhumadata® is supported by unrestricted grants from Abbvie Canada, Amgen Canada, Eli LillyCanada, Novartis Canada, Pfizer Canada, Sandoz Canada and Sanofi Canada. Conflicts of interest: The following authors declare potential conflicts of interest. D Choquette: AbbVie Canada, Amgen Canada, Eli Lilly Canada, Merk Canada, Novartis Canada, Pfizer Canada, Sandoz Canada, Sanofi-Genzyme Canada. V Bykerk: Consultant for Amgen, BMS, Gilead, Sanofi-Genzyme/Regeneron, Scipher, Pfizer Pharmaceuticals, UCB. The remainder of the authors declared no conflicts. Address correspondence to Glen Hazlewood MD PhD, , 3280 Hospital Drive NW, HMRB Building, Room 451, Calgary, AB T2N 4N1
| | - Claire Bombardier
- Department of Medicine, University of Calgary; Department of Community Health Sciences, University of Calgary; Arthritis Research Canada; McCaig Institute for Bone and Joint Health; Department of Medicine University of Toronto; Toronto General Research Institute; Ontario Best Practices Research Initiative (OBRI); Institute of Health Policy, Management and Evaluation, University of Toronto; Université de Montréal, CHUM; RHUMADATA®; Hospital for Special Surgery, Weill Cornell Medical College; Canadian Early Arthritis Cohort (CATCH); Department of Medicine, McGill University; Canadian Arthritis Patient Alliance. Funding: This project was funded by an Arthritis Alliance of Canada Legacy Award. GSH is supported by a Canadian Institutes of Health Research New Investigator Award. CEHB has an Arthritis Stars Career Development Award, funded by the Canadian Institutes of Health Research-Institute of Musculoskeletal Health and Arthritis STAR-19-0611/CIHR SI2-169745. DAMar is supported by the Arthur J.E. Child Chair in Rheumatology and a Canada Research Chair in Health Systems and Services Research (2008-2018). The CATCH study was designed and implemented by the investigators and financially supported through unrestricted research grants from: Amgen and Pfizer Canada - Founding sponsors since January 2007; AbbVie Corporation and Hoffmann-LaRoche since 2011; Medexus Inc. since 2013; Eli Lilly Canada since 2016, Merck Canada since 2017, Sandoz Canada, Biopharmaceuticals since 2019 and Gilead Sciences Canada since 2020. Previously funded by Janssen Biotech from 2011-2016, UCB Canada and Bristol-Myers Squibb Canada from 2011-2018, and Sanofi Genzyme from 2016-2017. OBRI was funded by peer reviewed grants from CIHR (Canadian Institute for Health Research), Ontario Ministry of Health and Long-Term Care (MOHLTC ), Canadian Arthritis Network (CAN) and unrestricted grants from: Abbvie, Amgen, Celgene, Hospira, Janssen, Lilly, Merck, Novartis, Pfizer, Roche, Sanofi, & UCB. The Rheum4U Program is supported by unrestricted educational grants from the following pharmaceutical companies: AbbVie; Amgen; Bristol-Myers Squibb (BMS); Celgene; Janssen; Merck; Novartis; Pfizer;Roche; Sanofi; Sandoz; Swedish Orphan Biovitrum AB (publ) (Sobi); and Union Chimique Belge (UCB). Rhumadata® is supported by unrestricted grants from Abbvie Canada, Amgen Canada, Eli LillyCanada, Novartis Canada, Pfizer Canada, Sandoz Canada and Sanofi Canada. Conflicts of interest: The following authors declare potential conflicts of interest. D Choquette: AbbVie Canada, Amgen Canada, Eli Lilly Canada, Merk Canada, Novartis Canada, Pfizer Canada, Sandoz Canada, Sanofi-Genzyme Canada. V Bykerk: Consultant for Amgen, BMS, Gilead, Sanofi-Genzyme/Regeneron, Scipher, Pfizer Pharmaceuticals, UCB. The remainder of the authors declared no conflicts. Address correspondence to Glen Hazlewood MD PhD, , 3280 Hospital Drive NW, HMRB Building, Room 451, Calgary, AB T2N 4N1
| | - Xiuying Li
- Department of Medicine, University of Calgary; Department of Community Health Sciences, University of Calgary; Arthritis Research Canada; McCaig Institute for Bone and Joint Health; Department of Medicine University of Toronto; Toronto General Research Institute; Ontario Best Practices Research Initiative (OBRI); Institute of Health Policy, Management and Evaluation, University of Toronto; Université de Montréal, CHUM; RHUMADATA®; Hospital for Special Surgery, Weill Cornell Medical College; Canadian Early Arthritis Cohort (CATCH); Department of Medicine, McGill University; Canadian Arthritis Patient Alliance. Funding: This project was funded by an Arthritis Alliance of Canada Legacy Award. GSH is supported by a Canadian Institutes of Health Research New Investigator Award. CEHB has an Arthritis Stars Career Development Award, funded by the Canadian Institutes of Health Research-Institute of Musculoskeletal Health and Arthritis STAR-19-0611/CIHR SI2-169745. DAMar is supported by the Arthur J.E. Child Chair in Rheumatology and a Canada Research Chair in Health Systems and Services Research (2008-2018). The CATCH study was designed and implemented by the investigators and financially supported through unrestricted research grants from: Amgen and Pfizer Canada - Founding sponsors since January 2007; AbbVie Corporation and Hoffmann-LaRoche since 2011; Medexus Inc. since 2013; Eli Lilly Canada since 2016, Merck Canada since 2017, Sandoz Canada, Biopharmaceuticals since 2019 and Gilead Sciences Canada since 2020. Previously funded by Janssen Biotech from 2011-2016, UCB Canada and Bristol-Myers Squibb Canada from 2011-2018, and Sanofi Genzyme from 2016-2017. OBRI was funded by peer reviewed grants from CIHR (Canadian Institute for Health Research), Ontario Ministry of Health and Long-Term Care (MOHLTC ), Canadian Arthritis Network (CAN) and unrestricted grants from: Abbvie, Amgen, Celgene, Hospira, Janssen, Lilly, Merck, Novartis, Pfizer, Roche, Sanofi, & UCB. The Rheum4U Program is supported by unrestricted educational grants from the following pharmaceutical companies: AbbVie; Amgen; Bristol-Myers Squibb (BMS); Celgene; Janssen; Merck; Novartis; Pfizer;Roche; Sanofi; Sandoz; Swedish Orphan Biovitrum AB (publ) (Sobi); and Union Chimique Belge (UCB). Rhumadata® is supported by unrestricted grants from Abbvie Canada, Amgen Canada, Eli LillyCanada, Novartis Canada, Pfizer Canada, Sandoz Canada and Sanofi Canada. Conflicts of interest: The following authors declare potential conflicts of interest. D Choquette: AbbVie Canada, Amgen Canada, Eli Lilly Canada, Merk Canada, Novartis Canada, Pfizer Canada, Sandoz Canada, Sanofi-Genzyme Canada. V Bykerk: Consultant for Amgen, BMS, Gilead, Sanofi-Genzyme/Regeneron, Scipher, Pfizer Pharmaceuticals, UCB. The remainder of the authors declared no conflicts. Address correspondence to Glen Hazlewood MD PhD, , 3280 Hospital Drive NW, HMRB Building, Room 451, Calgary, AB T2N 4N1
| | - Mohammad Movahedi
- Department of Medicine, University of Calgary; Department of Community Health Sciences, University of Calgary; Arthritis Research Canada; McCaig Institute for Bone and Joint Health; Department of Medicine University of Toronto; Toronto General Research Institute; Ontario Best Practices Research Initiative (OBRI); Institute of Health Policy, Management and Evaluation, University of Toronto; Université de Montréal, CHUM; RHUMADATA®; Hospital for Special Surgery, Weill Cornell Medical College; Canadian Early Arthritis Cohort (CATCH); Department of Medicine, McGill University; Canadian Arthritis Patient Alliance. Funding: This project was funded by an Arthritis Alliance of Canada Legacy Award. GSH is supported by a Canadian Institutes of Health Research New Investigator Award. CEHB has an Arthritis Stars Career Development Award, funded by the Canadian Institutes of Health Research-Institute of Musculoskeletal Health and Arthritis STAR-19-0611/CIHR SI2-169745. DAMar is supported by the Arthur J.E. Child Chair in Rheumatology and a Canada Research Chair in Health Systems and Services Research (2008-2018). The CATCH study was designed and implemented by the investigators and financially supported through unrestricted research grants from: Amgen and Pfizer Canada - Founding sponsors since January 2007; AbbVie Corporation and Hoffmann-LaRoche since 2011; Medexus Inc. since 2013; Eli Lilly Canada since 2016, Merck Canada since 2017, Sandoz Canada, Biopharmaceuticals since 2019 and Gilead Sciences Canada since 2020. Previously funded by Janssen Biotech from 2011-2016, UCB Canada and Bristol-Myers Squibb Canada from 2011-2018, and Sanofi Genzyme from 2016-2017. OBRI was funded by peer reviewed grants from CIHR (Canadian Institute for Health Research), Ontario Ministry of Health and Long-Term Care (MOHLTC ), Canadian Arthritis Network (CAN) and unrestricted grants from: Abbvie, Amgen, Celgene, Hospira, Janssen, Lilly, Merck, Novartis, Pfizer, Roche, Sanofi, & UCB. The Rheum4U Program is supported by unrestricted educational grants from the following pharmaceutical companies: AbbVie; Amgen; Bristol-Myers Squibb (BMS); Celgene; Janssen; Merck; Novartis; Pfizer;Roche; Sanofi; Sandoz; Swedish Orphan Biovitrum AB (publ) (Sobi); and Union Chimique Belge (UCB). Rhumadata® is supported by unrestricted grants from Abbvie Canada, Amgen Canada, Eli LillyCanada, Novartis Canada, Pfizer Canada, Sandoz Canada and Sanofi Canada. Conflicts of interest: The following authors declare potential conflicts of interest. D Choquette: AbbVie Canada, Amgen Canada, Eli Lilly Canada, Merk Canada, Novartis Canada, Pfizer Canada, Sandoz Canada, Sanofi-Genzyme Canada. V Bykerk: Consultant for Amgen, BMS, Gilead, Sanofi-Genzyme/Regeneron, Scipher, Pfizer Pharmaceuticals, UCB. The remainder of the authors declared no conflicts. Address correspondence to Glen Hazlewood MD PhD, , 3280 Hospital Drive NW, HMRB Building, Room 451, Calgary, AB T2N 4N1
| | - Denis Choquette
- Department of Medicine, University of Calgary; Department of Community Health Sciences, University of Calgary; Arthritis Research Canada; McCaig Institute for Bone and Joint Health; Department of Medicine University of Toronto; Toronto General Research Institute; Ontario Best Practices Research Initiative (OBRI); Institute of Health Policy, Management and Evaluation, University of Toronto; Université de Montréal, CHUM; RHUMADATA®; Hospital for Special Surgery, Weill Cornell Medical College; Canadian Early Arthritis Cohort (CATCH); Department of Medicine, McGill University; Canadian Arthritis Patient Alliance. Funding: This project was funded by an Arthritis Alliance of Canada Legacy Award. GSH is supported by a Canadian Institutes of Health Research New Investigator Award. CEHB has an Arthritis Stars Career Development Award, funded by the Canadian Institutes of Health Research-Institute of Musculoskeletal Health and Arthritis STAR-19-0611/CIHR SI2-169745. DAMar is supported by the Arthur J.E. Child Chair in Rheumatology and a Canada Research Chair in Health Systems and Services Research (2008-2018). The CATCH study was designed and implemented by the investigators and financially supported through unrestricted research grants from: Amgen and Pfizer Canada - Founding sponsors since January 2007; AbbVie Corporation and Hoffmann-LaRoche since 2011; Medexus Inc. since 2013; Eli Lilly Canada since 2016, Merck Canada since 2017, Sandoz Canada, Biopharmaceuticals since 2019 and Gilead Sciences Canada since 2020. Previously funded by Janssen Biotech from 2011-2016, UCB Canada and Bristol-Myers Squibb Canada from 2011-2018, and Sanofi Genzyme from 2016-2017. OBRI was funded by peer reviewed grants from CIHR (Canadian Institute for Health Research), Ontario Ministry of Health and Long-Term Care (MOHLTC ), Canadian Arthritis Network (CAN) and unrestricted grants from: Abbvie, Amgen, Celgene, Hospira, Janssen, Lilly, Merck, Novartis, Pfizer, Roche, Sanofi, & UCB. The Rheum4U Program is supported by unrestricted educational grants from the following pharmaceutical companies: AbbVie; Amgen; Bristol-Myers Squibb (BMS); Celgene; Janssen; Merck; Novartis; Pfizer;Roche; Sanofi; Sandoz; Swedish Orphan Biovitrum AB (publ) (Sobi); and Union Chimique Belge (UCB). Rhumadata® is supported by unrestricted grants from Abbvie Canada, Amgen Canada, Eli LillyCanada, Novartis Canada, Pfizer Canada, Sandoz Canada and Sanofi Canada. Conflicts of interest: The following authors declare potential conflicts of interest. D Choquette: AbbVie Canada, Amgen Canada, Eli Lilly Canada, Merk Canada, Novartis Canada, Pfizer Canada, Sandoz Canada, Sanofi-Genzyme Canada. V Bykerk: Consultant for Amgen, BMS, Gilead, Sanofi-Genzyme/Regeneron, Scipher, Pfizer Pharmaceuticals, UCB. The remainder of the authors declared no conflicts. Address correspondence to Glen Hazlewood MD PhD, , 3280 Hospital Drive NW, HMRB Building, Room 451, Calgary, AB T2N 4N1
