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  • Mylène Tantchou Dipankui (a1), Marie-Pierre Gagnon (a2), Marie Desmartis (a1), France Légaré (a3), Florence Piron (a4), Johanne Gagnon (a3), Marc Rhiands (a5) and Martin Coulombe (a5)...


Objectives: We sought to evaluate patient involvement (consultation and direct participation) in the assessment of alternative measures to restraint and seclusion among adults in short-term hospital wards (in psychiatry) and long-term care facilities for the elderly.

Methods: We conducted individual semi-structured interviews with thirteen stakeholders: caregivers, healthcare managers, patient representatives, health technology assessment (HTA) unit members, researchers, and members of the local HTA scientific committee. Data were collected until saturation. We carried out content analysis of two HTA reports and four other documents that were produced in relation with this HTA. We also used field notes taken during formal meetings and informal discussions with stakeholders. We performed thematic analysis based on a framework for assessing patient involvement in HTA. We then triangulated data.

Results: For the majority of interviewees, patient consultation enriched the content of the HTA report and its recommendations. This also made it possible to suggest other alternatives that could reduce the use of restraint and seclusion and helped confirm some views and comments from healthcare professionals consulted in this HTA. The direct participation of patient representatives enabled rephrasing of some findings so as to bring the patient perspective to the HTA report.

Conclusions: Patient consultation was seen as having directly influenced the content of the HTA report while direct participation made it possible to rephrase some findings. This is one of few studies to assess the impact of patient involvement in HTA and more such studies are needed to identify the best ways to improve the input of such involvement.



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1. Kreis, J, Schmidt, H. Public engagement in health technology assessment and coverage decisions: A study of experiences in France, Germany, and the United Kingdom. J Health Polit Policy Law. 2013;38:89122.
2. Whitty, JA. An International Survey of the Public Engagement Practices of Health Technology Assessment Organizations. Value Health. 2013;16:155163.
3. Abelson, J, Bombard, Y, Gauvin, FP, Simeonov, D, Boesveld, S. Assessing the impacts of citizen deliberations on the health technology process. Int J Technol Assess Health Care. 2013;29:282289.
4. Menon, D, Stafinski, T. Role of patient and public participation in health technology assessment and coverage decisions. Expert Rev Pharmacoecon Outcomes Res. 2011;11:7589.
5. Facey, K, Boivin, A, Gracia, J, et al. Patients' perspectives in health technology assessment: A route to robust evidence and fair deliberation. Int J Technol Assess Health Care. 2010;26:334340.
6. Pivik, J, Rode, E, Ward, C. A consumer involvement model for health technology assessment in Canada. Health Policy. 2004;69:253268.
7. Health Equality Europe. Understanding health technology assessment (HTA). Health Equality Europe; 2008.
8. British Medical Association. Patient and public involvement – A toolkit for doctors. London: BMA; 2011.
9. Segal, L. The importance of patient empowerment in health system reform. Health Policy. 1998;44:3144.
10. Gagnon, M-P, Desmartis, M, Lepage-Savary, D, et al. Introducing patients' and the public's perspectives to health technology assessment: A systematic review of international experiences. Int J Technol Assess Health Care. 2011;27:3142.
11. Staniszewska, S, Brett, J, Mockford, C, Barber, R. The GRIPP checklist: Strengthening the quality of patient and public involvement reporting in research. Int J Technol Assess Health Care. 2011;27:391399.
12. Crawford, MJ, Rutter, D, Manley, C, et al. Systematic review of involving patients in the planning and development of health care. BMJ. 2002;325:1263.
13. Ministère de la santé et des services sociaux. Vers un changement de pratique afin de réduire le recours à la contention et à l'isolement. Québec: Ministère de la santé et des services sociaux; 2008. French
14. Dimant, J. Avoiding physical restraints in long-term care facilities. J Am Med Dir Assoc. 2003;4:207215.
15. Gagnon, MP, Desmartis, M, Dipankui, MT, Gagnon, J, St-Pierre, M. Alternatives to seclusion and restraint in psychiatry and in long-term care facilities for the elderly: Perspectives of service users and family members. Patient. 2013;6:269280.
16. Gagnon, MP, Gagnon, J, St-Pierre, M, et al. Involving patients in HTA activities at local level: A study protocol based on the collaboration between researchers and knowledge users. BMC Health Serv Res. 2012;12:14.
17. Unité d'évaluation des technologies et des modes d'intervention en santé du CHU de Québec (UETMIS du CHU de Québec). Évaluation de la surveillance constante et des technologies d'aide à la surveillance comme mesures alternatives à la contention et à l'isolement chez des adultes hospitalisés ou en centres d'hébergement. Québec: CHU de Québec; 2012. French
18. Unité d'évaluation des technologies et des modes d'intervention en santé du CHU de Québec. Évaluation des pratiques, des barrières et des facilitateurs de l'implantation des mesures de remplacement de la contention et de l'isolement dans le RUIS de l'Université Laval. Québec: CHU de Québec; 2013. French
19. Unité d'évaluation des technologies et des modes d'intervention en santé du Centre hospitalier universitaire de Québec (UETMIS du CHUQ). Évaluation des mesures alternatives à la contention et à l'isolement chez les patients adultes hospitalisés ou en centre d'hébergement. Québec: Centre Hospitalier Universitaire de Québec; 2010. French
20. Huberman, MA, Miles, MB. Qualitative data analysis: An expanded sourcebook. Thousand Oaks: Sage Publications; 1994.
21. Hansen, HP, Lee, A, Van Randwijk, CB. Patient aspects: A review of fifty-eight Danish HTA reports. Int J Technol Assess Health Care. 2011;27:330336.
22. Tjornhoj-Thomsen, T, Hansen, HP. Knowledge in health technology assessment: Who, what, how? Int J Technol Assess Health Care. 2011;27:324329.
23. Brennan, C. Case 9: Canadian Blood Services' stakeholder engagement for organ and tissue donation. In: Canadian Institutes of Health Research, ed. CIHR's Citizen Engagement in Health Casebook. Ottawa: Canadian Institutes of Health Research; 2012:5760.
24. Boivin, A, Currie, K, Fervers, B, et al. Patient and public involvement in clinical guidelines: International experiences and future perspectives. Qual Saf Health Care. 2010;19:e22.
25. Simpson, EL, House, AO. User and carer involvement in mental health services: From rhetoric to science. Br J Psychiatry. 2003;183:8991.
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International Journal of Technology Assessment in Health Care
  • ISSN: 0266-4623
  • EISSN: 1471-6348
  • URL: /core/journals/international-journal-of-technology-assessment-in-health-care
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