Differences In Treatment Satisfaction Research Articles

Digital Health Tools and Behavioral Strategies to Increase Engagement With Diabetes Self-Management Education and Support: Design and Feasibility of DM-BOOST.

The purpose of the study was to describe the development and feasibility of implementing the DM-BOOST program in support of an established diabetes self-management education and support (DSMES) program. A patient panel of 4 adults with type 2 diabetes (T2DM) codesigned DM-BOOST. DM-BOOST is a patient-focused program that includes peer-written text messages about diabetes self-management behaviors and digital health training to improve patient portal use and initiate goal setting prior to a scheduled DSMES appointment. Adults with T2DM and A1C ≥8.0% participated in a 6-month feasibility pilot. Participants were randomly assigned (1:1) to receive either DM-BOOST or usual care. Outcomes included DSMES engagement (scheduled and attended DSMES appointments) and changes in diabetes self-efficacy and treatment satisfaction. Pilot participants (n = 60) were 60.0% female with mean age 45.5 years (SD 8.3) and A1C 10.1% (SD 1.8%). All DM-BOOST participants (30/30, 100%) had DSMES appointments scheduled compared to 86.7% of usual care (26/30). DM-BOOST participants had fewer DSMES appointment no-shows/cancellations (3/30, 10%) compared to usual care (10/26, 35%). There was greater improvement in diabetes self-efficacy in the DM-BOOST group compared to usual care and no difference in treatment satisfaction. DM-BOOST, leveraging peer-written text messaging and digital health training, increased DSMES engagement. Implementation of DM-BOOST was determined to be feasible, with several system-level barriers identified, including obtaining provider referrals and scheduling appointments. An effectiveness trial of DM-BOOST is needed to evaluate the impact on clinical outcomes.

Long-term outcome of percutaneous vertebroplasty versus conservative treatment for osteoporotic vertebral compression fractures: a retrospective cohort study with three-year follow-up.

Osteoporotic vertebral compression fractures (OVCF) appear to be more common as the population ages. Previous studies have found that percutaneous vertebroplasty (PVP) can achieve better short-term clinical outcomes than conservative treatment (CT) for OVCF. However, the long-term outcomes of PVP compared with CT for OVCF has been rare explored. This study was designed to explore the clinical outcomes of PVP or CT within 3 years after OVCF. This study reviewed the clinical outcomes of patients who underwent PVP or CT for OVCF in a single center from January 2015 to December 2019. The back pain visual analogue scale (VAS), Oswestry disability index (ODI) and satisfaction rate were compared between the two groups at baseline, 1 week, 1 month, 3 months, 6 months, 12 months, 24 months and 36 months after treatment. The baseline data including gender, age, bone mineral density, body mass index, back pain VAS, and ODI were not significantly different between the two groups. The back pain VAS and ODI of CT patients were significantly higher than those of PVP group at 1 week, 1 month, 3 months, 6 months and 12 months after treatment. The satisfaction rate in the PVP group were significantly higher than those in the CT group at 1 week, 1 month, 3 months and 6 months after treatment. Subsequently, the back pain VAS and ODI showed no significant difference between the two groups at 24 and 36 months. In addition, there was no significant difference in treatment satisfaction between the two groups at 36 months. There was no significant difference in the rate of new vertebral compression fractures between the two groups within 36 months after treatment. The clinical outcomes within 12 months after PVP and patient satisfaction rate within 6 months after PVP were significantly higher than CT. However, during 12 months to 36 months, this advantage generated by PVP was gradually diluted over time. Compared with CT, the long-term effect of PVP on OVCF should not be overestimated.

Patient-Reported Satisfaction with Thyroid Hormone Replacement Therapy for Subclinical Hypothyroidism in Older Adults: A Pooled Analysis of Individual Participant Data from Two Randomized Controlled Trials.

