Co‐construction of health technology assessment recommendations with patients: An example with cardiac defibrillator replacement

Abstract

Context: The National Institute of Excellence in Health and Social Services (INESSS),which functions as the Québec health technology assessment (HTA) agency, tested a new way to engage patients along with health‐care professionals in the co‐construc-tion of recommendations regarding implantable cardioverter‐defibrillator replacement.

Objective: The objective of this article was to describe the process of co‐construc-tion of recommendations and to propose methods of building best practices for pa-tient involvement (PI) in HTA.Design: Throughout the process, documents were collected and participant observa-tions were made. Individual interviews were conducted with patients, health‐care professionals and the INESSS scientific team, from January to March 2018.

Results: Three committees were established: an expert patient committee to reflect on patient experience literature; an expert health professional committee to reflect on medical literature; and a co‐construction committee through which both patients and health‐care professionals contributed to develop the recommendations. The ex-pert patients validated and contextualized a literature review produced by the sci-entific team. This allowed the scientists to consider aspects related to the patient experience and to integrate the feedback from patients into HTA recommendations.The most important factor contributing to a positive PI experience was the struc-tured methodology for selecting patient participants, and a key factor that inhibited the process was a lack of training in PI on the part of the scientific team.

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