Finding and engaging patients and the public to work collaboratively on an acute infection microbiology research public panel.

PLAIN ENGLISH SUMMARY: In 2015 a microbiology team in Bristol joined a European research project that aims to develop new antibiotics to fight drug resistant infections. The microbiology team were convinced of the benefits of patient and public involvement, but had found it difficult to find former patients to work with on earlier microbiology research. This paper describes how the team overcame this challenge to successfully recruit a PPI panel to develop PPI within the European project.The advice from people with experience in public involvement was to decide what criteria were desirable for panel membership, think about what the work of the panel might involve and how long the project will go on. The team decided that experience of suffering a serious acute infection would qualify people to comment on this project. Next, the team needed to identify ways of finding people to join the PPI panel.The microbiology research team tried different ways to approach potential panel members. These included distributing flyers at public research events, sending emails to potentially interested people, posting a message on the hospital Facebook page and approaching eligible people known to the team. A direct approach was the most successful method - either by email, mail or in person. Ultimately 16 people were selected to form the panel. Key factors for success were planning what the work of the panel might be, perseverance despite early lack of success, and one person having overall responsibility for setting up the panel, with the support of the whole team. ABSTRACT: Background In 2015 the microbiology research team became involved in a large European programme of research aiming to bring new antimicrobial drugs onto the market to combat the increasing problem of multi-drug resistant infection. With the purpose of developing patient and public involvement (PPI) in this project, the team decided to recruit a PPI panel to work with. The microbiology team had previously worked with a PPI panel on other research, but had found it difficult to recruit members. Methods Steps taken to recruit the panel were as follows:Advice was sought from people experienced in co-ordinating public involvement in research.One person in the team had overall responsibility but the whole research team was committed and met regularly.Two of the team undertook training in group facilitation and connecting with the public.Decisions were made about the criteria for inclusion into the panel, what tasks we envisaged for the panel, the length of and frequency of meetings.Advertising the involvement opportunity through flyers, social media, emails and direct contact with possible panel recruits known to the research team.Relevant documents such as a Role Profile and expression of interest form were drafted.An initial public meeting was planned for all who had shown interest in the panel.The expression of interest form was used for us to select as broad a group as possible.. Results Two out of three people who were approached directly and known by team members expressed interest in joining the panel (66%). Three out of seven members of a former panel were next (43%), then 10 out of 25 spinal infection clinic patients (40%), and finally 12 people responded to an email sent to 1261 foundation trust members (1%). No-one who was approached by indirect methods e.g. flyers or advertising on Facebook, expressed interest in the panel. Sixteen people were eventually selected for the panel. Conclusions It is possible to recruit a patient and public involvement panel for research in a discipline as challenging as microbiology. Good planning and the commitment of the research team were key to success.

Extent, quality and impact of patient and public involvement in antimicrobial drug development research: A systematic review.

BACKGROUND: Patient and public involvement (PPI) is increasingly recognized as bringing a range of benefits to clinical and health services research. Recent systematic reviews have identified and synthesized many benefits (eg higher recruitment rates) and some costs (eg extra time need). Much of the literature focuses on PPI in long-term conditions rather than more acute health care in which the majority of microbiological research is undertaken. OBJECTIVES: The aim was to identify the extent, quality and impact of PPI in antimicrobial drug development research. Objectives were to identify any relevant reporting of PPI in antimicrobial research; appraise the quality of reporting on PPI using recognized PPI reporting and critical appraisal tools; and extract and synthesize data on the impact of PPI. SEARCH STRATEGY: A systematic review was undertaken with a search strategy based on four word groups (PPI, patients, antimicrobial drug development and outcomes). Eight online databases were searched. INCLUSION CRITERIA: English language publication, publication between 1996 and 2016 and studies describing PPI in antimicrobial drug development research. MAIN RESULTS: No studies were found through online searching that met the search strategy and inclusion criteria. One relevant protocol paper with a brief mention of PPI was identified through expert recommendation. Commentary papers recommending PPI were identified through website searching and expert opinion. DISCUSSION AND CONCLUSIONS: Despite strong policy guidance encouraging PPI at the international and national levels, and anecdotal accounts of PPI taking place, evidence for the extent, quality and impact of PPI in antimicrobial drug development research has not yet appeared in the peer-reviewed literature.

Antimicrobial resistance surveillance in urinary tract infections in primary care.

Urinary tract infection (UTI) is one of the most common reasons for prescription of antimicrobials in primary care. Laboratory resistance data produced because of specimen analysis to support individual patient diagnosis and management are generalized to guide empirical therapy across a wider population, but are limited by bias toward certain patient groups and almost certainly overestimate the incidence of resistance. Other methods of surveillance are required to provide unbiased estimates of antimicrobial resistance, but need to be sustainable. Sentinel surveillance, perineal flora sampling and development of clinical algorithms to support more stratified and personalized antimicrobial prescribing need to be further investigated. Linkages to prescription and clinical outcome data are essential if the burden of antimicrobial resistance in UTI is to be understood. Pilot and feasibility studies need to be performed to establish the best approach to enhancing the quality, relevance and sustainability of antimicrobial resistance surveillance in community-acquired UTI.