Incorporating patients' perspectives in hospital-based health technology assessment (HTA): The views of HTA producers, hospital managers and patients

Article type
Authors
Gagnon M1, Desmartis M2, Lepage-Savary D3, Gagnon J1, St-Pierre M4, Rhainds M3, Lemieux R5, Gauvin F6, Légaré F7
1Faculty of Nursing, Laval University, Quebec, Canada
2Quebec University Hospital Research Centre, Quebec, Canada
3Quebec University Hospital Centre, Quebec, Canada
4Department of Management, Laval University, Quebec, Canada
5Sherbrooke University Medical Centre, Sherbrooke, Canada
6National Collaborating Centre for Healthy Public Policy, Quebec, Canada
7Department of Family Medicine and Emergency medicine, Laval University, Quebec
Abstract
Background: Hospital-based HTA units have been implemented in the province of Quebec (Canada) in order to improve the relevance and timeliness of HTA recommendations and, ultimately, to facilitate their uptake. They provide a unique opportunity to foster an increased participation of patients in decisions regarding health technologies and interventions.

Objective: To explore perceptions of HTA producers, hospital managers and patients regarding the incorporation of patients' perspective in hospital-based HTA activities.

Methods: We conducted semi-structured interviews and focus groups with HTA producers, hospital managers, and patients' representatives. The following themes were covered: current practices and preferences regarding the type and level of patient involvement in hospital-based HTA activities, impacts of patient involvement, perceived barriers and facilitators to involving patients. Interviews and focus groups were audio recorded and we analysed data using the NVivo software.

Results: A total of 21 interviews (involving 24 HTA producers, hospital managers and other professionals) and two focus groups (with 13 patient representatives) were conducted. Participants reported a few experiences of patient involvement in this area but they all agreed on the importance to consider more the patients' perspectives in HTA. Across interviews and focus groups, all participants mentioned the relevance of consulting patients in evaluation of some types of technologies. Some HTA producers and hospital managers are not yet ready to involve patients in HTA committees, although the majority of them agreed on which stages of the HTA process are relevant for involving patients.

Conclusion: There is a consensus on the importance of incorporating patients' perspectives in hospital-based HTA activities but very few experiences report on its impact. Strategies for incorporating patients' perspectives in HTA at the local level should be developed based on the needs and resources of these structures and their impact on the production of evidence regarding health technologies should be assessed.