| | - Louis Coupal
- Department of Medicine, University of Calgary; Department of Community Health Sciences, University of Calgary; Arthritis Research Canada; McCaig Institute for Bone and Joint Health; Department of Medicine University of Toronto; Toronto General Research Institute; Ontario Best Practices Research Initiative (OBRI); Institute of Health Policy, Management and Evaluation, University of Toronto; Université de Montréal, CHUM; RHUMADATA®; Hospital for Special Surgery, Weill Cornell Medical College; Canadian Early Arthritis Cohort (CATCH); Department of Medicine, McGill University; Canadian Arthritis Patient Alliance. Funding: This project was funded by an Arthritis Alliance of Canada Legacy Award. GSH is supported by a Canadian Institutes of Health Research New Investigator Award. CEHB has an Arthritis Stars Career Development Award, funded by the Canadian Institutes of Health Research-Institute of Musculoskeletal Health and Arthritis STAR-19-0611/CIHR SI2-169745. DAMar is supported by the Arthur J.E. Child Chair in Rheumatology and a Canada Research Chair in Health Systems and Services Research (2008-2018). The CATCH study was designed and implemented by the investigators and financially supported through unrestricted research grants from: Amgen and Pfizer Canada - Founding sponsors since January 2007; AbbVie Corporation and Hoffmann-LaRoche since 2011; Medexus Inc. since 2013; Eli Lilly Canada since 2016, Merck Canada since 2017, Sandoz Canada, Biopharmaceuticals since 2019 and Gilead Sciences Canada since 2020. Previously funded by Janssen Biotech from 2011-2016, UCB Canada and Bristol-Myers Squibb Canada from 2011-2018, and Sanofi Genzyme from 2016-2017. OBRI was funded by peer reviewed grants from CIHR (Canadian Institute for Health Research), Ontario Ministry of Health and Long-Term Care (MOHLTC ), Canadian Arthritis Network (CAN) and unrestricted grants from: Abbvie, Amgen, Celgene, Hospira, Janssen, Lilly, Merck, Novartis, Pfizer, Roche, Sanofi, & UCB. The Rheum4U Program is supported by unrestricted educational grants from the following pharmaceutical companies: AbbVie; Amgen; Bristol-Myers Squibb (BMS); Celgene; Janssen; Merck; Novartis; Pfizer;Roche; Sanofi; Sandoz; Swedish Orphan Biovitrum AB (publ) (Sobi); and Union Chimique Belge (UCB). Rhumadata® is supported by unrestricted grants from Abbvie Canada, Amgen Canada, Eli LillyCanada, Novartis Canada, Pfizer Canada, Sandoz Canada and Sanofi Canada. Conflicts of interest: The following authors declare potential conflicts of interest. D Choquette: AbbVie Canada, Amgen Canada, Eli Lilly Canada, Merk Canada, Novartis Canada, Pfizer Canada, Sandoz Canada, Sanofi-Genzyme Canada. V Bykerk: Consultant for Amgen, BMS, Gilead, Sanofi-Genzyme/Regeneron, Scipher, Pfizer Pharmaceuticals, UCB. The remainder of the authors declared no conflicts. Address correspondence to Glen Hazlewood MD PhD, , 3280 Hospital Drive NW, HMRB Building, Room 451, Calgary, AB T2N 4N1
| | - Vivian Bykerk
- Department of Medicine, University of Calgary; Department of Community Health Sciences, University of Calgary; Arthritis Research Canada; McCaig Institute for Bone and Joint Health; Department of Medicine University of Toronto; Toronto General Research Institute; Ontario Best Practices Research Initiative (OBRI); Institute of Health Policy, Management and Evaluation, University of Toronto; Université de Montréal, CHUM; RHUMADATA®; Hospital for Special Surgery, Weill Cornell Medical College; Canadian Early Arthritis Cohort (CATCH); Department of Medicine, McGill University; Canadian Arthritis Patient Alliance. Funding: This project was funded by an Arthritis Alliance of Canada Legacy Award. GSH is supported by a Canadian Institutes of Health Research New Investigator Award. CEHB has an Arthritis Stars Career Development Award, funded by the Canadian Institutes of Health Research-Institute of Musculoskeletal Health and Arthritis STAR-19-0611/CIHR SI2-169745. DAMar is supported by the Arthur J.E. Child Chair in Rheumatology and a Canada Research Chair in Health Systems and Services Research (2008-2018). The CATCH study was designed and implemented by the investigators and financially supported through unrestricted research grants from: Amgen and Pfizer Canada - Founding sponsors since January 2007; AbbVie Corporation and Hoffmann-LaRoche since 2011; Medexus Inc. since 2013; Eli Lilly Canada since 2016, Merck Canada since 2017, Sandoz Canada, Biopharmaceuticals since 2019 and Gilead Sciences Canada since 2020. Previously funded by Janssen Biotech from 2011-2016, UCB Canada and Bristol-Myers Squibb Canada from 2011-2018, and Sanofi Genzyme from 2016-2017. OBRI was funded by peer reviewed grants from CIHR (Canadian Institute for Health Research), Ontario Ministry of Health and Long-Term Care (MOHLTC ), Canadian Arthritis Network (CAN) and unrestricted grants from: Abbvie, Amgen, Celgene, Hospira, Janssen, Lilly, Merck, Novartis, Pfizer, Roche, Sanofi, & UCB. The Rheum4U Program is supported by unrestricted educational grants from the following pharmaceutical companies: AbbVie; Amgen; Bristol-Myers Squibb (BMS); Celgene; Janssen; Merck; Novartis; Pfizer;Roche; Sanofi; Sandoz; Swedish Orphan Biovitrum AB (publ) (Sobi); and Union Chimique Belge (UCB). Rhumadata® is supported by unrestricted grants from Abbvie Canada, Amgen Canada, Eli LillyCanada, Novartis Canada, Pfizer Canada, Sandoz Canada and Sanofi Canada. Conflicts of interest: The following authors declare potential conflicts of interest. D Choquette: AbbVie Canada, Amgen Canada, Eli Lilly Canada, Merk Canada, Novartis Canada, Pfizer Canada, Sandoz Canada, Sanofi-Genzyme Canada. V Bykerk: Consultant for Amgen, BMS, Gilead, Sanofi-Genzyme/Regeneron, Scipher, Pfizer Pharmaceuticals, UCB. The remainder of the authors declared no conflicts. Address correspondence to Glen Hazlewood MD PhD, , 3280 Hospital Drive NW, HMRB Building, Room 451, Calgary, AB T2N 4N1
| | - Orit Schieir
- Department of Medicine, University of Calgary; Department of Community Health Sciences, University of Calgary; Arthritis Research Canada; McCaig Institute for Bone and Joint Health; Department of Medicine University of Toronto; Toronto General Research Institute; Ontario Best Practices Research Initiative (OBRI); Institute of Health Policy, Management and Evaluation, University of Toronto; Université de Montréal, CHUM; RHUMADATA®; Hospital for Special Surgery, Weill Cornell Medical College; Canadian Early Arthritis Cohort (CATCH); Department of Medicine, McGill University; Canadian Arthritis Patient Alliance. Funding: This project was funded by an Arthritis Alliance of Canada Legacy Award. GSH is supported by a Canadian Institutes of Health Research New Investigator Award. CEHB has an Arthritis Stars Career Development Award, funded by the Canadian Institutes of Health Research-Institute of Musculoskeletal Health and Arthritis STAR-19-0611/CIHR SI2-169745. DAMar is supported by the Arthur J.E. Child Chair in Rheumatology and a Canada Research Chair in Health Systems and Services Research (2008-2018). The CATCH study was designed and implemented by the investigators and financially supported through unrestricted research grants from: Amgen and Pfizer Canada - Founding sponsors since January 2007; AbbVie Corporation and Hoffmann-LaRoche since 2011; Medexus Inc. since 2013; Eli Lilly Canada since 2016, Merck Canada since 2017, Sandoz Canada, Biopharmaceuticals since 2019 and Gilead Sciences Canada since 2020. Previously funded by Janssen Biotech from 2011-2016, UCB Canada and Bristol-Myers Squibb Canada from 2011-2018, and Sanofi Genzyme from 2016-2017. OBRI was funded by peer reviewed grants from CIHR (Canadian Institute for Health Research), Ontario Ministry of Health and Long-Term Care (MOHLTC ), Canadian Arthritis Network (CAN) and unrestricted grants from: Abbvie, Amgen, Celgene, Hospira, Janssen, Lilly, Merck, Novartis, Pfizer, Roche, Sanofi, & UCB. The Rheum4U Program is supported by unrestricted educational grants from the following pharmaceutical companies: AbbVie; Amgen; Bristol-Myers Squibb (BMS); Celgene; Janssen; Merck; Novartis; Pfizer;Roche; Sanofi; Sandoz; Swedish Orphan Biovitrum AB (publ) (Sobi); and Union Chimique Belge (UCB). Rhumadata® is supported by unrestricted grants from Abbvie Canada, Amgen Canada, Eli LillyCanada, Novartis Canada, Pfizer Canada, Sandoz Canada and Sanofi Canada. Conflicts of interest: The following authors declare potential conflicts of interest. D Choquette: AbbVie Canada, Amgen Canada, Eli Lilly Canada, Merk Canada, Novartis Canada, Pfizer Canada, Sandoz Canada, Sanofi-Genzyme Canada. V Bykerk: Consultant for Amgen, BMS, Gilead, Sanofi-Genzyme/Regeneron, Scipher, Pfizer Pharmaceuticals, UCB. The remainder of the authors declared no conflicts. Address correspondence to Glen Hazlewood MD PhD, , 3280 Hospital Drive NW, HMRB Building, Room 451, Calgary, AB T2N 4N1
| | - Dianne Mosher
- Department of Medicine, University of Calgary; Department of Community Health Sciences, University of Calgary; Arthritis Research Canada; McCaig Institute for Bone and Joint Health; Department of Medicine University of Toronto; Toronto General Research Institute; Ontario Best Practices Research Initiative (OBRI); Institute of Health Policy, Management and Evaluation, University of Toronto; Université de Montréal, CHUM; RHUMADATA®; Hospital for Special Surgery, Weill Cornell Medical College; Canadian Early Arthritis Cohort (CATCH); Department of Medicine, McGill University; Canadian Arthritis Patient Alliance. Funding: This project was funded by an Arthritis Alliance of Canada Legacy Award. GSH is supported by a Canadian Institutes of Health Research New Investigator Award. CEHB has an Arthritis Stars Career Development Award, funded by the Canadian Institutes of Health Research-Institute of Musculoskeletal Health and Arthritis STAR-19-0611/CIHR SI2-169745. DAMar is supported by the Arthur J.E. Child Chair in Rheumatology and a Canada Research Chair in Health Systems and Services Research (2008-2018). The CATCH study was designed and implemented by the investigators and financially supported through unrestricted research grants from: Amgen and Pfizer Canada - Founding sponsors since January 2007; AbbVie Corporation and Hoffmann-LaRoche since 2011; Medexus Inc. since 2013; Eli Lilly Canada since 2016, Merck Canada since 2017, Sandoz Canada, Biopharmaceuticals since 2019 and Gilead Sciences Canada since 2020. Previously funded by Janssen Biotech from 2011-2016, UCB Canada and Bristol-Myers Squibb Canada from 2011-2018, and Sanofi Genzyme from 2016-2017. OBRI was funded by peer reviewed grants from CIHR (Canadian Institute for Health Research), Ontario Ministry of Health and Long-Term Care (MOHLTC ), Canadian Arthritis Network (CAN) and unrestricted grants from: Abbvie, Amgen, Celgene, Hospira, Janssen, Lilly, Merck, Novartis, Pfizer, Roche, Sanofi, & UCB. The Rheum4U Program is supported by unrestricted educational grants from the following pharmaceutical companies: AbbVie; Amgen; Bristol-Myers Squibb (BMS); Celgene; Janssen; Merck; Novartis; Pfizer;Roche; Sanofi; Sandoz; Swedish Orphan Biovitrum AB (publ) (Sobi); and Union Chimique Belge (UCB). Rhumadata® is supported by unrestricted grants from Abbvie Canada, Amgen Canada, Eli LillyCanada, Novartis Canada, Pfizer Canada, Sandoz Canada and Sanofi Canada. Conflicts of interest: The following authors declare potential conflicts of interest. D Choquette: AbbVie Canada, Amgen Canada, Eli Lilly Canada, Merk Canada, Novartis Canada, Pfizer Canada, Sandoz Canada, Sanofi-Genzyme Canada. V Bykerk: Consultant for Amgen, BMS, Gilead, Sanofi-Genzyme/Regeneron, Scipher, Pfizer Pharmaceuticals, UCB. The remainder of the authors declared no conflicts. Address correspondence to Glen Hazlewood MD PhD, , 3280 Hospital Drive NW, HMRB Building, Room 451, Calgary, AB T2N 4N1
| | - Deborah A Marshall