Background: The benefit of levothyroxine treatment of subclinical hypothyroidism (SCH) is subject to debate. This study compared treatment satisfaction between older adults with SCH using levothyroxine or placebo. Methods: We analyzed pooled individual participant data from two randomized, double-blind, placebo-controlled trials investigating the effects of levothyroxine treatment in older adults with SCH. Community-dwelling participants aged ≥65 years, with SCH (persistent thyrotropin levels 4.60-19.99 mIU/L for >3 months and normal free T4 level), were included. Intervention dose titration until thyrotropin levels normalized, with a mock dose adjustment of placebo. Treatment satisfaction was determined during the final study visit using the Treatment Satisfaction Questionnaire for Medication (TSQM), encompassing perceived effectiveness, side effects, convenience, and global satisfaction, along with the participants' desire to continue study medication after the trial. Results: We included 536 participants. At baseline, the median (interquartile range [IQR]) age was 74.9 (69.7-81.4) years, and 292 (55%) were women. The median (IQR) thyrotropin levels were 5.80 (5.10-7.00) mIU/L at baseline in both groups; at final visit, 4.97 (3.90-6.35) mIU/L in the placebo and 3.24 (2.49-4.41) mIU/L in the levothyroxine group. After treatment, the groups did not differ significantly in global satisfaction (mean difference [CI] -1.1 [-4.5 to 2.1], p = 0.48), nor in any other domain of treatment satisfaction. These results held true regardless of baseline thyrotropin levels or symptom burden. No major differences were found in the numbers of participants who wished to continue medication after the trial (levothyroxine 35% vs. placebo 27%), did not wish to continue (levothyroxine 27% vs. placebo 30%), or did not know (levothyroxine 37% vs. placebo 42%) (p = 0.14). In a subpopulation with high symptom burden from hypothyroid symptoms at baseline, those using levothyroxine more often desired to continue the medication after the trial than those using placebo (mean difference [CI]: -21.1% [-35.6% to -6.5%]). Conclusion: These pooled data from two RCTs showed no major differences in treatment satisfaction between older adults receiving levothyroxine or placebo. This finding has important implications for decision-making regarding initiating levothyroxine treatment for SCH. Our findings generally support refraining from routinely prescribing levothyroxine in older adults with SCH.

Importance of the type of pharmacological treatment in patients with severe mental disorder

Introduction The use of long-acting treatments is a common clinical practice in psychiatry. No disease insight and the risk of treatment discontinuation in a significant portion of our patients, increase the demand for psychiatric emergency and hospital admissions. Treatment adherence must be facilitated, taking into account possible side effects and patient´s subjective satisfaction.Objectives-Evaluate the type of long-acting intramuscular treatment in selected patients. -Evaluate the differences in treatment satisfaction between different types of long-acting intramuscular treatments as well as frequency of psychiatric emergency and hospital admissions in the last year.MethodsWe select patients with different severe mental disorders who stay in a Medium Stay Unit, Sociosanitary Community Residence, Supervise house and Residence for the elderly in Albacete (Spain); all of them, with intramuscular neuroleptic treatment (zuclopenthixol dihydrochloride, aripiprazole long acting, palmitate paliperidone monthly, 3-monthly and 6-monthly) at least 1 year.We evaluate their sociodemographic characteristics, the satisfaction questionnaire with the treatment (TSQM-9) and the rate of psychiatric emergencies and admissions after current intramuscular treatment in last year.ResultsWe have selected 57 patients with an average age of 45.86. 78.94% with a diagnosis of schizophrenia, 12.28% with schizoaffective disorder, 5.26% bipolar disorder and 3.5% unspecified psychotic disorder.We can see in the graphics below that the longer duration of the intramuscular treatment, the greater satisfaction in all the items of the TSQM-9 questionnaire. 31% of the patients with zuclopenthixol dihydrochloride treatment, have gone to psychiatric emergencies and 28% of psychiatric admissions in the last year.18% of the patients with aripiprazole long acting, 17% with paliperidone palmitate long acting-monthly and 12% de 3-monthly have gone to psychiatric emergencies and 15%, 12% and 12% needed psychiatric admissions respectively. Patients with palmitate long acting-monthly have not emergencies or psychiatric admissions in the last year.Image:Image 2:Image 3:Conclusions- The longer long acting of the intramuscular treatments, the better patient satisfaction.- With the longer duration treatment (Palmitate paliperidone LD 6 month), we have lower psychiatric emergencies and hospital admissions.Disclosure of InterestNone Declared

The clinical effectiveness of a self-management intervention for patients with persistent depressive disorder and their partners/caregivers: results from a multicenter, pragmatic randomized controlled trial.

