Involving different stakeholders in prioritising outcomes to assess healthcare systems response for type 1 diabetes management: Using co-creation approaches in Peru

IF 1.9 4区医学 Q3 HEALTH POLICY & SERVICES

International Journal of Health Planning and Management Pub Date : 2024-07-18 DOI:10.1002/hpm.3821

Jessica Hanae Zafra-Tanaka, Guillermo Almeida, Jackelyn Elizabeth Andrade Montalvo, Cecilia Anza-Ramirez, Josselyn Jauregui, Silvana Perez-Leon, Maria Lazo-Porras, Nikol Mayo-Puchoc, Alvaro Taype-Rondán, J. Jaime Miranda, David Beran

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引用次数: 0

Abstract

Background

Engaging diverse stakeholders in developing core outcome sets (COSs) can produce more meaningful metrics as well as research responsive to patient needs. The most common COS prioritisation method, Delphi surveys, has limitations related to selection bias and participant understanding, while qualitative methods like group discussions are less frequently used. This study aims to test a co-creation approach to COS development for type 1 diabetes (T1DM) in Peru.

Methods

Using a co-creation approach, we aimed to prioritise outcomes for T1DM management in Peru, incorporating perspectives from people with T1DM, caregivers, healthcare professionals, and decision-makers. A set of outcomes were previously identified through a systematic review and qualitative evidence synthesis. Through qualitative descriptive methods, including in-person workshops, each group of stakeholders contributed to the ranking of outcomes. Decision-makers also discussed the feasibility of measuring these outcomes within the Peruvian healthcare system.

Results

While priorities varied among participant groups, all underscored the significance of monitoring healthcare system functionality over mortality. Participants recognized the interconnected nature of healthcare system performance, clinical outcomes, self-management, and quality of life. When combining the rankings from all the groups, metrics related to economic impact on the individual and structural support, policies promoting health, and protecting those living with T1DM were deemed more important in comparison to measuring clinical outcomes.

Conclusion

We present the first COS for T1DM focused on low-and-middle-income countries and show aspects of care that are relevant in this setting. Diverse prioritisation among participant groups underscores the need of inclusive decision-making processes. By incorporating varied perspectives, healthcare systems can better address patient needs and enhance overall care quality.

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让不同利益相关者参与确定成果的优先次序，以评估医疗保健系统对 1 型糖尿病管理的响应：在秘鲁使用共同创造方法。

背景：让不同的利益相关者参与制定核心结果集（COS），可以制定出更有意义的指标，并开展符合患者需求的研究。最常见的 COS 优先级排序方法--德尔菲调查--存在选择偏差和参与者理解方面的局限性，而小组讨论等定性方法则较少使用。本研究旨在测试秘鲁 1 型糖尿病（T1DM）COS 开发的共同创造方法：我们采用共同创造的方法，旨在结合 T1DM 患者、护理人员、医疗保健专业人员和决策者的观点，确定秘鲁 T1DM 管理成果的优先次序。此前，我们已通过系统回顾和定性证据综合确定了一系列结果。通过定性描述方法（包括面对面的研讨会），每一组利益相关者都为结果排序做出了贡献。决策者还讨论了在秘鲁医疗保健系统中衡量这些结果的可行性：虽然各参与群体的优先事项各不相同，但所有参与群体都强调了监测医疗保健系统功能而非死亡率的重要性。与会者认识到医疗系统的绩效、临床结果、自我管理和生活质量之间的相互关联性。综合所有小组的排名，与衡量临床结果相比，与对个人和结构性支持的经济影响、促进健康的政策以及保护 T1DM 患者相关的指标被认为更为重要：我们首次提出了针对中低收入国家的 T1DM COS，并展示了与这种情况相关的护理方面。各参与群体对优先事项的不同看法凸显了包容性决策过程的必要性。通过纳入不同的观点，医疗保健系统可以更好地满足患者的需求并提高整体护理质量。

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来源期刊

International Journal of Health Planning and Management Multiple-

CiteScore

4.50

自引率

3.70%

发文量

197

期刊介绍： Policy making and implementation, planning and management are widely recognized as central to effective health systems and services and to better health. Globalization, and the economic circumstances facing groups of countries worldwide, meanwhile present a great challenge for health planning and management. The aim of this quarterly journal is to offer a forum for publications which direct attention to major issues in health policy, planning and management. The intention is to maintain a balance between theory and practice, from a variety of disciplines, fields and perspectives. The Journal is explicitly international and multidisciplinary in scope and appeal: articles about policy, planning and management in countries at various stages of political, social, cultural and economic development are welcomed, as are those directed at the different levels (national, regional, local) of the health sector. Manuscripts are invited from a spectrum of different disciplines e.g., (the social sciences, management and medicine) as long as they advance our knowledge and understanding of the health sector. The Journal is therefore global, and eclectic.