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患者和公众是卫生技术评估中的重要利益相关者,但他们的参与程度较低——行动呼吁。

Patients and public are important stakeholders in health technology assessment but the level of involvement is low - a call to action.

作者信息

Wale Janet L, Thomas Samuel, Hamerlijnck Dominique, Hollander Ronald

机构信息

HTAi Patient and Citizen Involvement in HTA Interest Group (PCIG), 11A Lydia Street, Brunswick, Victoria, 3056, Australia.

Avalere Health, 1201 New York Ave, NW, Suite 1000, Washington, DC, 20005, USA.

出版信息

Res Involv Engagem. 2021 Jan 5;7(1):1. doi: 10.1186/s40900-020-00248-9.

Abstract

BACKGROUND

Health technology assessment (HTA) agencies have an important role in the evaluation and approval of new technologies. They determine their value within a health system so to promote equitable, quality care with available healthcare resources. Many HTA agencies have some mechanism for involving patients in their processes, but there is great variability and an absence of comprehensive, robust practices for involvement. The accelerating pace of medical innovation creates a need to improve the depth and breadth of patient involvement in the HTA process.

MAIN BODY

In this 'Call to action', we present ideas from three HTA expert commentaries calling for collaborative learning and to share innovative ideas for changes in HTA. We also draw on examples of HTA agencies creatively pursuing this goal. We propose a 'Call to action' for HTA stakeholders to undertake serious dialogue with patient advocates aimed at creating shared goals. HTA agencies can use these goals to ensure meaningful patient involvement at every step of the HTA process. Five elements are explored. In 'Recognizing the value of shared purpose', we highlight examples of HTA agencies that have patients working in partnership with medical practitioners and HTA staff. Results include improved processes that instil confidence. 'Committing to patient involvement as part of HTA culture' highlights several initiatives aimed at changes in HTA organisational culture to be more inclusive of patients. In 'Aligning patient and HTA goals' we cite work in Belgium and New Zealand which places a greater emphasis on quality of life rather than life expectancy and cost-effectiveness. By 'Integrating patient involvement at every step of the HTA process' patients can make vital contributions at every stage of the HTA process. We provide two examples of where HTA agencies have successfully involved patients early in the process in order to broaden the scope of evaluations. 'Developing a common language and working together' can support transformative dialogue through 'unified language'.

CONCLUSION

The authors of this commentary ask that agencies and stakeholders involved in HTA take up this call to work together for visionary and transformative elevation of the voice of patients in HTA worldwide.

摘要

背景

卫生技术评估(HTA)机构在新技术的评估和审批中发挥着重要作用。它们在卫生系统内确定新技术的价值,从而利用现有的医疗资源促进公平、优质的医疗服务。许多HTA机构都有让患者参与其流程的某种机制,但存在很大差异,且缺乏全面、有力的参与实践。医学创新步伐的加快使得有必要提高患者在HTA流程中的参与深度和广度。

主体内容

在这篇“行动呼吁”中,我们展示了三篇HTA专家评论文章中的观点,这些观点呼吁开展合作学习,并分享关于HTA变革的创新想法。我们还借鉴了HTA机构创造性地追求这一目标的实例。我们向HTA利益相关者提出“行动呼吁”,要求他们与患者权益倡导者进行认真对话,以达成共同目标。HTA机构可以利用这些目标确保在HTA流程的每一步都有意义地让患者参与进来。探讨了五个要素。在“认识到共同目标的价值”中,我们强调了HTA机构让患者与医生和HTA工作人员合作的实例。结果包括改进流程并增强信心。“将患者参与作为HTA文化的一部分”强调了多项旨在改变HTA组织文化以更包容患者的举措。在“使患者和HTA目标保持一致”中,我们引用了比利时和新西兰的工作,这些工作更加强调生活质量而非预期寿命和成本效益。通过“在HTA流程的每一步都融入患者参与”,患者可以在HTA流程的每个阶段做出重要贡献。我们提供了两个HTA机构在流程早期成功让患者参与以扩大评估范围的实例。“开发共同语言并共同努力”可以通过“统一语言”支持变革性对话。

结论

这篇评论文章的作者要求参与HTA的机构和利益相关者响应这一呼吁,共同努力,在全球范围内实现患者在HTA中声音的富有远见和变革性的提升。

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