- Department of Medicine, University of Calgary; Department of Community Health Sciences, University of Calgary; Arthritis Research Canada; McCaig Institute for Bone and Joint Health; Department of Medicine University of Toronto; Toronto General Research Institute; Ontario Best Practices Research Initiative (OBRI); Institute of Health Policy, Management and Evaluation, University of Toronto; Université de Montréal, CHUM; RHUMADATA®; Hospital for Special Surgery, Weill Cornell Medical College; Canadian Early Arthritis Cohort (CATCH); Department of Medicine, McGill University; Canadian Arthritis Patient Alliance. Funding: This project was funded by an Arthritis Alliance of Canada Legacy Award. GSH is supported by a Canadian Institutes of Health Research New Investigator Award. CEHB has an Arthritis Stars Career Development Award, funded by the Canadian Institutes of Health Research-Institute of Musculoskeletal Health and Arthritis STAR-19-0611/CIHR SI2-169745. DAMar is supported by the Arthur J.E. Child Chair in Rheumatology and a Canada Research Chair in Health Systems and Services Research (2008-2018). The CATCH study was designed and implemented by the investigators and financially supported through unrestricted research grants from: Amgen and Pfizer Canada - Founding sponsors since January 2007; AbbVie Corporation and Hoffmann-LaRoche since 2011; Medexus Inc. since 2013; Eli Lilly Canada since 2016, Merck Canada since 2017, Sandoz Canada, Biopharmaceuticals since 2019 and Gilead Sciences Canada since 2020. Previously funded by Janssen Biotech from 2011-2016, UCB Canada and Bristol-Myers Squibb Canada from 2011-2018, and Sanofi Genzyme from 2016-2017. OBRI was funded by peer reviewed grants from CIHR (Canadian Institute for Health Research), Ontario Ministry of Health and Long-Term Care (MOHLTC ), Canadian Arthritis Network (CAN) and unrestricted grants from: Abbvie, Amgen, Celgene, Hospira, Janssen, Lilly, Merck, Novartis, Pfizer, Roche, Sanofi, & UCB. The Rheum4U Program is supported by unrestricted educational grants from the following pharmaceutical companies: AbbVie; Amgen; Bristol-Myers Squibb (BMS); Celgene; Janssen; Merck; Novartis; Pfizer;Roche; Sanofi; Sandoz; Swedish Orphan Biovitrum AB (publ) (Sobi); and Union Chimique Belge (UCB). Rhumadata® is supported by unrestricted grants from Abbvie Canada, Amgen Canada, Eli LillyCanada, Novartis Canada, Pfizer Canada, Sandoz Canada and Sanofi Canada. Conflicts of interest: The following authors declare potential conflicts of interest. D Choquette: AbbVie Canada, Amgen Canada, Eli Lilly Canada, Merk Canada, Novartis Canada, Pfizer Canada, Sandoz Canada, Sanofi-Genzyme Canada. V Bykerk: Consultant for Amgen, BMS, Gilead, Sanofi-Genzyme/Regeneron, Scipher, Pfizer Pharmaceuticals, UCB. The remainder of the authors declared no conflicts. Address correspondence to Glen Hazlewood MD PhD, , 3280 Hospital Drive NW, HMRB Building, Room 451, Calgary, AB T2N 4N1
| | - Sasha Bernatsky
- Department of Medicine, University of Calgary; Department of Community Health Sciences, University of Calgary; Arthritis Research Canada; McCaig Institute for Bone and Joint Health; Department of Medicine University of Toronto; Toronto General Research Institute; Ontario Best Practices Research Initiative (OBRI); Institute of Health Policy, Management and Evaluation, University of Toronto; Université de Montréal, CHUM; RHUMADATA®; Hospital for Special Surgery, Weill Cornell Medical College; Canadian Early Arthritis Cohort (CATCH); Department of Medicine, McGill University; Canadian Arthritis Patient Alliance. Funding: This project was funded by an Arthritis Alliance of Canada Legacy Award. GSH is supported by a Canadian Institutes of Health Research New Investigator Award. CEHB has an Arthritis Stars Career Development Award, funded by the Canadian Institutes of Health Research-Institute of Musculoskeletal Health and Arthritis STAR-19-0611/CIHR SI2-169745. DAMar is supported by the Arthur J.E. Child Chair in Rheumatology and a Canada Research Chair in Health Systems and Services Research (2008-2018). The CATCH study was designed and implemented by the investigators and financially supported through unrestricted research grants from: Amgen and Pfizer Canada - Founding sponsors since January 2007; AbbVie Corporation and Hoffmann-LaRoche since 2011; Medexus Inc. since 2013; Eli Lilly Canada since 2016, Merck Canada since 2017, Sandoz Canada, Biopharmaceuticals since 2019 and Gilead Sciences Canada since 2020. Previously funded by Janssen Biotech from 2011-2016, UCB Canada and Bristol-Myers Squibb Canada from 2011-2018, and Sanofi Genzyme from 2016-2017. OBRI was funded by peer reviewed grants from CIHR (Canadian Institute for Health Research), Ontario Ministry of Health and Long-Term Care (MOHLTC ), Canadian Arthritis Network (CAN) and unrestricted grants from: Abbvie, Amgen, Celgene, Hospira, Janssen, Lilly, Merck, Novartis, Pfizer, Roche, Sanofi, & UCB. The Rheum4U Program is supported by unrestricted educational grants from the following pharmaceutical companies: AbbVie; Amgen; Bristol-Myers Squibb (BMS); Celgene; Janssen; Merck; Novartis; Pfizer;Roche; Sanofi; Sandoz; Swedish Orphan Biovitrum AB (publ) (Sobi); and Union Chimique Belge (UCB). Rhumadata® is supported by unrestricted grants from Abbvie Canada, Amgen Canada, Eli LillyCanada, Novartis Canada, Pfizer Canada, Sandoz Canada and Sanofi Canada. Conflicts of interest: The following authors declare potential conflicts of interest. D Choquette: AbbVie Canada, Amgen Canada, Eli Lilly Canada, Merk Canada, Novartis Canada, Pfizer Canada, Sandoz Canada, Sanofi-Genzyme Canada. V Bykerk: Consultant for Amgen, BMS, Gilead, Sanofi-Genzyme/Regeneron, Scipher, Pfizer Pharmaceuticals, UCB. The remainder of the authors declared no conflicts. Address correspondence to Glen Hazlewood MD PhD, , 3280 Hospital Drive NW, HMRB Building, Room 451, Calgary, AB T2N 4N1
| | - Nicole Spencer
- Department of Medicine, University of Calgary; Department of Community Health Sciences, University of Calgary; Arthritis Research Canada; McCaig Institute for Bone and Joint Health; Department of Medicine University of Toronto; Toronto General Research Institute; Ontario Best Practices Research Initiative (OBRI); Institute of Health Policy, Management and Evaluation, University of Toronto; Université de Montréal, CHUM; RHUMADATA®; Hospital for Special Surgery, Weill Cornell Medical College; Canadian Early Arthritis Cohort (CATCH); Department of Medicine, McGill University; Canadian Arthritis Patient Alliance. Funding: This project was funded by an Arthritis Alliance of Canada Legacy Award. GSH is supported by a Canadian Institutes of Health Research New Investigator Award. CEHB has an Arthritis Stars Career Development Award, funded by the Canadian Institutes of Health Research-Institute of Musculoskeletal Health and Arthritis STAR-19-0611/CIHR SI2-169745. DAMar is supported by the Arthur J.E. Child Chair in Rheumatology and a Canada Research Chair in Health Systems and Services Research (2008-2018). The CATCH study was designed and implemented by the investigators and financially supported through unrestricted research grants from: Amgen and Pfizer Canada - Founding sponsors since January 2007; AbbVie Corporation and Hoffmann-LaRoche since 2011; Medexus Inc. since 2013; Eli Lilly Canada since 2016, Merck Canada since 2017, Sandoz Canada, Biopharmaceuticals since 2019 and Gilead Sciences Canada since 2020. Previously funded by Janssen Biotech from 2011-2016, UCB Canada and Bristol-Myers Squibb Canada from 2011-2018, and Sanofi Genzyme from 2016-2017. OBRI was funded by peer reviewed grants from CIHR (Canadian Institute for Health Research), Ontario Ministry of Health and Long-Term Care (MOHLTC ), Canadian Arthritis Network (CAN) and unrestricted grants from: Abbvie, Amgen, Celgene, Hospira, Janssen, Lilly, Merck, Novartis, Pfizer, Roche, Sanofi, & UCB. The Rheum4U Program is supported by unrestricted educational grants from the following pharmaceutical companies: AbbVie; Amgen; Bristol-Myers Squibb (BMS); Celgene; Janssen; Merck; Novartis; Pfizer;Roche; Sanofi; Sandoz; Swedish Orphan Biovitrum AB (publ) (Sobi); and Union Chimique Belge (UCB). Rhumadata® is supported by unrestricted grants from Abbvie Canada, Amgen Canada, Eli LillyCanada, Novartis Canada, Pfizer Canada, Sandoz Canada and Sanofi Canada. Conflicts of interest: The following authors declare potential conflicts of interest. D Choquette: AbbVie Canada, Amgen Canada, Eli Lilly Canada, Merk Canada, Novartis Canada, Pfizer Canada, Sandoz Canada, Sanofi-Genzyme Canada. V Bykerk: Consultant for Amgen, BMS, Gilead, Sanofi-Genzyme/Regeneron, Scipher, Pfizer Pharmaceuticals, UCB. The remainder of the authors declared no conflicts. Address correspondence to Glen Hazlewood MD PhD, , 3280 Hospital Drive NW, HMRB Building, Room 451, Calgary, AB T2N 4N1
| | - Dawn P Richards
- Department of Medicine, University of Calgary; Department of Community Health Sciences, University of Calgary; Arthritis Research Canada; McCaig Institute for Bone and Joint Health; Department of Medicine University of Toronto; Toronto General Research Institute; Ontario Best Practices Research Initiative (OBRI); Institute of Health Policy, Management and Evaluation, University of Toronto; Université de Montréal, CHUM; RHUMADATA®; Hospital for Special Surgery, Weill Cornell Medical College; Canadian Early Arthritis Cohort (CATCH); Department of Medicine, McGill University; Canadian Arthritis Patient Alliance. Funding: This project was funded by an Arthritis Alliance of Canada Legacy Award. GSH is supported by a Canadian Institutes of Health Research New Investigator Award. CEHB has an Arthritis Stars Career Development Award, funded by the Canadian Institutes of Health Research-Institute of Musculoskeletal Health and Arthritis STAR-19-0611/CIHR SI2-169745. DAMar is supported by the Arthur J.E. Child Chair in Rheumatology and a Canada Research Chair in Health Systems and Services Research (2008-2018). The CATCH study was designed and implemented by the investigators and financially supported through unrestricted research grants from: Amgen and Pfizer Canada - Founding sponsors since January 2007; AbbVie Corporation and Hoffmann-LaRoche since 2011; Medexus Inc. since 2013; Eli Lilly Canada since 2016, Merck Canada since 2017, Sandoz Canada, Biopharmaceuticals since 2019 and Gilead Sciences Canada since 2020. Previously funded by Janssen Biotech from 2011-2016, UCB Canada and Bristol-Myers Squibb Canada from 2011-2018, and Sanofi Genzyme from 2016-2017. OBRI was funded by peer reviewed grants from CIHR (Canadian Institute for Health Research), Ontario Ministry of Health and Long-Term Care (MOHLTC ), Canadian Arthritis Network (CAN) and unrestricted grants from: Abbvie, Amgen, Celgene, Hospira, Janssen, Lilly, Merck, Novartis, Pfizer, Roche, Sanofi, & UCB. The Rheum4U Program is supported by unrestricted educational grants from the following pharmaceutical companies: AbbVie; Amgen; Bristol-Myers Squibb (BMS); Celgene; Janssen; Merck; Novartis; Pfizer;Roche; Sanofi; Sandoz; Swedish Orphan Biovitrum AB (publ) (Sobi); and Union Chimique Belge (UCB). Rhumadata® is supported by unrestricted grants from Abbvie Canada, Amgen Canada, Eli LillyCanada, Novartis Canada, Pfizer Canada, Sandoz Canada and Sanofi Canada. Conflicts of interest: The following authors declare potential conflicts of interest. D Choquette: AbbVie Canada, Amgen Canada, Eli Lilly Canada, Merk Canada, Novartis Canada, Pfizer Canada, Sandoz Canada, Sanofi-Genzyme Canada. V Bykerk: Consultant for Amgen, BMS, Gilead, Sanofi-Genzyme/Regeneron, Scipher, Pfizer Pharmaceuticals, UCB. The remainder of the authors declared no conflicts. Address correspondence to Glen Hazlewood MD PhD, , 3280 Hospital Drive NW, HMRB Building, Room 451, Calgary, AB T2N 4N1
| | - Laurie Proulx
