Can the Delphi method be used to engage with patients?

Can the Delphi method be used to engage with patients?

It is well established that the Delphi method can be used to engage clinicians and drive the development of optimal care standards ^1–4. By gathering the opinions of a panel of experts over multiple rounds of feedback, the Delphi method allows for consensus building, the generation of evidence, and peer mobilisation. Healthcare practitioners often highlight the importance of patient education and awareness, stating that shared, informed decision-making is a crucial aspect of healthcare^5–7. Patients must see themselves as stakeholders who are empowered to take ownership of their condition ^8,9.

On an individual level, engaging with patients and carers helps them to understand their treatment options and adhere to their chosen therapy^10–12. At a wider level, patient and carer contributions provide legitimacy and transparency to clinical guidelines^9,13. In fact, international guideline standards state patient involvement is a core principle for developing high-quality clinical practice guidelines¹⁴. However, it can be difficult to understand how to effectively communicate with patients and incorporate their views in a systematic way when developing overarching care standards^15,16.

So, can the Delphi method be used to build consensus directly with patients?

In short, yes! Using a modified Delphi method allows a group of experienced individuals to get together to discuss challenges and opportunities within a specific therapy area. This group can be comprised of individuals from a variety of backgrounds, including specialist clinicians, nurses, hospital administrators, patients, carers, and patient representatives. This ensures that a wide range of voices are engaged and heard throughout the process and help with decision-making at each stage.

How does the Delphi method involve patients in consensus building?

Once initial statements have been developed it is then possible to test these with a wider audience. Triducive does this through the dissemination of surveys to a representative sample of the expert audience (in this case, including patients). Once results are received and the level of agreement with statements established, the next step may be an additional round of testing (with modifications made to any statements not reaching agreement) or moving to discuss the results with the steering group (if sufficient agreement across statements is achieved).

Overall, when effectively conducted the Delphi method is an excellent way to establish consensus on the optimal standard of care when evidence is lacking. As patients are central stakeholders in healthcare, it is important they are included when developing optimal care standards. Delphi studies are flexible and can be designed to include patients and patient representatives, either through their inclusion in the core steering group or by gathering their opinions through a consensus survey. Both methods allow for patient and carer voices to be heard and incorporated into the development of clinical protocols. It’s a surefire way to ensure better decisions get actioned!

Discover how Triducive can help

Triducive is an expert medical communications agency that generates consensus-led evidence, which is published and supports change in healthcare. Through Delphi consensus studies, Triducive has experience in publishing over 50 manuscripts in peer-reviewed journals. Our team of healthcare experts and scientific writers is ready to provide guidance and support at any stage of the evidence generation process. Contact us for more information about Delphi consensus studies.

References:

1. Niederberger M, Spranger J. Delphi Technique in Health Sciences: A Map. Front Public Health; 8. Epub ahead of print 22 September 2020. DOI: 10.3389/fpubh.2020.00457.
2. Nasa P, Jain R, Juneja D. Delphi methodology in healthcare research: How to decide its appropriateness. World J Methodol 2021; 11: 116–129.
3. Spranger J, Homberg A, Sonnberger M, et al. Reporting guidelines for Delphi techniques in health sciences: A methodological review. Zeitschrift fur Evidenz, Fortbildung und Qualitat im Gesundheitswesen 2022; 172: 1–11.
4. Humphrey-Murto S, Varpio L, Wood TJ, et al. The Use of the Delphi and Other Consensus Group Methods in Medical Education Research: A Review. Academic Medicine 2017; 92: 1491–1498.
5. Arici M, Assaad-Khalil SH, Bertoluci MC, et al. Results from a cross-specialty consensus on optimal management of patients with chronic kidney disease (CKD): from screening to complications. BMJ Open 2024; 14: e080891.
6. Godbout K, Bhutani M, Connors L, et al. Recommendations from a Canadian Delphi consensus study on best practice for optimal referral and appropriate management of severe asthma. Allergy, Asthma and Clinical Immunology; 19. Epub ahead of print 1 December 2023. DOI: 10.1186/s13223-023-00767-6.
7. Orme S, Yates A, Fortes-Mayer G, et al. Establishing consensus on the appropriate selection of continence pads to achieve optimal care while reducing the risk of harm: part of a holistic approach for people with incontinence. Nursing and Residential Care 2022; 24: 24–37.
8. Guerra-Farfan E, Garcia-Sanchez Y, Jornet-Gibert M, et al. Clinical practice guidelines: The good, the bad, and the ugly. Injury. Epub ahead of print 2022. DOI: 10.1016/j.injury.2022.01.047.
9. Mikdashi J. The Meaningful Role of Patients, and Other Stakeholders in Clinical Practice Guideline Development. Rheumatic Disease Clinics of North America 2022; 48: 691–703.
10. Desai NR, Farbaniec M, Karalis DG. Nonadherence to lipid‐lowering therapy and strategies to improve adherence in patients with atherosclerotic cardiovascular disease. Clin Cardiol 2023; 46: 13–21.
11. George M, Bender B. New insights to improve treatment adherence in asthma and COPD. Patient Preference and Adherence 2019; 13: 1325–1334.
12. Hiligsmann M, Cornelissen D, Vrijens B, et al. Determinants, consequences and potential solutions to poor adherence to anti-osteoporosis treatment: results of an expert group meeting organized by the European Society for Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (ESCEO) and the International Osteoporosis Foundation (IOF). Osteoporosis International 2019; 30: 2155–2165.
13. Wang T, Tan J-Y (Benjamin), Liu X-L, et al. Barriers and enablers to implementing clinical practice guidelines in primary care: an overview of systematic reviews. BMJ Open 2023; 13: e062158.
14. Guidelines International Network. GIN Public Toolkit: patient and public involvement in guidelines, https://g-i-n.net/toolkit/ (2021).
15. Kredo T, Bernhardsson S, Machingaidze S, et al. Guide to clinical practice guidelines: The current state of play. International Journal for Quality in Health Care 2016; 28: 122–128.
16. Blackwood J, Armstrong MJ, Schaefer C, et al. How do guideline developers identify, incorporate and report patient preferences? An international cross-sectional survey. BMC Health Services Research; 20. Epub ahead of print 24 May 2020. DOI: 10.1186/s12913-020-05343-x.