Follow-up by same physician, injectable drugs linked to better patient experience
Consistent follow-up visits with the same physician and treatment with subcutaneous or IV drugs are associated with better patient-reported experiences among those with inflammatory arthritis, according to findings published in the Journal of Clinical Rheumatology.
“Patients’ experience with health care is a key component for the provision of a patient-centered health care model, as both clinical effectiveness and patients’ safety are correlated positively with patients’ experience,” Javier de Toro, PhD, of A Coruña University Hospital in Spain, and colleagues wrote. “In patients with chronic conditions, a more positive patient experience is associated with improved quality of care, with the interaction of patients with health care professionals, particularly general practitioners, being important for patient well-being.”
They added, “Effective chronic illness management also depends on multidisciplinary care teams, including nurses and pharmacists, with clinical and behavioral skill.”
To examine the health care experience of patients with inflammatory arthritis, as well as patient- and care-related factors, de Toro and colleagues conducted a cross-sectional survey of adults at 25 hospitals clinics across Spain. Participants included 625 patients with rheumatoid arthritis, axial spondyloarthritis or psoriatic arthritis, who were given the 12-item Instrument to Evaluate the Experience of Patients with Chronic diseases (IEXPAC) survey.
The IEXPAC tool, developed in Spain, focuses on interactions between patients and the health care system, including integrated care, social care, self-management and new technological interventions, rather than with specific professionals. In addition to the IEXPAC, participants answered questions regarding demographics and health care and treatment-related characteristics. A total of 359 participants completed all survey questions.
According to the researchers, patient responses were generally positive, with more than 60% providing answers of “always/mostly” for statements describing interactions between themselves and health care professionals, or self-management after receiving guidance from a professional. However, positive patient responses were scarcer, accounting for less than 13%, for items related to interactions with the health care system through the internet, or with other patients. In addition, just 25.6% of patients who had been hospitalized reported receiving a follow-up call or visit following discharge.
Following bivariate analysis, the researchers found that self-reported experiences with the health care system were better among men, those seen by fewer specialists or by the same physician, and those treated with a fewer number of drugs or with subcutaneous or IV drugs. Multivariate analyses also revealed that regular follow-up by the same physician, as well as treatment with subcutaneous or IV drugs, were associated with a better patient experience.
“This study has identified areas of rheumatic disease care with potential to improve patients’ experiences if properly addressed, such as patient interaction with the health care system via the internet or with peers, provision of patient information on health and social resources, and closer follow-up after hospital discharge,” de Toro and colleagues wrote. “The study also highlights the importance of patient-physician relationships and a comprehensive multidisciplinary approach.” – by Jason Laday
Disclosure: The researchers report funding from Merck Sharp and Dohme Spain. See the full study for additional author disclosures.