- Department of Medicine, University of Calgary; Department of Community Health Sciences, University of Calgary; Arthritis Research Canada; McCaig Institute for Bone and Joint Health; Department of Medicine University of Toronto; Toronto General Research Institute; Ontario Best Practices Research Initiative (OBRI); Institute of Health Policy, Management and Evaluation, University of Toronto; Université de Montréal, CHUM; RHUMADATA®; Hospital for Special Surgery, Weill Cornell Medical College; Canadian Early Arthritis Cohort (CATCH); Department of Medicine, McGill University; Canadian Arthritis Patient Alliance. Funding: This project was funded by an Arthritis Alliance of Canada Legacy Award. GSH is supported by a Canadian Institutes of Health Research New Investigator Award. CEHB has an Arthritis Stars Career Development Award, funded by the Canadian Institutes of Health Research-Institute of Musculoskeletal Health and Arthritis STAR-19-0611/CIHR SI2-169745. DAMar is supported by the Arthur J.E. Child Chair in Rheumatology and a Canada Research Chair in Health Systems and Services Research (2008-2018). The CATCH study was designed and implemented by the investigators and financially supported through unrestricted research grants from: Amgen and Pfizer Canada - Founding sponsors since January 2007; AbbVie Corporation and Hoffmann-LaRoche since 2011; Medexus Inc. since 2013; Eli Lilly Canada since 2016, Merck Canada since 2017, Sandoz Canada, Biopharmaceuticals since 2019 and Gilead Sciences Canada since 2020. Previously funded by Janssen Biotech from 2011-2016, UCB Canada and Bristol-Myers Squibb Canada from 2011-2018, and Sanofi Genzyme from 2016-2017. OBRI was funded by peer reviewed grants from CIHR (Canadian Institute for Health Research), Ontario Ministry of Health and Long-Term Care (MOHLTC ), Canadian Arthritis Network (CAN) and unrestricted grants from: Abbvie, Amgen, Celgene, Hospira, Janssen, Lilly, Merck, Novartis, Pfizer, Roche, Sanofi, & UCB. The Rheum4U Program is supported by unrestricted educational grants from the following pharmaceutical companies: AbbVie; Amgen; Bristol-Myers Squibb (BMS); Celgene; Janssen; Merck; Novartis; Pfizer;Roche; Sanofi; Sandoz; Swedish Orphan Biovitrum AB (publ) (Sobi); and Union Chimique Belge (UCB). Rhumadata® is supported by unrestricted grants from Abbvie Canada, Amgen Canada, Eli LillyCanada, Novartis Canada, Pfizer Canada, Sandoz Canada and Sanofi Canada. Conflicts of interest: The following authors declare potential conflicts of interest. D Choquette: AbbVie Canada, Amgen Canada, Eli Lilly Canada, Merk Canada, Novartis Canada, Pfizer Canada, Sandoz Canada, Sanofi-Genzyme Canada. V Bykerk: Consultant for Amgen, BMS, Gilead, Sanofi-Genzyme/Regeneron, Scipher, Pfizer Pharmaceuticals, UCB. The remainder of the authors declared no conflicts. Address correspondence to Glen Hazlewood MD PhD, , 3280 Hospital Drive NW, HMRB Building, Room 451, Calgary, AB T2N 4N1
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Hausmann JS, Kennedy K, Simard JF, Liew JW, Sparks JA, Moni TT, Harrison C, Larché MJ, Levine M, Sattui SE, Semalulu T, Foster G, Surangiwala S, Thabane L, Beesley RP, Durrant KL, Mateus EF, Mingolla S, Nudel M, Palmerlee CA, Richards DP, Liew DFL, Hill CL, Bhana S, Costello W, Grainger R, Machado PM, Robinson PC, Sufka P, Wallace ZS, Yazdany J, Sirotich E. Immediate effect of the COVID-19 pandemic on patient health, health-care use, and behaviours: results from an international survey of people with rheumatic diseases. Lancet Rheumatol 2021; 3:e707-e714. [PMID: 34316727 PMCID: PMC8298011 DOI: 10.1016/s2665-9913(21)00175-2] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Background The impact and consequences of the COVID-19 pandemic on people with rheumatic disease are unclear. We developed the COVID-19 Global Rheumatology Alliance Patient Experience Survey to assess the effects of the COVID-19 pandemic on people with rheumatic disease worldwide. Methods Survey questions were developed by key stakeholder groups and disseminated worldwide through social media, websites, and patient support organisations. Questions included demographics, rheumatic disease diagnosis, COVID-19 diagnosis, adoption of protective behaviours to mitigate COVID-19 exposure, medication access and changes, health-care access and communication with rheumatologists, and changes in employment or schooling. Adults age 18 years and older with inflammatory or autoimmune rheumatic diseases were eligible for inclusion. We included participants with and without a COVID-19 diagnosis. We excluded participants reporting only non-inflammatory rheumatic diseases such as fibromyalgia or osteoarthritis. Findings 12 117 responses to the survey were received between April 3 and May 8, 2020, and of these, 10 407 respondents had included appropriate age data. We included complete responses from 9300 adults with rheumatic disease (mean age 46·1 years; 8375 [90·1%] women, 893 [9·6%] men, and 32 [0·3%] participants who identified as non-binary). 6273 (67·5%) of respondents identified as White, 1565 (16·8%) as Latin American, 198 (2·1%) as Black, 190 (2·0%) as Asian, and 42 (0·5%) as Native American or Aboriginal or First Nation. The most common rheumatic disease diagnoses included rheumatoid arthritis (3636 [39·1%] of 9300), systemic lupus erythematosus (2882 [31·0%]), and Sjögren's syndrome (1290 [13·9%]). Most respondents (6921 [82·0%] of 8441) continued their antirheumatic medications as prescribed. Almost all (9266 [99·7%] of 9297) respondents adopted protective behaviours to limit SARS-CoV-2 exposure. A change in employment status occurred in 2524 (27·1%) of 9300) of respondents, with a 13·6% decrease in the number in full-time employment (from 4066 to 3514). Interpretation People with rheumatic disease maintained therapy and followed public health advice to mitigate the risks of COVID-19. Substantial employment status changes occurred, with potential implications for health-care access, medication affordability, mental health, and rheumatic disease activity. Funding American College of Rheumatology.
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Affiliation(s)
- Jonathan S Hausmann
- Division of Rheumatology and Clinical Immunology, Beth Israel Deaconess Medical Center, Boston, MA, USA
- Division of Immunology, Boston Children's Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Kevin Kennedy
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada
| | - Julia F Simard
- Department of Epidemiology and Population Health, and Division of Immunology and Rheumatology, Department of Medicine, Stanford School of Medicine, Stanford, CA, USA
| | - Jean W Liew
- Department of Medicine, Boston University School of Medicine, Boston, MA, USA
| | - Jeffrey A Sparks
- Division of Rheumatology, Inflammation, and Immunity, Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA
| | - Tarin T Moni
- Department of Biochemistry and Biomedical Sciences, McMaster University, Hamilton, ON, Canada
| | | | - Maggie J Larché
- Divisions of Rheumatology/Clinical Immunology and Allergy, McMaster University, Hamilton, ON, Canada
| | - Mitchell Levine
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada
- Department of Medicine, McMaster University, Hamilton, ON, Canada
- Department of Clinical Pharmacology and Toxicology, McMaster University, Hamilton, ON, Canada
| | - Sebastian E Sattui
- Division of Rheumatology, Department of Medicine, Hospital for Special Surgery, New York, NY, USA
| | - Teresa Semalulu
- Department of Medicine, McMaster University, Hamilton, ON, Canada
| | - Gary Foster
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada
- Department of Medicine, McMaster University, Hamilton, ON, Canada
| | | | - Lehana Thabane
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada
| | - Richard P Beesley
- Juvenile Arthritis Research, Tonbridge, UK
- European Network for Childhood Arthritis, Tonbridge, UK
| | | | - Elsa F Mateus
- Portuguese League Against Rheumatic Diseases, Comprehensive Health Research Centre, Lisbon, Portugal
| | - Serena Mingolla
- Italian National Association of People with Rheumatic and Rare Diseases, Brindisi, Italy
| | - Michal Nudel
- The Israeli association for RMDs patients "Mifrakim Tz'eirim", Haifa, Israel
| | - Candace A Palmerlee
- Relapsing Polychondritis Foundation, International Relapsing Polychondritis Research Network, Walnut Creek, CA, USA
| | | | - David F L Liew
- Department of Rheumatology, Austin Health, Heidelberg, Australia
| | - Catherine L Hill
- Rheumatology Unit, The Queen Elizabeth Hospital, Woodville South, Australia
- Discipline of Medicine, University of Adelaide, Adelaide, Australia
| | | | | | - Rebecca Grainger
- Department of Medicine, University of Otago, Wellington, New Zealand
| | - Pedro M Machado
- Centre for Rheumatology and Department of Neuromuscular Diseases, University College London, London, UK
- National Institute for Health Research University College London Hospitals Biomedical Research Centre, University College London Hospitals National Health Service Foundation Trust, London, UK
- Department of Rheumatology, Northwick Park Hospital, London North West University Healthcare NHS Trust, London, UK
| | - Philip C Robinson
- Faculty of Medicine, University of Queensland, Brisbane, QLD, Australia
| | | | - Zachary S Wallace
- Division of Rheumatology, Allergy, and Immunology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Jinoos Yazdany
- Division of Rheumatology, Department of Medicine, University of California San Francisco, San Francisco, CA, USA
| | - Emily Sirotich
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada
- Canadian Arthritis Patient Alliance, Toronto, ON, Canada
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Orkin AM, Gill PJ, Ghersi D, Campbell L, Sugarman J, Emsley R, Steg PG, Weijer C, Simes J, Rombey T, Williams HC, Wittes J, Moher D, Richards DP, Kasamon Y, Getz K, Hopewell S, Dickersin K, Wu T, Ayala AP, Schulz KF, Calleja S, Boutron I, Ross JS, Golub RM, Khan KM, Mulrow C, Siegfried N, Heber J, Lee N, Kearney PR, Wanyenze RK, Hróbjartsson A, Williams R, Bhandari N, Jüni P, Chan AW. Guidelines for Reporting Trial Protocols and Completed Trials Modified Due to the COVID-19 Pandemic and Other Extenuating Circumstances: The CONSERVE 2021 Statement. JAMA 2021; 326:257-265. [PMID: 34152382 DOI: 10.1001/jama.2021.9941] [Citation(s) in RCA: 134] [Impact Index Per Article: 44.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
IMPORTANCE Extenuating circumstances can trigger unplanned changes to randomized trials and introduce methodological, ethical, feasibility, and analytical challenges that can potentially compromise the validity of findings. Numerous randomized trials have required changes in response to the COVID-19 pandemic, but guidance for reporting such modifications is incomplete. OBJECTIVE As a joint extension for the CONSORT and SPIRIT reporting guidelines, CONSERVE (CONSORT and SPIRIT Extension for RCTs Revised in Extenuating Circumstances) aims to improve reporting of trial protocols and completed trials that undergo important modifications in response to extenuating circumstances. EVIDENCE A panel of 37 international trial investigators, patient representatives, methodologists and statisticians, ethicists, funders, regulators, and journal editors convened to develop the guideline. The panel developed CONSERVE following an accelerated, iterative process between June 2020 and February 2021 involving (1) a rapid literature review of multiple databases (OVID Medline, OVID EMBASE, and EBSCO CINAHL) and gray literature sources from 2003 to March 2021; (2) consensus-based panelist meetings using a modified Delphi process and surveys; and (3) a global survey of trial stakeholders. FINDINGS The rapid review yielded 41 673 citations, of which 38 titles were relevant, including emerging guidance from regulatory and funding agencies for managing the effects of the COVID-19 pandemic on trials. However, no generalizable guidance for all circumstances in which trials and trial protocols might face unanticipated modifications were identified. The CONSERVE panel used these findings to develop a consensus reporting guidelines following 4 rounds of meetings and surveys. Responses were received from 198 professionals from 34 countries, of whom 90% (n = 178) indicated that they understood the concept definitions and 85.4% (n = 169) indicated that they understood and could use the implementation tool. Feedback from survey respondents was used to finalize the guideline and confirm that the guideline's core concepts were applicable and had utility for the trial community. CONSERVE incorporates an implementation tool and checklists tailored to trial reports and trial protocols for which extenuating circumstances have resulted in important modifications to the intended study procedures. The checklists include 4 sections capturing extenuating circumstances, important modifications, responsible parties, and interim data analyses. CONCLUSIONS AND RELEVANCE CONSERVE offers an extension to CONSORT and SPIRIT that could improve the transparency, quality, and completeness of reporting important modifications to trials in extenuating circumstances such as COVID-19.
