Development and application of a rapid research prioritisation process for identifying health research priorities in low- and middle-income countries: the RAPID-RP stakeholder analysis

Background: Health research should be locally prioritised by key stakeholders to ensure the best use of available resources, maximum likelihood of research leading to uptake into policy and practice and relevance to the needs of the potential beneficiaries. Established approaches are complex and time-consuming, therefore not feasible in settings where prioritisation is uncommon and time is limited.

Objectives: We developed and applied a simple, rapid research prioritisation approach (RAPID-RP) to elicit the views of stakeholders.

Setting and participants: This was a collaboration between a multidisciplinary group of UK academics, the International Primary Care Respiratory Group (IPCRG) and primary care respiratory researchers from four low- and middle-income countries (LMIC): Brazil, China, Georgia and North Macedonia. We identified 10 topics for research prioritisation through workshops involving 26 topic, methods and local context experts, and considering the programme remit, to develop, adapt and evaluate culturally appropriate community and behavioural approaches for the prevention, early identification and management of COPD in primary care. Design and methods: In each setting, local research teams convened stakeholder groups of patients, clinicians, managers / policy makers and researchers. Each group briefly discussed the ten potential research study topics. Discussions were facilitated using short vignettes for each topic, and participants encouraged to consider importance, feasibility and equity. Individual participants rated each study on a 3-point traffic light scale, then ranked them following a facilitated discussion on what drove the ratings. The research team rated then ranked each study considering three further criteria (international novelty, potential for future funding and capacity building on a 5-point scale). Within each group, ranks were summed to create a final rank order which guided our research programme and provided insight for future projects.

Results: In each country, 4-8 members attended each stakeholder group, The engagement process was completed in less than four hours and feedback was very positive, especially from patients who valued the opportunity to contribute to research decision-making about their own condition. Ranking varied to some extent between groups and settings, but there was consistency around topics that were prioritised among the top 5 in all groups (identifying efficient COPD screening test strategies, evaluations of lung age to aid smoking cessation, feasibility of locally-adapted pulmonary rehabilitation, clinical education for primary care staff) and study topics that consistently ranked low (use of e-cigarettes for smoking cessation, weight management to improve COPD symptoms and handwashing to reduce infections).

Limitations: Despite attempts to maximise inclusivity and diversity, stakeholders were mainly limited geographically to the centres where researchers were based, potentially limiting generalisability of views across the countries. Facilitator styles varied and may have influenced some of the discussions and potentially the ranking.

Conclusions: Despite some limitations, we demonstrated the feasibility and acceptability of the RAPID-RP stakeholder analysis for identifying locally relevant research priorities in LMIC settings.

Future work: Further validation is needed for aspects of the process. We have identified some useful lessons from our evaluation of the process, to facilitate future use of this approach.