Establishing local priorities for a health research agenda

Abstract

Aim/background: To describe the two-stage prioritization process being used by the UK National Institute for Health Research's Collaboration for Leadership in Applied Health Research and Care for the South-West Peninsula (or PenCLAHRC) - a joint health service and university partnership and reflect on implications for the wider context of priority setting in health-care research.

Method: PenCLAHRC's process establishes the priorities of Stakeholders including service users across a regional health system for locally relevant health services research and implementation. Health research questions are collected from clinicians, academics and service users in Devon and Cornwall (UK) using a web-based question formulation tool. There is a two-stage prioritization process which uses explicit criteria and a wide Stakeholder group, including service users to identify important research questions relevant to the south-west peninsula locality.

Results: To date, a wide variety of health research topics have been prioritized by the PenCLAHRC Stakeholders. The research agenda reflects the interests of academics, clinicians and service users in the local area. Potential challenges to implementation of the process include time constraints, variable quality of questions (including the language of research) and initiating and maintaining engagement in the process. Shared prioritization of local health research needs can be achieved between Stakeholders from a wide range of perspectives.

Conclusions: The processes developed have been successful and, with minor changes, will continue to be used during subsequent rounds of prioritization. Engagement of Stakeholders in establishing a research agenda encourages the most relevant health questions to be asked and may improve implementation of research findings and take up by service users.

Keywords: Stakeholders; barriers; health services; research prioritization methods; user involvement.

Figure 1

The role of PenCLAHRC in a dynamic approach to research and research prioritization.

Figure 2

Total number of questions through the prioritization process (August 2009–June 2012).

Figure 3

Proportion of questions submitted to – and supported by‐ PenCLAHRC by ICD 10 classification. ICD 10 Classification Key, I – Infectious and parasitic diseases, II – Neoplasms, III – Diseases of the blood and blood forming organs and certain disorders of immune mechanism, IV – Endocrine, nutritional and metabolic diseases, V – Mental and Behavioural disorders, VI – Diseases of the nervous system, VII – Diseases of the eye and adnexa, VIII – Diseases of the ear and mastoid process, IX – Diseases of the circulatory system, X – Diseases of the respiratory system, XI ‐ Diseases of the digestive system, XII – Diseases of the skin and subcutaneous tissue, XIII – Diseases of the musculoskeletal system and connective tissue, XIV – Diseases of the genitourinary system, XV – Pregnancy, childbirth and the puerperium, XVI – Certain conditions originating in the perinatal period, XVII – Congenital malformations and chromosomal abnormalities, XVIII – Symptoms, signs and abnormal clinical laboratory findings, not elsewhere classified, XIX – Injury, poisoning and certain other consequences of external causes, XX – External causes of morbidity and mortality, XXI – Factors influencing health status and contact with health services, SD – Service design/organizational topics.

Figure 4

Proportion of questions submitted to PenCLAHRC by question type – and supported by‐ PenCLAHRC by question type.

Figure 5

Proportion of questions supported by PenCLAHRC by question type.