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Affiliation(s)
- Aaron M Orkin
- Division of Emergency Medicine, Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Peter J Gill
- Hospital for Sick Children, Department of Paediatrics, University of Toronto, Toronto, Ontario, Canada
| | - Davina Ghersi
- National Health and Medical Research Council, Canberra, Australia
| | - Lisa Campbell
- Clinical Trials Unit, Medicines and Healthcare Products Regulatory Agency, London, England
| | - Jeremy Sugarman
- Berman Institute of Bioethics, Johns Hopkins University, Baltimore, Maryland
| | - Richard Emsley
- Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, England
| | | | - Charles Weijer
- Departments of Medicine, Epidemiology and Biostatistics, and Philosophy, Western University, London, Ontario, Canada
| | - John Simes
- National Health and Medical Research Council Clinical Trials Centre, University of Sydney, Sydney, Australia
| | - Tanja Rombey
- Department of Health Care Management, Technische Universität Berlin, Berlin, Germany
| | - Hywel C Williams
- University of Nottingham, Nottingham, England
- National Institute for Health Research, Nottingham, England
| | | | - David Moher
- Centre for Journalology, Clinical Epidemiology Program, Ottawa Hospital Research Institute, School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada
| | | | - Yvette Kasamon
- Office of Oncologic Diseases, Center for Drug Evaluation and Research, US Food and Drug Administration, Silver Spring, Maryland
| | - Kenneth Getz
- Tufts Center for the Study of Drug Development, Boston, Massachusetts
| | - Sally Hopewell
- Oxford Clinical Trials Research Unit, Centre for Statistics in Medicine, University of Oxford, Oxford, England
| | - Kay Dickersin
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Taixiang Wu
- Chinese Clinical Trial Registry, Sichuan University, Chengdu, China
| | - Ana Patricia Ayala
- Gerstein Science Information Centre, University of Toronto, Toronto, Ontario, Canada
| | - Kenneth F Schulz
- FHI 360, Durham, North Carolina
- School of Medicine, University of North Carolina at Chapel Hill
| | - Sabine Calleja
- Gerstein Science Information Centre, University of Toronto, Toronto, Ontario, Canada
| | - Isabelle Boutron
- Centre of Research in Epidemiology and Statistics, Université de Paris, Inserm, Paris, France
| | - Joseph S Ross
- Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut
- The BMJ , London, England
| | - Robert M Golub
- Deputy Editor, JAMA
- Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Karim M Khan
- Canadian Institutes of Health Research Institute of Musculoskeletal Health and Arthritis, Ottawa, Ontario, Canada
| | - Cindy Mulrow
- University of Texas Health Science Center, San Antonio
| | - Nandi Siegfried
- Alcohol, Tobacco, and Other Drugs Research Unit, South African Medical Research Council, Cape Town, South Africa
| | - Joerg Heber
- Lawrence Berkeley National Laboratory, Berkeley, California
| | | | - Pamela Reed Kearney
- Office of Extramural Research, Division of Human Subjects Research, National Institutes of Health, Bethesda, Maryland
| | - Rhoda K Wanyenze
- Department of Disease Control and Environmental Health, School of Public Health, Makerere University, Kampala, Uganda
| | - Asbjørn Hróbjartsson
- Centre for Evidence-Based Medicine Odense (CEBMO) and Cochrane Denmark, University of Southern Denmark, Odense, Denmark
| | - Rebecca Williams
- ClinicalTrials.gov, National Library of Medicine, National Institutes of Health, Bethesda, Maryland
| | - Nita Bhandari
- Centre for Health Research and Development, Society for Applied Studies, New Delhi, India
| | - Peter Jüni
- Applied Health Research Centre, St Michael's Hospital, University of Toronto, Toronto, Ontario, Canada
| | - An-Wen Chan
- Women's College Research Institute, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
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Brehaut JC, Carroll K, Gordon J, Presseau J, Richards DP, Fergusson DA, Graham ID, Marlin S. Results from a Theory-Guided Survey to Support Breast Cancer Trial Participation: Barriers, Enablers, and What to Do about them. ACTA ACUST UNITED AC 2021; 28:2014-2028. [PMID: 34073279 PMCID: PMC8161779 DOI: 10.3390/curroncol28030187] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Revised: 05/18/2021] [Accepted: 05/21/2021] [Indexed: 11/30/2022]
Abstract
Background: Ensuring adequate, informed, and timely participation in clinical trials is a multifactorial problem. We have previously developed a systematic, tailorable survey development approach that is informed by theory, can identify barriers and enablers to participation, and can suggest recruitment strategies to address these issues. In this study, we surveyed subscribers to the Canadian Breast Cancer Network (CBCN) in order to identify a comprehensive list of theory-informed barriers and enablers relevant to participation in a hypothetical breast cancer trial. Methods: We developed and conducted an online survey of breast cancer patients informed by the Theoretical Domains Framework and designed to determine previous experience with clinical trials, knowledge about clinical trials, and importance of a comprehensive list of barriers and enablers to trial participation. Participants were contacted by email or through social media. Results: From 2451 subscribers of the CBCN, we received 244 responses and 210 completed surveys (244/2451 or 9.9% participation, 210/244 or 86.1% completion). A total of 38% of respondents indicated experience in trial participation, but 83% indicated confidence in their knowledge about clinical trials. Those who had previously participated in clinical trials were more confident in their knowledge (χ2= 6.77, p = 0.009) and answered more knowledge questions (t = −3.90 p = 0.000). Endorsed barriers and enablers to participation included 39 factors across 12 of 14 domains relevant to behaviour change. Our approach identifies barriers that might be meaningfully addressed by careful knowledge provision (‘If I would learn more about my condition’; ‘If I find the trial documents hard to understand’), those that may require other theory-informed approaches to address (‘my feelings about the quality of my drug plan’; ‘my worry over unknown side effects’), and those that may require tailored approaches depending on participant differences such as previous experience in trials (‘If there were patient-friendly decision-making tools to help you make your participation decision’). Discussion: This work demonstrates that a comprehensive, theory-guided survey of barriers and enablers to participation in breast cancer clinical trials is feasible, can lead to detailed knowledge about the issues related to participation in specific trials, and most importantly, can lead to insights about evidence-based ways to better support patient participation.
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Affiliation(s)
- Jamie C. Brehaut
- Clinical Epidemiology Program, Ottawa Hospital Research Institute (OHRI), The Ottawa Hospital, General Campus, 501 Smyth Rd, Ottawa, ON K1H 8L6, Canada; (K.C.); (J.P.); (D.A.F.); (I.D.G.)
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON K1G 5Z3, Canada
- Correspondence:
| | - Kelly Carroll
- Clinical Epidemiology Program, Ottawa Hospital Research Institute (OHRI), The Ottawa Hospital, General Campus, 501 Smyth Rd, Ottawa, ON K1H 8L6, Canada; (K.C.); (J.P.); (D.A.F.); (I.D.G.)
| | - Jenn Gordon
- Canadian Breast Cancer Network, 331 Cooper St. Suite 602, Ottawa, ON K2P 0G5, Canada;
| | - Justin Presseau
- Clinical Epidemiology Program, Ottawa Hospital Research Institute (OHRI), The Ottawa Hospital, General Campus, 501 Smyth Rd, Ottawa, ON K1H 8L6, Canada; (K.C.); (J.P.); (D.A.F.); (I.D.G.)
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON K1G 5Z3, Canada
| | - Dawn P. Richards
- Clinical Trials Ontario, 661 University Avenue, Suite 460, MaRS Centre, West Tower, Toronto, ON M5G 1M1, Canada; (D.P.R.); (S.M.)
| | - Dean A. Fergusson
- Clinical Epidemiology Program, Ottawa Hospital Research Institute (OHRI), The Ottawa Hospital, General Campus, 501 Smyth Rd, Ottawa, ON K1H 8L6, Canada; (K.C.); (J.P.); (D.A.F.); (I.D.G.)
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON K1G 5Z3, Canada
| | - Ian D. Graham
- Clinical Epidemiology Program, Ottawa Hospital Research Institute (OHRI), The Ottawa Hospital, General Campus, 501 Smyth Rd, Ottawa, ON K1H 8L6, Canada; (K.C.); (J.P.); (D.A.F.); (I.D.G.)
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON K1G 5Z3, Canada
| | - Susan Marlin
- Clinical Trials Ontario, 661 University Avenue, Suite 460, MaRS Centre, West Tower, Toronto, ON M5G 1M1, Canada; (D.P.R.); (S.M.)
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Thomas M, Fraenkel L, Boonen A, Bansback N, Buchbinder R, Marshall D, Proulx L, Voshaar M, Richards P, Richards DP, Hiligsmann M, Guillemin F, Shea B, Tugwell P, Hazlewood G. Patient preferences to value health outcomes in rheumatology clinical trials: Report from the OMERACT special interest group ✰. Semin Arthritis Rheum 2021; 51:919-924. [PMID: 34134892 DOI: 10.1016/j.semarthrit.2021.05.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Revised: 05/12/2021] [Accepted: 05/14/2021] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To inform a research plan for future studies by obtaining stakeholder input on the application of preference-based methods to clinical trial design. METHODS We conducted a virtual OMERACT session to encourage stakeholder engagement. We developed materials for the session to facilitate discussion based on identified case examples and feedback sessions. RESULTS Participants prioritized incorporating patient preferences in all aspects of trial design with an emphasis on outcome selection. Participants highlighted the need for careful consideration around preference heterogeneity and equity factors. CONCLUSION Including patient preferences in trial design was considered a priority requiring further exploration to develop comprehensive guidance.
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Affiliation(s)
- Megan Thomas
- Department of Community Health Sciences, University of Calgary, Calgary, Canada
| | - Liana Fraenkel
- Yale University School of Medicine, Section of Rheumatology, CT, USA
| | - Annelies Boonen
- Department of Internal Medicine, Maastricht University Medical Center, Care and Public Health Research Institute, Maastricht, The Netherlands
| | - Nick Bansback
- School of Population and Public Health, Faculty of Medicine, University of British Columbia, Vancouver, Canada
| | - Rachelle Buchbinder
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University and Monash Department of Clinical Epidemiology, Cabrini Institute, Melbourne, Australia
| | | | - Laurie Proulx
- Patient research partner, Canadian Arthritis Patient Alliance, Ottawa, Canada
| | - Marieke Voshaar
- Patient research partner, Radboud University, Department of Pharmacy, Nijmegen, the Netherlands
| | - Pamela Richards
- Patient research partner, University Hospitals, Bristol NHS Trust, Bristol, UK
| | - Dawn P Richards
- Patient research partner, Canadian Arthritis Patient Alliance, Ottawa, Canada; Patient research partner, Five02 Labs Inc., Toronto, Canada
| | - Mickael Hiligsmann
- Department of Health Services Research, CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht, the Netherlands
| | | | - Beverly Shea
- Department of Medicine, University of Ottawa, Ottawa, Canada
| | - Peter Tugwell
- Department of Medicine, University of Ottawa, Ottawa, Canada
| | - Glen Hazlewood
- Department of Community Health Sciences, University of Calgary, Calgary, Canada; Department of Medicine, University of Calgary, Calgary, Canada.
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Hazlewood GS, Pardo JP, Barnabe C, Schieir O, Barber CEH, Bernatsky S, Colmegna I, Hitchon C, Loeb M, Mertz D, Proulx L, Richards DP, Scuccimarri R, Tugwell P, Schünemann HJ, Mirza RD, Zhou AL, Nikolic RPA, Thomas M, Chase H, Ejaredar M, Nieuwlaat R. Canadian Rheumatology Association Recommendation for the Use of COVID-19 Vaccination for Patients With Autoimmune Rheumatic Diseases. J Rheumatol 2021; 48:1330-1339. [PMID: 33993119 DOI: 10.3899/jrheum.210288] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/14/2021] [Indexed: 12/21/2022]
Abstract
OBJECTIVE To develop guidance on the use of coronavirus disease 2019 (COVID-19) vaccines in patients with autoimmune rheumatic diseases (ARD). METHODS The Canadian Rheumatology Association (CRA) formed a multidisciplinary panel including rheumatologists, researchers, methodologists, vaccine experts, and patients. The panel used the GRADE (Grading of Recommendations Assessment, Development, and Evaluation) approach. Outcomes were prioritized according to their importance for patients and clinicians. Evidence from the COVID-19 clinical trials was summarized. Indirect evidence for non-COVID-19 vaccines in ARD was also considered. The GRADE evidence-to-decision (EtD) framework was used to develop a recommendation for the use of the 4 COVID-19 vaccines approved in Canada as of March 25, 2021 (BNT162b2, mRNA-1273, ChAdOx1, and Ad26.COV2.S), over 4 virtual panel meetings. RESULTS The CRA guideline panel suggests using COVID-19 vaccination in persons with ARD. The panel unanimously agreed that for the majority of patients, the potential health benefits of vaccination outweigh the potential harms in people with ARDs. The recommendation was graded as conditional because of low or very low certainty of the evidence on the effects in the population of interest, primarily due to indirectness and imprecise effect estimates. The panel felt strongly that persons with autoimmune rheumatic diseases who meet local eligibility should not be required to take additional steps compared to people without ARDs to obtain their vaccination. Guidance on medications, implementation, monitoring of vaccine uptake, and research priorities are also provided. CONCLUSION This recommendation will be updated over time as new evidence emerges, with the latest recommendation, evidence summaries, and EtD available on the CRA website.
