Co-production in action: improving the relevance of a Cochrane Review on person-centred care

Article type
Authors
Merner B1, Colombo C2, Xafis V3, Gaulden CM4, Graham-Wisener L5, Hill S1
1Centre for Health Communication and Participation, La Trobe University
2Laboratory of research on consumer involvement, Department of Public Health, IRCCS Istituto di Ricerche Farmacologiche Mario Negri
3The Sydney Children's Hospital Network, Sydney
4No affiliation
5Marie Curie Hospice
Abstract
Background:
Person-centred care remains an elusive goal for healthcare systems worldwide. Cochrane Reviews, as the gold standard for healthcare evidence, can contribute to improving person-centred care only when they are relevant to end-users, particularly consumers, health professionals and policy-makers.

Objectives:
To co-produce a Cochrane Review on person-centred care to improve its usefulness and relevance to end-users.

Methods:
We convened a purposively sampled, Australian-based panel of stakeholders (n = 18), including consumer representatives (n = 6), clinicians (n = 6) and health decision-makers (n = 6) to provide guidance at different stages of the review. We have currently held panel meetings to 1) determine the type of review and 2) finalise the review question and selection criteria. The next meeting of the panel will take place in August 2018 to finalise the results of the review.

During each meeting, stakeholders have been invited to give feedback on particular issues or questions. After the meeting, when relevant, stakeholders have voted on their preferred option. We have implemented the majority vote (when taken) and panel feedback in the development of the protocol. The author team reports back to the stakeholders after each meeting about how their feedback has been implemented.

Results:
Contributions from the panel have so far altered the direction of the review in the following ways:

1) After in-depth discussion of the options, 13/15 stakeholders voted for a qualitative review - therefore the review type was changed.
2) Changes to the selection criteria and scope: the background section was redrafted to increase its relevance; new objectives were added to aid implementation; inclusion and exclusion criteria were broadened.

It is anticipated that further changes may be made to the review itself when the panel meets again in August 2018.

Conclusions:
Co-production of a review with a stakeholder advisory panel resulted in changes at the protocol stage that may increase the relevance and usefulness of the review to end-users. We will provide data about the impacts of the panel at the review stage.

Patient or healthcare consumer involvement:
Consumers were part of the stakeholder advisory panel co-producing this review with the author team.