Persistent depressive disorder (PDD) is prevalent and debilitating. For patients with PDD, psychiatric rehabilitation using self-management interventions is advised as the next therapeutic step after multiple unsuccessful treatment attempts. The "Patient and Partner Education Program for All Chronic Diseases" (PPEP4All) is a brief, structured self-management program that focuses on functional recovery for patients and their partners/caregivers. In chronic somatic disorder populations, PPEP4All has already been shown to be clinically effective. We examined whether PPEP4All adapted for PDD (PPEP4All-PDD, nine weekly group or individual sessions) is also clinically effective for adults/elderly with PDD and their partners/caregivers compared to care-as-usual (CAU) in specialized mental healthcare. In this mixed-method multicenter pragmatic randomized controlled trial, 70 patients with PDD and 14 partners/caregivers were allocated to either PPEP4All-PDD (patients, n = 37; partners/caregivers, n = 14) or CAU (patients, n = 33; partners/caregivers, not included) and completed questionnaires at 0, 3, 6, and 12months regarding depressive symptoms, psychopathology, psychosocial burden, mental resilience, and happiness/well-being. Qualitative data were collected regarding treatment satisfaction. Data were analyzed using mixed model analyses and an intention-to-treat (ITT) approach. There was no statistically significant difference in any outcome regarding clinical effectiveness between PPEP4All-PDD and CAU. Subgroup analysis for depressive symptoms did not show any interaction effect for any subgroup. Although 78% of participants recommended PPEP4All-PDD, there was no difference in treatment satisfaction between PPEP4All-PDD (score = 6.6; SD = 1.7) and CAU (score = 7.6; SD = 1.2), p = 0.06. Although depressive symptoms did not improve relative to CAU, this only confirmed that treatment for patients with treatment-resistant PDD should move from symptom reduction to functional recovery. Also, functional recovery may be reflected in other outcomes than psychosocial burden, such as self-empowerment, in patients with treatment-resistant PDD. Future research on PPEP4All-PDD could focus on a longer-term program and/or online program that may also be offered earlier in the treatment process as an empowerment intervention. TRIAL REGISTRATION: Netherlands Trial Register Identifier NL5818. Registered on 20 July 2016 https://clinicaltrialregister.nl/nl/trial/20302.

922-P: Improved Satisfaction while Maintaining Safety and High Time in Range (TIR) with a Medtronic Investigational Enhanced Advanced Hybrid Closed-Loop System (eAHCL)

Background: Hybrid closed loop (HCL) systems are evolving. We aimed to assess treatment satisfaction and glucose control with an investigational eAHCL system. Methods: Adults with type 1 diabetes (T1D) received sequentially the MiniMed™ 780G /Guardian™ Sensor 3 AHCL system, and a Medtronic investigational eAHCL system each for 12 weeks. The eAHCL system incorporates updated software, a new simple to use, no calibration, all-in-one sensor, and 7 day extended wear infusion set. The primary outcome was difference in treatment satisfaction measured using “current” and “change” versions of the Diabetes Technology Questionnaire (DTQ) following each 12 week period. Secondary outcomes included time spent changing infusion sets and sensors recorded on a phone app and CGM metrics. Results: Twenty-one adults (11 men, mean [SD] age 48 [12.4] years) completed the trial. DTQ “current” score improved on eAHCL, and 86% of participants reported less “Effort to keep low blood sugar from happening” on DTQ “change”. There was less fear of hypoglycemia; more time in Auto Mode; fewer alarms; less time spent changing infusion sets and sensors; reduced CGM hypoglycemia and glycemic variability (Table 1). Conclusions: Transition to eAHCL in T1D adults resulted in a better user experience and reduced fear of and time in hypoglycemia while maintaining safety and >80% TIR. Disclosure C.Yuan: None. R.Macisaac: None. E.Netzer: None. B.Paldus: None. L.Robinson: None. A.Roy: Employee; Medtronic. C.M.Sims: Stock/Shareholder; Medtronic. S.Trawley: Research Support; Insulet Corporation, Juvenile Diabetes Research Foundation (JDRF). S.Vogrin: None. D.N.O'neal: None. Y.W.Kong: None. T.Amoore: None. K.Brown: None. B.Grosman: Employee; Medtronic. A.Jenkins: Advisory Panel; Insulet Corporation, Board Member; Insulin for Life, Research Support; Abbott Diabetes, Medtronic, Hemsley Charitable Trust, Juvenile Diabetes Research Foundation (JDRF), National Institutes of Health. H.Jones: None. N.Kurtz: Employee; Medtronic. M.H.Lee: Speaker's Bureau; Medtronic.