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Affiliation(s)
- Glen S Hazlewood
- G.S. Hazlewood, MD, PhD, Associate Professor of Medicine, C. Barnabe, MD, MSc, Associate Professor of Medicine, C.E. Barber, MD, PhD, Assistant Professor of Medicine, Departments of Medicine and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, and Arthritis Research Canada, Richmond, British Columbia;
| | - Jordi Pardo Pardo
- J.P. Pardo, LDO, Managing Editor, Centre for Global Health, University of Ottawa, Ottawa, Ontario
| | - Cheryl Barnabe
- G.S. Hazlewood, MD, PhD, Associate Professor of Medicine, C. Barnabe, MD, MSc, Associate Professor of Medicine, C.E. Barber, MD, PhD, Assistant Professor of Medicine, Departments of Medicine and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, and Arthritis Research Canada, Richmond, British Columbia
| | - Orit Schieir
- O. Schieir, PhD, Canadian Early Arthritis Cohort Study, Toronto, Ontario
| | - Claire E H Barber
- G.S. Hazlewood, MD, PhD, Associate Professor of Medicine, C. Barnabe, MD, MSc, Associate Professor of Medicine, C.E. Barber, MD, PhD, Assistant Professor of Medicine, Departments of Medicine and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, and Arthritis Research Canada, Richmond, British Columbia
| | - Sasha Bernatsky
- S. Bernatsky, MD, PhD, Professor of Medicine, Research Institute of the McGill University Health Centre (RI-MUHC), Montreal, Quebec
| | - Ines Colmegna
- I. Colmegna, MD, Associate Professor of Medicine, Division of Rheumatology, Department of Medicine, McGill University, Montreal, Quebec
| | - Carol Hitchon
- C. Hitchon, MD, MSc, Associate Professor of Medicine, Department of Internal Medicine, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba
| | - Mark Loeb
- M. Loeb, MD, MSc, Professor, D. Mertz, MD, MSc, Associate Professor of Medicine, H.J. Schünemann, MD, MSc, PhD, Professor of Medicine and Clinical Epidemiology, Departments of Medicine and Health Research Methods, Evidence, and Impact, McMaster GRADE Centers, Hamilton
| | - Dominik Mertz
- M. Loeb, MD, MSc, Professor, D. Mertz, MD, MSc, Associate Professor of Medicine, H.J. Schünemann, MD, MSc, PhD, Professor of Medicine and Clinical Epidemiology, Departments of Medicine and Health Research Methods, Evidence, and Impact, McMaster GRADE Centers, Hamilton
| | - Laurie Proulx
- L. Proulx, B.Com, D.P. Richards, PhD, Canadian Arthritis Patient Alliance, Toronto, Ontario
| | - Dawn P Richards
- L. Proulx, B.Com, D.P. Richards, PhD, Canadian Arthritis Patient Alliance, Toronto, Ontario
| | - Rosie Scuccimarri
- R. Scuccimarri, MD, Associate Professor of Pediatrics, Division of Pediatric Rheumatology, Department of Pediatrics, McGill University, Montreal, Quebec
| | - Peter Tugwell
- P. Tugwell, MD, Professor of Medicine, A.L. Zhou, MD, Department of Medicine, University of Ottawa, Ottawa, Ontario
| | - Holger J Schünemann
- M. Loeb, MD, MSc, Professor, D. Mertz, MD, MSc, Associate Professor of Medicine, H.J. Schünemann, MD, MSc, PhD, Professor of Medicine and Clinical Epidemiology, Departments of Medicine and Health Research Methods, Evidence, and Impact, McMaster GRADE Centers, Hamilton
| | - Reza D Mirza
- R.D. Mirza, MD, Department of Medicine, University of Toronto, Toronto, Ontario
| | - Alan L Zhou
- P. Tugwell, MD, Professor of Medicine, A.L. Zhou, MD, Department of Medicine, University of Ottawa, Ottawa, Ontario
| | - Roko P A Nikolic
- R.P. Nikolic, BSc, Cumming School of Medicine, University of Calgary, Calgary, Alberta
| | - Megan Thomas
- M. Thomas, BHSc, M. Ejaredar, PhD, Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta
| | | | - Maede Ejaredar
- M. Thomas, BHSc, M. Ejaredar, PhD, Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta
| | - Robby Nieuwlaat
- R. Nieuwlaat, MSc, PhD, Associate Professor, Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
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Barber CEH, Spencer N, Bansback N, Zimmermann GL, Li LC, Richards DP, Proulx L, Mosher DP, Hazlewood GS. Development of an Implementation Strategy for Patient Decision Aids in Rheumatoid Arthritis Through Application of the Behavior Change Wheel. ACR Open Rheumatol 2021; 3:312-323. [PMID: 33793083 PMCID: PMC8126755 DOI: 10.1002/acr2.11250] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Accepted: 02/25/2021] [Indexed: 12/19/2022] Open
Abstract
OBJECTIVE Decision aids are being developed to support guideline-based rheumatology care in Canada. The study objective was to identify barriers to decision aid use in rheumatoid arthritis (RA) within a behavior change model to inform an implementation strategy. METHODS Perspectives from Canadian health care providers (HCPs) and patients living with RA were obtained on an early RA decision aid and on perceived facilitators and barriers to decision aid implementation. Data were collected through semistructured interviews, transcribed, and then analyzed by inductive thematic analysis. The lessons learned were then mapped to the behavior change wheel COM-B system (C = capability, O = opportunity, and M = motivation interact to influence B = behavior) to inform key elements of a national implementation strategy. RESULTS Fifteen HCPs and fifteen patients participated. The analysis resulted in five lessons learned: 1) paternalistic decision-making is a dominant practice in early RA, 2) patients need emotional support and access to educational tools to facilitate participation in shared decision-making (SDM), 3) there are many logistical barriers to decision aid implementation in current care models, 4) flexibility is necessary for successful implementation, and 5) HCPs have limited interest in further training opportunities about decision aids. Implementation recommendations included the following: 1) making the decision aids directly available to patients (O) and providing SDM education (C/M), 2) creating an SDM rheumatology curriculum (C/O/M), 3) using "decision coaches" or patient partners as peer support (C/O/M), 4) linking decision aids to "living" rheumatology guidelines (M), and 5) designing trials of patient decision aid/SDM interventions to evaluate patient-important outcomes (O/M). CONCLUSION A multifaceted strategy is suggested to improve uptake of decision aids.
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Affiliation(s)
- Claire E H Barber
- University of Calgary, Calgary, Alberta, Canada, and Arthritis Research Canada, Richmond, British Columbia, Canada
| | | | - Nick Bansback
- Centre for Health Evaluation and Outcome Sciences at St. Paul's Hospital and University of British Columbia, Vancouver, British Columbia, Canada, and Arthritis Research Canada, Richmond, British Columbia, Canada
| | - Gabrielle L Zimmermann
- Alberta Strategy for Patient Oriented Research (SPOR) SUPPORT Unit, University of Alberta, Edmonton, Alberta, Canada, and University of Calgary, Calgary, Alberta, Canada
| | - Linda C Li
- University of British Columbia, Vancouver, British Columbia, Canada, and Arthritis Research Canada, Richmond, British Columbia, Canada
| | | | | | | | - Glen S Hazlewood
- University of Calgary, Calgary, Alberta, Canada, and Arthritis Research Canada, Richmond, British Columbia, Canada
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Brehaut JC, Carroll K, Presseau J, Richards DP, Gordon J, Bénard A, Hudek N, Graham ID, Fergusson DA, Marlin S. A patient-focused, theory-guided approach to survey design identified barriers to and drivers of clinical trial participation. J Clin Epidemiol 2020; 132:106-115. [PMID: 33338563 DOI: 10.1016/j.jclinepi.2020.12.013] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Revised: 11/16/2020] [Accepted: 12/08/2020] [Indexed: 12/27/2022]
Abstract
OBJECTIVES Despite clear evidence showing that many clinical trials fail or are delayed because of poor patient recruitment, there is surprisingly little empirically supported guidance for trialists seeking to optimize their trial recruitment strategies. We propose that the challenges of recruitment can be better understood and addressed by thinking of research participation as one or more behaviors, subject to the same forces as other human behaviors. In this article, we describe an adaptable, behavioral theory-driven approach for designing pretrial surveys of the barriers and drivers relevant to trial participation. Instead of proposing a single survey instrument intended to be used uniformly across many situations, we propose that tailored surveys be informed by a common comprehensive, theory-guided development approach that ensures all domains potentially guiding participation are considered. STUDY DESIGN AND SETTING We used the Theoretical Domains Framework (TDF), which organizes over 100 constructs known to be associated with behavior and behavior change into 14 domains that describe determinants of professional and patient health behaviors, to inform the development of tailored surveys about barriers to and drivers of clinical trial participation. After searching the literature for barriers and drivers to trial recruitment relevant to each of the TDF domains, we developed separate surveys for members of two national health charities (Canadian Breast Cancer Network, Huntington Society of Canada) to exemplify how the approach can be adapted across settings. We conducted think-aloud interviews with members of each group to maximize the clarity and usability of the surveys, elicited opinions about which barriers/drivers were relevant for each patient group, and identified additional barriers/drivers. Interviews proceeded iteratively with changes incorporated into subsequent interviews. Here, we describe our two target patient groups, as well as our process of modifying, adding, and deleting barrier/driver items for each group and across theoretical domains. RESULTS We interviewed 8 women with a history of breast cancer from the Canadian Breast Cancer Network (48-65 year old) and 11 Huntington Disease community members (9 women) from the Huntington Society of Canada (26-70 year old). After the iterative development interviews, the breast cancer group had identified 38 barriers/drivers thought relevant to their participation in clinical trials across 12 TDF domains. The Huntington group identified 47 items across 13 TDF domains. CONCLUSION Our patient-focused and theory-guided approach was able to identify a more comprehensive range of barriers to and drivers of trial participation than existing published tools. Our approach is also more broadly adaptable than such tools, in that it uses a theoretical framework and in-depth piloting to generate a set of items tailored to each specific clinical area, rather than a single set of items intended to be applicable to all situations. This theory-guided approach also enables more specific recruitment strategies to be developed once domain-specific barriers are known, potentially optimizing participation for a given trial and helping build a cumulative evidence of barriers/drivers and strategies for addressing them.
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Affiliation(s)
- Jamie C Brehaut
- Clinical Epidemiology Program, Ottawa Hospital Research Institute (OHRI), The Ottawa Hospital, General Campus, 501 Smyth Rd, Ottawa Ontario, Canada, K1H 8L6; Faculty of Medicine, School of Epidemiology and Public Health, University of Ottawa, Ottawa, Canada, K1G 5Z3.
| | - Kelly Carroll
- Clinical Epidemiology Program, Ottawa Hospital Research Institute (OHRI), The Ottawa Hospital, General Campus, 501 Smyth Rd, Ottawa Ontario, Canada, K1H 8L6
| | - Justin Presseau
- Clinical Epidemiology Program, Ottawa Hospital Research Institute (OHRI), The Ottawa Hospital, General Campus, 501 Smyth Rd, Ottawa Ontario, Canada, K1H 8L6; Faculty of Medicine, School of Epidemiology and Public Health, University of Ottawa, Ottawa, Canada, K1G 5Z3
| | - Dawn P Richards
- Clinical Trials Ontario, 661 University Avenue, Suite 460, MaRS Centre, West Tower, Toronto, Canada M5G 1M1
| | - Jenn Gordon
- Canadian Breast Cancer Network, 331 Cooper St. Suite 602, Ottawa, Canada, K2P 0G5
| | - Angèle Bénard
- Huntington Society of Canada (HSC), 20 Erb Street West, Suite 801, Waterloo, Ontario, N2L1T2
| | - Natasha Hudek
- Clinical Epidemiology Program, Ottawa Hospital Research Institute (OHRI), The Ottawa Hospital, General Campus, 501 Smyth Rd, Ottawa Ontario, Canada, K1H 8L6
| | - Ian D Graham
- Clinical Epidemiology Program, Ottawa Hospital Research Institute (OHRI), The Ottawa Hospital, General Campus, 501 Smyth Rd, Ottawa Ontario, Canada, K1H 8L6; Faculty of Medicine, School of Epidemiology and Public Health, University of Ottawa, Ottawa, Canada, K1G 5Z3
| | - Dean A Fergusson
- Clinical Epidemiology Program, Ottawa Hospital Research Institute (OHRI), The Ottawa Hospital, General Campus, 501 Smyth Rd, Ottawa Ontario, Canada, K1H 8L6; Faculty of Medicine, School of Epidemiology and Public Health, University of Ottawa, Ottawa, Canada, K1G 5Z3
| | - Susan Marlin
- Clinical Trials Ontario, 661 University Avenue, Suite 460, MaRS Centre, West Tower, Toronto, Canada M5G 1M1
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Parry M, Bjørnnes AK, Toupin-April K, Najam A, Wells D, Sivakumar A, Richards DP, Ceroni T, Park M, Ellis AK, Gilron I, Marlin S. Patient Engagement Partnerships in Clinical Trials: Development of Patient Partner and Investigator Decision Aids. Patient 2020; 13:745-756. [PMID: 33026639 PMCID: PMC7655585 DOI: 10.1007/s40271-020-00460-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 09/19/2020] [Indexed: 12/20/2022]
Abstract
BACKGROUND A 2017 systematic review suggested patient engagement in clinical trials has been limited, with little active engagement in trial design or data analysis, interpretation or dissemination. Additionally, there remains limited sex/gender reporting in clinical trial research. OBJECTIVES The overall goal of this project was to disseminate sex/gender knowledge and build capacity for patient engagement in clinical trials. Specific objectives were to (1) create capacity and identify opportunities for patient engagement in clinical trials and sponsor- or investigator-led activities (e.g. clinical trial design and conduct); and (2) enhance new/early investigator sex/gender knowledge and skills related to patient-oriented research (POR). METHODS We used the Canadian Institutes of Health Research Strategy for Patient-Oriented Research (SPOR) Capacity Development Framework and the SPOR Patient Engagement Framework to guide three phases of this project: (1) conduct a scoping review using methods described by the Evidence for Policy and Practice Information (EPPI) and the Coordinating Centre at the Institute of Education (Phase 1); (2) host a 1-day POR consultation workshop (Phase 2); and (3) deliver a new/early investigator POR training day (Phase 3). Six electronic databases (CINAHL, MEDLINE, EMBASE, PsychInfo, the Cochrane Library, and AMED) were searched from 1996 using keywords and Medical Subject Heading (MeSH) terms in accordance with the International Association for Public Participation (IAP2) and the search criteria in the bibliographic databases. Standard approaches were used to search the grey literature. RESULTS A total of 79 studies and over 150 websites were subject to data abstraction by team members, capturing information on sex/gender and SPOR's patient engagement guiding principles of inclusiveness, support, mutual respect, and co-building. Results were presented to 32 key stakeholders at the consultation workshop and input was sought on next steps using nominal group techniques. Based on the plethora of existing POR resources, relevant POR information from the scoping review was collated into two decision aids (patient and investigator) to determine readiness to engage with/as a patient partner in a clinical trial. The decision aids were presented at a POR training day with 88 new/early investigators, clinicians, patient partners and decision makers. The decision aids showed 'good' usability, assessed using the System Usability Scale (SUS). Attendees thought the decision aids were engaging, they increased their understanding of sex/gender, patient engagement and POR, and they would recommend them to others. POR principles and practices were integrated across all phases of the project. Patient partners (1) identified research priorities/search terms; (2) collected/analyzed data; (3) designed the patient partner decision aid; and (4) disseminated the results through presentation. CONCLUSION Our digital patient partner and investigator decision aids are the first to provide information technology to deliver sex/gender, POR knowledge, and decision support beyond the traditional decision aids used for health screening and/or treatment decisions. The decision aids have the potential to make a significant contribution to Canada's Strategy for POR and support the collaborative efforts of patients and investigators to build a sustainable, accessible and equitable health care system.
