Experiences of co-production in systematic reviews on preventing postoperative urinary retention in surgical patients

Session: 

Oral session: Patient or healthcare consumers involvement and shared decision-making (2)

Date: 

Sunday 16 September 2018 - 14:00 to 14:20

Location: 

Carrick 1

All authors in correct order:

Davies P1, Leggett N1, Jackson J1, Nugawela M1, Scott L1, Leach V1, Richards A1, Blacker A2, Abrams P3, Sharma J2, Donovan J1, Whiting P1
1 The National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care West (NIHR CLAHRC West) at University Hospitals Bristol NHS Foundation Trust, UK
2 University Hospitals Coventry and Warwickshire, UK
3 North Bristol NHS Trust, UK
Presenting author and contact person

Presenting author:

Philippa Davies

Contact person:

Philippa Davies
Abstract text
Background:
We present our experience of successful public involvement in two systematic reviews conducted as part of a project aimed at preventing postoperative urinary retention (PO-UR). PO-UR is an acute, transient inability to void after surgery, despite a full bladder. It can be painful and distressing for the patient and lead to complications such as urinary tract infection, acute kidney injury and chronic bladder dysfunction. Standard treatment is catheterisation (inserting a tube to drain the bladder). Catheterisation delays full mobilisation, extends hospital stay and has a plethora of adverse effects. Patients often find it upsetting, embarrassing, invasive and uncomfortable.

In 2014, Nick Leggett, a public contributor with experience of PO-UR, submitted a research idea to the National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care West (NIHR CLAHRC West) to develop and test a protocol to identify and pre-emptively treat surgical patients at risk of developing PO-UR. As part of this work, Nick and CLAHRC West conducted a pair of systematic reviews to identify: 1) risk factors for the development of PO-UR in high-risk surgeries, and 2) interventions to prevent or treat PO-UR. Here we describe our experiences of co-production.

Objectives:
- Describe the co-production process.
- Reflect on the benefits and challenges encountered.
- Provide suggestions to inform future involvement of public contributors in systematic reviews.

Results:
The two reviews included a total of 152 studies. Nick contributed to all stages including developing inclusion criteria, screening search results and extracting data, as well as organising and chairing meetings in his role as co-principal investigator. Nick’s personal experience and unique knowledge of the topic area supported the research team by deepening their understanding of the condition and expanding their realisation of why this is an important research area.

Conclusions:
With the reviews nearly complete but still to be finalised, conclusions must be tentative and provisional. The team, including Nick do, however, already feel that 1) co-production enriched and clarified many aspects of the review, and 2) Nick's own skills as a public contributor were substantially enhanced, to the point that he was able successfully to become a NICE lay adviser.

Relevance to patients and consumers: 

The research presented describes two systematic reviews on a topic proposed by a public contributor and former patient who also helped to conduct the review work. We describe our experiences and give recommendations for future involvement of patients and consumers to ensure that systematic reviews are relevant, useful and will ultimately benefit patient care. Public contributor helped to reach this statement.