Evaluating the Process and Outcome of a Primary Care Patient and Public Involvement (PPI) Programme: A Pilot Study

Patient and public involvement (PPI) in research maximises its relevance, quality, and impact by partnering with the public throughout the research journey. In Singapore, a PPI group named Patient Research Advocate and Guidance to Maximise Safety in Trials and Innovation Committee (PRAGMATIC) was established in 2020 by a public primary care institution to create a conducive platform for the public to provide feedback to primary care researchers on their research proposals. This pilot study aimed to evaluate the impact of the committee's feedback on the research process.

From 2023 to 2024, researchers were invited to present their patient-fronting research proposals to PRAGMATIC. Before the presentation, researchers submitted a lay-language research proposal summary that the committee reviewed in advance. The proposals were presented at 3-monthly PRAGMATIC meetings with the committee providing written and verbal feedback. After each meeting, researchers completed a questionnaire capturing the number, type, acceptability, and helpfulness of the committee's feedback. Reporting followed recommended PPI reporting standards (GRIPP2-LF).

PRAGMATIC reviewed seven projects and generated 26 potentially actionable feedback. Researchers included two nurses, one medical student, one research associate, and three primary care physicians. Project topics included asthma, postnatal mental health, hearing loss, cervical cancer screening, female smoking, and osteoarthritis. The researchers accepted majority of the feedback (21/26, 80.8%) and rated them as helpful (24/26, 92.3%). The most impact was observed in intervention design and data collection, where feedback led to the adoption of remote interviews, reduced intervention duration, and medical device software refinement. Feedback on participant selection were less accepted but led to improved methodological justification.

Initial evaluations indicate that a structured PPI programme can positively shape study design and implementation in primary care research. These findings are encouraging and have potential to inform future refinements to guide PPI in research.

PPI partners were involved in the co-design of study materials, ensuring their clarity, relevance, and acceptability to participants.