1. Stirling Bryan, PhD Scientific Director, BC SUPPORT Unit
The Rise and Rise of Patient-Oriented Research: What implications for Scotland’s agenda on Realistic Medicine?
Stirling Bryan, PhD
Scientific Director, BC SUPPORT Unit
RHIS Annual Research Symposium, April 25, 2019

2. Disclosures
I am not aware of any actual or potential conflicts of interest in relation to this presentation
Some of my relevant roles:
Scientific Director, BC SUPPORT Unit, BC AHSN
Senior Scientist, Centre for Clinical Epidemiology & Evaluation, VCHRI (research funding contract with BC AHSN)
Professor, University of British Columbia
Professor (part-time), University of Aberdeen
No industry consultancy

3. Overview of talk
Introduction to Canada’s Strategy for Patient-Oriented Research (SPOR),
with a particular emphasis on the work moving forward in British Columbia
My interpretation of key components of Scotland’s Realistic Medicine initiative
Some reflections on Realistic Medicine through a patient-oriented research lens

4. Canada’s Strategy for Patient-Oriented Research (SPOR)
A new partnership in Canadian health research
Researchers
Patients
Care providers
Health system decision-makers

5. What is patient-oriented research?
A continuum of research that engages patients as partners
Focuses on patient-identified priorities in order to improve patient-centred outcomes
Conducted by multidisciplinary teams in partnership with relevant stakeholders
Aims to apply the knowledge generated to improve health care systems and practices

6. Patient engagement SPOR definition:
“Meaningful and active collaboration in governance, priority setting, conducting research and/or knowledge translation.”

7. South Asian TKA patients: research priorities
(unpublished)

8. Why patient engagement?
The moral argument
People have a right to be involved in endeavours that affect them personally
The impact argument
We see a need for greater impact on policy and practice change
The relevance argument
Patients know what matters to them
The quality argument
Patients bring a unique perspective that complements scientific and academic expertise

9. Spectrum of engagement
Increasing impact on decisions…
Inform
Consult
Involve
Collaborate
Empower
To provide with information
To obtain feedback
To work with to develop alternatives
To partner in each aspect of decision-making
To decide
International Association for Public Participation (IAP2)

11. BC SUPPORT Unit’s Methods Clusters

12. Patient Engagement Methods Cluster Engagement/Consultation Process
Online Survey
(62 people)
32 Individual Interviews
& 2 Focus Groups
(38 people)
Visioning Workshop
(51 people)
Tweetchat
(27k impressions,
~ 500 engagements)
Webinar
(16 people)
29 post-webinar views
2nd webinar
Oct 24, 2018

13. Advancing and Embracing Diversity in
Patient Engagement in Research in BC

14. Scotland’s Realistic Medicine initiative

15. “Building a more personalised approach to care, in partnership with people through shared decision making, is perhaps the most important aim of Realistic Medicine…”
“Shared decision making achieves its potential only if healthcare professionals make collaborative decisions with patients and their families.”
Catherine Calderwood, CMO for Scotland

16. How do we know that the public really wants “Realistic Medicine”?
Patient surveys
“over one-third of respondents told us that they would like to be more involved in decisions about their care”
Citizens’ Panel
“The willingness to ask some of these questions depends on the behaviour/style of the doctor and how busy they are/or are perceived to be”
Citizens’ Jury
“to give members of the public an opportunity to consider Realistic Medicine in greater depth”

18. Returning to the definition of patient-oriented research
A continuum of research that engages patients as partners
Focuses on patient-identified priorities in order to improve patient-centred outcomes
Conducted by multidisciplinary teams in partnership with relevant stakeholders
Aims to apply the knowledge generated to improve health care systems and practices

19. Three general POR reflections on Realistic Medicine
Partnerships
Patients/citizens, clinicians, and policy-makers as full partners?
Methods
Evidence-based approach to the initiative?
Equity
Unintended distributional implications?