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Four factors that influence patient and public involvement in health research


  • In an analysis of 3,000 health research articles, only around 1 in 5 reported patient and public involvement.
  • The inclusion of patient and public involvement varied depending on location, research methods and topic, and the source of funding.

A recent study led by Dr Iain Lang found that despite efforts to increase patient and public involvement (PPI) in health research, such as stipulations by state and charitable funding bodies that PPI should be a part of health research, its inclusion is still uncommon, and the extent of its inclusion varies depending on several factors.

In a cross-sectional analysis of 3,000 original research articles published in BMJ Open between 1 January 2020 and 31 December 2020, approximately 21% included PPI. The study also looked at whether the inclusion of PPI differed depending on research location, method, topic, and funding source, and found large variation across these categories:

  • by location (the country of the primary affiliation of the first author): 45% of research based in the UK vs 3% of research in China included PPI
  • by method (based on a categorisation of words in the title): 39% of articles with mixed methods vs 5% of simulation articles included PPI
  • by research topic (based on the section of the journal to which the article was assigned): 37% of articles on mental health vs 3% of articles on medical education and training included PPI
  • by funding source (taken from the funding section of each article): 57% of articles funded by the National Institute for Health and Care Research (NIHR) vs 3% of articles funded by a Chinese funding body included PPI.

Further studies are needed to evaluate effects of attitudes, policies, or beliefs at different levels within research organisations on patient and public engagement.

“We will need different methods to study such influences on how and why PPI in health research occurs—and why it does not.”

However, the authors believe the considerable differences identified by their study may indicate ways to increase PPI inclusion in research by targeting the areas with the lowest patient and public involvement.


What do you think – should funding bodies include patient and public involvement as a requirement for research funding?

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