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Affiliation(s)
- Monica Parry
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, 155 College Street, Suite 130, Toronto, ON, M5T 1P8, Canada.
| | - Ann Kristin Bjørnnes
- Department of Nursing and Health Promotion, Oslo Metropolitan University, Oslo, Norway
| | - Karine Toupin-April
- School of Rehabilitation Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada
- Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Adhiyat Najam
- Patient Partner, Diabetes Action Canada, Toronto, ON, Canada
| | - David Wells
- Patient Partner, Diabetes Action Canada, Toronto, ON, Canada
| | - Aditi Sivakumar
- Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
| | | | - Tina Ceroni
- Patient Partner, Clinical Trials Ontario, Toronto, ON, Canada
| | - Marianne Park
- Patient Partner, Network of Women with Disabilities, Woodstock, ON, Canada
| | - Anne K Ellis
- Department of Medicine, Queen's University, Kingston, ON, Canada
| | - Ian Gilron
- Departments of Anesthesiology and Perioperative Medicine, Biomedical and Molecular Sciences and School of Policy Studies, Queen's University, Kingston, ON, Canada
| | - Susan Marlin
- Patient Partner, Diabetes Action Canada, Toronto, ON, Canada
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Décary S, Barton JL, Proulx L, Richards DP, Paterson G, de Wit M, Toupin-April K. How to Effectively Support Patients with Rheumatic Conditions Now and Beyond COVID-19. ACR Open Rheumatol 2020; 2:505-506. [PMID: 32403182 PMCID: PMC7272921 DOI: 10.1002/acr2.11152] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Accepted: 05/05/2020] [Indexed: 01/04/2023] Open
Affiliation(s)
| | | | - Laurie Proulx
- Patient research partner, Canadian Arthritis Patient Alliance, Ottawa, Ontario, Canada
| | - Dawn P Richards
- Patient research partner, Canadian Arthritis Patient Alliance, Toronto, Ontario, Canada
| | | | | | - Karine Toupin-April
- Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada and University of Ottawa, Ottawa, Ontario, Canada
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Richards DP, Birnie KA, Eubanks K, Lane T, Linkiewich D, Singer L, Stinson JN, Begley KN. Guidance on authorship with and acknowledgement of patient partners in patient-oriented research. Res Involv Engagem 2020; 6:38. [PMID: 32637153 PMCID: PMC7331134 DOI: 10.1186/s40900-020-00213-6] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/22/2020] [Accepted: 06/16/2020] [Indexed: 05/14/2023]
Abstract
The Strategy for Patient-Oriented Research Chronic Pain Network was founded in 2016 and is a patient-oriented research network funded by the Canadian Institutes of Health Research. The Network incorporates patient partners throughout its governance and operations meaning that patient partners may contribute to research projects in ways that warrant scientific authorship as defined by the International Committee of Medical Journal Editors. The Network did a brief informal review of guidance on patient authorship in 2019, but could not find any practical documentation to guide its members on this topic. Note the term patient partner here refers to a patient (or caregiver or other person with lived experience) who is a partner or collaborator on a research team. This guidance does not address patients as participants in a research study. This guidance has been co-written by a group of researchers and patient partners of the Chronic Pain Network in an effort to address this gap. It is intended for both researchers and patient partner audiences. This guidance is meant to facilitate conversations between researchers and patient partners about authorship and/or acknowledgement regarding research projects on which they collaborate. While the overall principles of academic authorship and acknowledgement remain unchanged, nuances for interpreting these principles through the lens of patient engagement or patient-oriented research is provided. Teams that carry out patient-oriented research projects will require different preparation to empower all team members (researchers and patient partners) to discuss authorship and acknowledgement. To facilitate these conversations, we have included an overview of the scientific publishing process, explanation of some common terms, and sets of considerations are provided for both patient partners and researchers in determining the range of team member contribution from acknowledgement to authorship. Conversations about authorship can be difficult, even for established research teams. This guidance, and the resources discussed within it, are provided with the intention of making these conversations easier and more thoughtful.
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Affiliation(s)
- Dawn P. Richards
- Chronic Pain Network, McMaster University, Hamilton, Ontario Canada
- Five02 Labs Inc, Toronto, Ontario Canada
| | - Kathryn A. Birnie
- Chronic Pain Network, McMaster University, Hamilton, Ontario Canada
- Department of Anesthesiology, Perioperative and Pain Medicine, University of Calgary, Calgary, Alberta Canada
| | - Kathleen Eubanks
- Chronic Pain Network, McMaster University, Hamilton, Ontario Canada
| | - Therese Lane
- Chronic Pain Network, McMaster University, Hamilton, Ontario Canada
| | | | - Lesley Singer
- Chronic Pain Network, McMaster University, Hamilton, Ontario Canada
| | - Jennifer N. Stinson
- Chronic Pain Network, McMaster University, Hamilton, Ontario Canada
- Research Institute, The Hospital for Sick Children and Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario Canada
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Graef ER, Liew JW, Putman MS, Simard JF, Sirotich E, Berenbaum F, Duarte-García A, Grainger R, Harrison C, Konig MF, Korsten P, Proulx L, Richards DP, Robinson PC, Sattui SE, Ugarte-Gil MF, Young KJ, Kim AH, Sparks JA. Festina lente: hydroxychloroquine, COVID-19 and the role of the rheumatologist. Ann Rheum Dis 2020; 79:734-736. [PMID: 32295786 DOI: 10.1136/annrheumdis-2020-217480] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Accepted: 04/08/2020] [Indexed: 12/23/2022]
Affiliation(s)
- Elizabeth R Graef
- Division of Rheumatology and Clinical Immunology, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
| | - Jean W Liew
- Department of Medicine, Division of Rheumatology, University of Washington, Seattle, WA, United States
| | - Michael S Putman
- Department of Medicine, Division of Rheumatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
| | - Julia F Simard
- Health Research & Policy, Division of Epidemiology and Department of Medicine, Division of Immunology & Rheumatology, Stanford School of Medicine, Stanford, California, USA.,Department of Medicine, Clinical Epidemiology Unit, Sweden
| | | | | | | | | | | | - Maximilian F Konig
- Division of Rheumatology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Peter Korsten
- Department of Nephrology and Rheumatology, University Medical Center Göttingen, Göttingen, Germany
| | - Laurie Proulx
- Canadian Arthritis Patient Alliance, Ottawa, Ontario, Canada
| | - Dawn P Richards
- Canadian Arthritis Patient Alliance, Ottawa, Ontario, Canada
| | - Philip C Robinson
- Princess Alexandra Hospital, Diamantina Institute, University of Queensland, Brisbane, Queensland, Australia
| | - Sebastian E Sattui
- Division of Rheumatology, Hospital for Special Surgery, New York, New York, USA
| | | | - Kristen J Young
- University of Texas Southwestern Medical School, Dallas, Texas, USA
| | - Alfred Hj Kim
- Division of Rheumatology, Department of Medicine, Washington University School of Medicine in St. Louis, Saint Louis, Missouri, USA
| | - Jeffrey A Sparks
- Division of Rheumatology, Inflammation, and Immunity, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA
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Richards DP. Don't call my experience a "patient story". BMJ 2020; 368:m414. [PMID: 32014850 DOI: 10.1136/bmj.m414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Deane K, Delbecque L, Gorbenko O, Hamoir AM, Hoos A, Nafria B, Pakarinen C, Sargeant I, Richards DP, Skovlund SE, Brooke N. Co-creation of patient engagement quality guidance for medicines development: an international multistakeholder initiative. ACTA ACUST UNITED AC 2019; 5:43-55. [PMID: 31645992 PMCID: PMC6792320 DOI: 10.1136/bmjinnov-2018-000317] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2018] [Revised: 01/22/2019] [Accepted: 01/29/2019] [Indexed: 01/20/2023]
Abstract
Introduction Meaningful patient engagement (PE) can enhance medicines' development. However, the current PE landscape is fragmentary and lacking comprehensive guidance. Methods We systematically searched for PE initiatives (SYNaPsE database/publications). Multistakeholder groups integrated these with their own PE expertise to co-create draft PE Quality Guidance which was evaluated by public consultation. Projects exemplifying good PE practice were identified and assessed against PE Quality Criteria to create a Book of Good Practices (BOGP). Results Seventy-six participants from 51 organisations participated in nine multistakeholder meetings (2016-2018). A shortlist of 20relevant PE initiatives (from 170 screened) were identified. The co-created INVOLVE guidelines provided the main framework for PE Quality Guidance and was enriched with the analysis of the PE initiatives and the PE expertise of stakeholders. Seven key PE Quality Criteria were identified. Public consultation yielded 67 responses from diverse backgrounds. The PE Quality Guidance was agreed to be useful for achieving quality PE in practice, understandable, easy to use, and comprehensive. Overall, eight initiatives from the shortlist and from meeting participants were selected for inclusion in the BOGP based on demonstration of PE Quality Criteria and willingness of initiative owners to collaborate. Discussion The PE Quality Guidance and BOGP are practical resources which will be continually updated in response to user feedback. They are not prescriptive, but rather based on core principles, which can be applied according to the unique needs of each interaction and initiative. Implementation of the guidance will facilitate improved and systematic PE across the medicines' development lifecycle.
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Affiliation(s)
- Katherine Deane
- School of Health Sciences, University of East Anglia, Norwich, UK
| | - Laure Delbecque
- Patient Reported Outcomes, Pharmerit International, Rotterdam, Belgium
| | - Oleksandr Gorbenko
- Chief Scientific and Medical Office - Patient Affairs, ViiV Healthcare, London, UK
| | | | - Anton Hoos
- Patient Focused Medicines Development, Brussels, Belgium
| | - Begonya Nafria
- Patient Engagement in Research, Institut de Recerca Sant Joan de Déu- Hospital Sant Joan de Déu, Esplugues de Llobregat, Spain
| | - Chi Pakarinen
- Patient Focused Medicines Development, Brussels, Belgium
| | - Ify Sargeant
- Patient Focused Medicines Development, Brussels, Belgium
| | | | - Soren Eik Skovlund
- Steno Diabetes Centre North Denmark, Aalborg University Hospital, Aalborg, Denmark
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Batist G, Michaud S, Richards DP, Servidio-Italiano F, Stein BD. Developing a model of a patient-group pathway to accessing cancer clinical trials in Canada. Curr Oncol 2018; 25:e597-e609. [PMID: 30607129 PMCID: PMC6291290 DOI: 10.3747/co.25.4213] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Background Colorectal Cancer Canada, in partnership with a Scientific Advisory Committee, is developing a Canadian Patient Group Pathway to Accessing Cancer Clinical Trials ("Pathway"). A central element of the Pathway is presented here-namely, a set of recommendations and tools aimed at each stakeholder group. Methods A summary of the peer-reviewed and grey literature informed discussions at a meeting, held in June 2017, in which a cross-section of stakeholders reached consensus on the potential roles of patient groups in the cancer clinical trials process, barriers to accessing cancer clinical trials, best practice models for patient-group integration, and a process for developing the Pathway. Canadian recommendations and tools were subsequently developed by a small working group and reviewed by the Scientific Advisory Committee. Results The major output of the consensus conference was agreement that the Clinical Trials Transformation Initiative (ctti) model, successfully applied in the United States, could be adapted to create a Canadian Pathway. Two main differences between the Canadian and American cancer clinical research environments were highlighted: the effects of global decision-making and systems of regulatory and funding approvals. The working group modified the ctti model to incorporate those aspects and to reflect Canadian stakeholder organizations and how they currently interact with patient groups. Conclusions Developing and implementing a Canadian Pathway that incorporates the concepts of multi-stakeholder collaboration and the inclusion of patient groups as equal partners is expected to generate significant benefits for all stakeholders. The next steps to bring forward a proposed Pathway will involve engaging the broader cancer research community. Clinical trial sponsors will be encouraged to adopt a Charter recognizing the importance of including patient groups, and to support the training of patient groups through an independent body to ensure quality research partners. Integration of patient groups into the process of developing "real world" evidence will be advanced by a further consensus meeting being organized by Colorectal Cancer Canada for 6-7 November 2018.
