Patient involvement in clinical pathway development, implementation and evaluation - A scoping review of international literature

OBJECTIVE: Although various pathway design methods recognize patients as stakeholders, an overview of current practice is lacking. This article describes the results of a literature review assessing patient involvement in clinical cancer pathway development, implementation and evaluation.

METHODS: A scoping review was conducted following PRISMA-ScR. Two databases were searched to identify studies published in English between 2014 and 2021.

RESULTS: Of 12841articles identified 22 articles met the inclusion criteria and reported on one or more of the three phases: development phase (N = 2), implementation (N = 4), evaluation (N = 11), development/evaluation (N = 3), and implementation/evaluation (N = 2) of clinical pathways. The numbers of involved patients ranged from 10 to 793, and the reported methods varied considerably.

CONCLUSION: This review presents a synthesis of methods for involving patients in the clinical pathway lifecycle. No relationship was found between methods and the number of involved patients or between pathway complexity and methods. Although patients are seen as valuable stakeholders in the pathway design, to involve them in practice using the best practice can be improved.

PRACTICE IMPLICATIONS: The lack of a clear justification for the choice of methods and number of involved patients calls for further research and framework development to inform pathway developers.