Engaging patients throughout the continuum of implementation science and practice: adapted evidence mapping review...

The role of patients in healthcare is dramatically changing. Patients have increased autonomy and responsibility for managing care interventions that influence their morbidity, mortality, and quality of life. Engagement of patients to meaningfully participate in health research, care, and decision-making is limited, negatively impacting diverse outcomes. Implementation science (IS) and patient engagement (PE) strive to improve patient care and outcomes. Integration of IS and PE may aid researchers/healthcare teams in engaging patients and improving outcomes. There is a paucity of literature and guidance to support integration of IS and PE. The aims of this research are to (1) present an overview of select IS theories/frameworks, strategies, outcomes, and reporting guidelines that may facilitate PE and (2) present a framework outlining opportunities within the IS research process to integrate PE approaches.

There are common theoretical constructs, identified across IS theories/frameworks, that may facilitate PE. Examples of such constructs include "engagement" and "patient/target audience characteristics and needs". In addition, 6 of the top 10 most cited IS theories/frameworks include more than one (> 3) of these constructs. Evidence-informed implementation strategies are indexed and categorized into thematic clusters in the published results of the Expert Recommendations for Implementing Change (ERIC) project. Examples of implementation strategies that may facilitate PE include "conduct educational meetings" and "prepare patients/consumers to be active participants". Proctor et al. propose a working taxonomy of implementation outcomes for IS research. Implementation outcomes that may facilitate measurement of PE-relevant outcomes include satisfaction, function, and symptomatology. There are no reporting guidelines that include both IS and PE research reporting recommendations. IS reporting guidelines such as Standards for Reporting Implementation Studies (StaRI) may be extended by combining them with existing PE-reporting guidelines such as the Guidance for Reporting Involvement of Patients and the Public (GRIPP) 2 reporting checklist.

There are IS theories/frameworks, strategies, and outcomes that may facilitate PE. PE-informed selection of IS methodologies is critical to improving patient outcomes by optimizing the patient's role in research, care, and health system decision-making. This article proposes a framework outlining important stages of IS research at which PE strategies, outcomes, and reporting guidelines may be suitable to integrate.