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Affiliation(s)
- G Batist
- McGill Centre for Translational Research in Cancer, Sir Mortimer B. Davis Jewish General Hospital, Montreal, QC
- Segal Cancer Centre, Sir Mortimer B. Davis Jewish General Hospital, Montreal, QC
- National Centre of Excellence in Personalized Medicine, Exactis Innovation, Montreal, QC
| | | | | | | | - B D Stein
- Colorectal Cancer Canada, Montreal, QC
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Richards DP, Jordan I, Strain K, Press Z. Patient partner compensation in research and health care: the patient perspective on why and how. Patient Experience Journal 2018. [DOI: 10.35680/2372-0247.1334] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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Abstract
Background: Little is known about the Canadian public’s perspective regarding clinical trials. Methods: We surveyed 1602 Ontario and British Columbia residents to ascertain their understanding of and willingness to participate in clinical trials. Results: Clinical trials are regarded positively with overall perceptions that they provide societal and personal benefits. Most respondents were somewhat (49%) or very willing (19%) to participate in a clinical trial. This increased with age and level of education. It was also greater among those with poor or very poor health, those with multiple chronic conditions, and those who had previously been invited into a clinical trial, all of which were correlated with age. Still, there was room for improvement in awareness and understanding of clinical trials. Forty-three percent of those surveyed felt not very informed or not at all informed and 37% had no opinion regarding clinical trials. Respondents would most often turn to their treating physician if considering participating in a clinical trial and least often to social media. Conclusion: While Canadians’ views about clinical trials are generally positive, they are somewhat muted and a significant minority feels poorly or not at all informed. They are less willing to participate in clinical research than Americans and are roughly equivalent to Europeans. While clinicians are the top choice for learning about clinical trials, they have little or no training and little time for this role. As we move toward integrating clinical trials into the practice setting, these issues of time, training, and resources must be addressed.
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Affiliation(s)
- Donald J Willison
- 1 Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
| | | | - Alison Orth
- 3 Clinical Trials BC, Vancouver, British Columbia, Canada
| | - Heather Harris
- 4 Can-SOLVE CKD Network, Vancouver, British Columbia, Canada
| | - Susan Marlin
- 2 Clinical Trials Ontario, Toronto, Ontario, Canada
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Keyler DE, Richards DP, Warrell DA, Weinstein SA. Local envenomation from the bite of a juvenile false water cobra (Hydrodynastes gigas; Dipsadidae). Toxicon 2016; 111:58-61. [PMID: 26743113 DOI: 10.1016/j.toxicon.2015.12.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2015] [Revised: 12/22/2015] [Accepted: 12/28/2015] [Indexed: 10/22/2022]
Abstract
The false water cobra (Hydrodynastes gigas) is a non-front-fanged colubroid snake frequently exhibited in zoos, and maintained by amateur collectors. Little detailed documentation regarding the time-course of symptoms development and the consequences of their bites to humans has been published. Reported here is a case of envenoming in a 25 yo male that occurred after the bite of a juvenile H. gigas. The victim was bitten on the fourth digit of the left hand while processing the snake for sex determination, and the snake remained attached to the digit for approximately 30 s; there was no jaw advancement. Within 5 min, intense local pain developed, and at 4hr post bite the entire dorsal aspect of the hand was significantly edematous, The local effects progressed and involved the entire forearm, and the local pain referred to the axillary region. Mild paresthesia and local blanching ("pallor") were noted in the affected digit, but resolved within 7 days. The clinical course in the patient showed that moderate localized symptoms may result from the bite of a juvenile H.gigas.
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Affiliation(s)
- D E Keyler
- Animal Venom Research International, Moreno Valley, CA, 92556, USA; Department of Experimental and Clinical Pharmacology, University of Minnesota, Minneapolis, MN, 55455, USA.
| | - D P Richards
- School of Life Sciences, University of Nottingham, United Kingdom
| | - D A Warrell
- Nufield Department of Clinical Medicine, University of Oxford, Oxford, OX3 9DW, UK
| | - S A Weinstein
- Toxinology Department, Women's and Children's Hospital, North Adelaide, 5006, Australia
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Richards DP, Sojo LE, Keller BO. Quantitative analysis with modern bioanalytical mass spectrometry and stable isotope labeling. J Labelled Comp Radiopharm 2007. [DOI: 10.1002/jlcr.1392] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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Krogan NJ, Cagney G, Yu H, Zhong G, Guo X, Ignatchenko A, Li J, Pu S, Datta N, Tikuisis AP, Punna T, Peregrín-Alvarez JM, Shales M, Zhang X, Davey M, Robinson MD, Paccanaro A, Bray JE, Sheung A, Beattie B, Richards DP, Canadien V, Lalev A, Mena F, Wong P, Starostine A, Canete MM, Vlasblom J, Wu S, Orsi C, Collins SR, Chandran S, Haw R, Rilstone JJ, Gandi K, Thompson NJ, Musso G, St Onge P, Ghanny S, Lam MHY, Butland G, Altaf-Ul AM, Kanaya S, Shilatifard A, O'Shea E, Weissman JS, Ingles CJ, Hughes TR, Parkinson J, Gerstein M, Wodak SJ, Emili A, Greenblatt JF. Global landscape of protein complexes in the yeast Saccharomyces cerevisiae. Nature 2006; 440:637-43. [PMID: 16554755 DOI: 10.1038/nature04670] [Citation(s) in RCA: 2010] [Impact Index Per Article: 111.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2005] [Accepted: 02/23/2006] [Indexed: 11/09/2022]
Abstract
Identification of protein-protein interactions often provides insight into protein function, and many cellular processes are performed by stable protein complexes. We used tandem affinity purification to process 4,562 different tagged proteins of the yeast Saccharomyces cerevisiae. Each preparation was analysed by both matrix-assisted laser desorption/ionization-time of flight mass spectrometry and liquid chromatography tandem mass spectrometry to increase coverage and accuracy. Machine learning was used to integrate the mass spectrometry scores and assign probabilities to the protein-protein interactions. Among 4,087 different proteins identified with high confidence by mass spectrometry from 2,357 successful purifications, our core data set (median precision of 0.69) comprises 7,123 protein-protein interactions involving 2,708 proteins. A Markov clustering algorithm organized these interactions into 547 protein complexes averaging 4.9 subunits per complex, about half of them absent from the MIPS database, as well as 429 additional interactions between pairs of complexes. The data (all of which are available online) will help future studies on individual proteins as well as functional genomics and systems biology.
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Affiliation(s)
- Nevan J Krogan
- Banting and Best Department of Medical Research, Terrence Donnelly Centre for Cellular and Biomolecular Research, University of Toronto, 160 College St, Toronto, Ontario M5S 3E1, Canada
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Jeronimo C, Langelier MF, Zeghouf M, Cojocaru M, Bergeron D, Baali D, Forget D, Mnaimneh S, Davierwala AP, Pootoolal J, Chandy M, Canadien V, Beattie BK, Richards DP, Workman JL, Hughes TR, Greenblatt J, Coulombe B. RPAP1, a novel human RNA polymerase II-associated protein affinity purified with recombinant wild-type and mutated polymerase subunits. Mol Cell Biol 2004; 24:7043-58. [PMID: 15282305 PMCID: PMC479746 DOI: 10.1128/mcb.24.16.7043-7058.2004] [Citation(s) in RCA: 61] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2003] [Revised: 02/09/2004] [Accepted: 05/14/2004] [Indexed: 11/20/2022] Open
Abstract
We have programmed human cells to express physiological levels of recombinant RNA polymerase II (RNAPII) subunits carrying tandem affinity purification (TAP) tags. Double-affinity chromatography allowed for the simple and efficient isolation of a complex containing all 12 RNAPII subunits, the general transcription factors TFIIB and TFIIF, the RNAPII phosphatase Fcp1, and a novel 153-kDa polypeptide of unknown function that we named RNAPII-associated protein 1 (RPAP1). The TAP-tagged RNAPII complex is functionally active both in vitro and in vivo. A role for RPAP1 in RNAPII transcription was established by shutting off the synthesis of Ydr527wp, a Saccharomyces cerevisiae protein homologous to RPAP1, and demonstrating that changes in global gene expression were similar to those caused by the loss of the yeast RNAPII subunit Rpb11. We also used TAP-tagged Rpb2 with mutations in fork loop 1 and switch 3, two structural elements located strategically within the active center, to start addressing the roles of these elements in the interaction of the enzyme with the template DNA during the transcription reaction.
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Affiliation(s)
- Célia Jeronimo
- Laboratory of Gene Transcription, Institut de Recherches Cliniques de Montréal, Montreal, Quebec, Canada H2W 1R7
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Quach TTT, Li N, Richards DP, Zheng J, Keller BO, Li L. Development and applications of in-gel CNBr/tryptic digestion combined with mass spectrometry for the analysis of membrane proteins. J Proteome Res 2004; 2:543-52. [PMID: 14582651 DOI: 10.1021/pr0340126] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Hydrophobic membrane proteins often have complex functions and are thus of great interest. However, their analysis presents a challenge because they are not readily soluble in polar solvents and often undergo aggregation. We present a sequential CNBr and trypsin in-gel digestion method combined with mass spectrometry for membrane protein analysis. CNBr selectively cleaves methionine residues. But due to the low number of methionines in proteins, CNBr cleavage produces a small number of large peptide fragments with MWs typically >2000, which are difficult to extract from gel pieces. To produce a larger number of smaller peptides than that obtained by using CNBr alone, we demonstrate that trypsin can be used to further digest the sample in gel. The use of n-octyl glucoside (n-OG) to enhance the digestion efficiency and peptide recovery was also studied. We demonstrate that the sensitivity of this membrane protein identification method is in the tens of picomole regime, which is compatible to the Coomassie staining gel-spot visualization method, and is more sensitive than other techniques reported in the literature. This CNBr/trypsin in-gel digestion method is also found to be very reproducible and has been successfully applied for the analysis of complex protein mixtures extracted from biological samples. The results are presented from a study of the analysis of bacteriorhodopsin, nitrate reductase 1 gamma chain, and a complex protein mixture extracted from the endoplasmic recticulum membrane of mouse liver.
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Affiliation(s)
- Thuy Tien T Quach
- Department of Chemistry, University of Alberta, Edmonton, Alberta, Canada T6G 2G2
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Peng WT, Krogan NJ, Richards DP, Greenblatt JF, Hughes TR. ESF1 is required for 18S rRNA synthesis in Saccharomyces cerevisiae. Nucleic Acids Res 2004; 32:1993-9. [PMID: 15056729 PMCID: PMC390369 DOI: 10.1093/nar/gkh518] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2004] [Revised: 03/10/2004] [Accepted: 03/10/2004] [Indexed: 11/14/2022] Open
Abstract
We report that Esf1p (Ydr365cp), an essential, evolutionarily conserved nucleolar protein, is required for the biogenesis of 18S rRNA in Saccharomyces cerevisiae. Depletion of Esf1p resulted in delayed processing of 35S precursor and a striking loss of 18S rRNA. Esf1p physically associated with ribosomal proteins and proteins involved in 18S rRNA biogenesis. Consistent with its role in 18S rRNA biogenesis, Esf1p also physically associated with U3 and U14 snoRNAs, but did not appear to be a core component of the SSU processome. These data indicate that Esf1p plays a direct role in early pre-rRNA processing.
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Affiliation(s)
- Wen-Tao Peng
- Banting and Best Department of Medical Research, University of Toronto, 112 College Street, Toronto, Ontario M5G 1L6, Canada
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50
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Krogan NJ, Peng WT, Cagney G, Robinson MD, Haw R, Zhong G, Guo X, Zhang X, Canadien V, Richards DP, Beattie BK, Lalev A, Zhang W, Davierwala AP, Mnaimneh S, Starostine A, Tikuisis AP, Grigull J, Datta N, Bray JE, Hughes TR, Emili A, Greenblatt JF. High-definition macromolecular composition of yeast RNA-processing complexes. Mol Cell 2004; 13:225-39. [PMID: 14759368 DOI: 10.1016/s1097-2765(04)00003-6] [Citation(s) in RCA: 301] [Impact Index Per Article: 15.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2003] [Revised: 11/18/2003] [Accepted: 11/24/2003] [Indexed: 11/29/2022]
Abstract
A remarkably large collection of evolutionarily conserved proteins has been implicated in processing of noncoding RNAs and biogenesis of ribonucleoproteins. To better define the physical and functional relationships among these proteins and their cognate RNAs, we performed 165 highly stringent affinity purifications of known or predicted RNA-related proteins from Saccharomyces cerevisiae. We systematically identified and estimated the relative abundance of stably associated polypeptides and RNA species using a combination of gel densitometry, protein mass spectrometry, and oligonucleotide microarray hybridization. Ninety-two discrete proteins or protein complexes were identified comprising 489 different polypeptides, many associated with one or more specific RNA molecules. Some of the pre-rRNA-processing complexes that were obtained are discrete sub-complexes of those previously described. Among these, we identified the IPI complex required for proper processing of the ITS2 region of the ribosomal RNA primary transcript. This study provides a high-resolution overview of the modular topology of noncoding RNA-processing machinery.
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Affiliation(s)
- Nevan J Krogan
- Banting and Best Department of Medical Research, University of Toronto, 112 College Street, Toronto, Ontario M5G 1L6, Canada
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