Telehealth v. face-to-face provision of care to patients with depression: a systematic review and meta-analysis.

Ensuring continuity of care for patients with major depressive disorders poses multiple challenges. We conducted a systematic review and meta-analysis of randomised controlled trials comparing real-time telehealth to face-to-face therapy for individuals with depression. We searched Medline, Embase, and Cochrane Central (to November 2020), conducted a citation analysis (January 2021), and searched clinical trial registries (March 2021). We included randomised controlled trials comparing similar or identical care, delivered via real-time telehealth (phone, video) to face-to-face. Outcomes included: depression severity, quality of life, therapeutic alliance, and care satisfaction. Where data were sufficient, mean differences were calculated. Nine trials (1268 patients) were included. There were no differences between telehealth and face-to-face care for depression severity at post-treatment (SMD -0.04, 95% CI -0.21 to 0.13, p = 0.67) or at other time points, except at 9 months post-treatment (SMD -0.39, 95% CI -0.75 to -0.02, p = 0.04). One trial reported no differences in quality-of-life scores at 3- or 12-months post-treatment. One trial found no differences in therapeutic alliance at weeks 4 and 14 of treatment. There were no differences in treatment satisfaction between telehealth and face-to-face immediately post-treatment (SMD -0.14, 95% CI -0.56 to 0.28, p = 0.51) or at 3 or 12-months. Evidence suggests that for patients with depression or depression symptoms, the provision of care via telehealth may be a viable alternative to the provision of care face-to-face. However, additional trials are needed with longer follow-up, conducted in a wider range of settings, and with younger patients.

Clinical observation of basic fibroblast growth factor (bFGF) combined with minoxidil in the treatment of male androgenetic alopecia.

Androgenetic alopecia (AGA) has been one of the most common progressive hair loss in the world, which affects 80% of white males. To date, only minoxidil and finasteride have been approved by FDA for the treatment of AGA. However, limited therapeutic effect and the toxic adverse events of these drugs limit their applications. Therefore, it is still an urgent clinical problem to find effective therapeutic drugs and medication regimen. The goal was to explore the efficacy and side effects of basic fibroblast growth factor (bFGF) combined with minoxidil in the treatment of male patients with early stage of androgenetic alopecia (AGA). Using a randomized control method, 80male patients with androgenetic alopecia in Hamilton grade II-IV were randomly divided into two groups, with 40 patients in each group. The Group A: 1ml minoxidil for external use twice a day; Group B: 3500IU basic fibroblast growth factor (bFGF) and 1ml minoxidil for external use twice a day. The selected patients received global photograph evaluation before treatment, 3months after treatment, and 6months after treatment, and the curative effect was judged according to the changes in the area and degree of hair loss on the top of the head and anterior parietal area of the patients shown in the photographs before and after treatment. At the same time, each patient had a satisfaction questionnaire survey before treatment, 3months after treatment, and 6months after treatment. During the research period, the adverse reactions of the patients were recorded. After 3months and 6months of treatment, the effective rate of the two groups was statistically significant (p<0.05), and the patients' hair conditions in the Group B improved significantly compared with those in the Group A. After 6months of treatment, the difference in treatment satisfaction between the two groups was statistically significant (p<0.05). The patients in the Group B were more satisfied than those in Group A. During the patient's medication, no serious adverse reactions occurred in the two groups, and the incidence of adverse reactions between the two groups was not statistically significant (p>0.05). Compared with 5% minoxidil alone, the combination of basic fibroblast growth factor (bFGF) +5% minoxidil in the treatment of male patients with early stage of androgenetic alopecia improved treatment efficiency and patient satisfaction.

Subjective Medication Satisfaction With Antipsychotic Polypharmacy in a Naturalistic Inpatient and Outpatient Sample.

Objective: The aim of this study was to examine satisfaction with pharmacologic treatment in patients who received antipsychotic polypharmacy compared to antipsychotic monotherapy. Methods: This longitudinal cohort study was conducted in two mental health care institutes in Amsterdam, the Netherlands, among a randomly selected sample of in- and outpatients with a severe mental illness. Analyses were performed on data collected in 2011 for 185 patients who were diagnosed with schizophrenia or unspecified psychosis according to DSM-IV criteria. The outcome measure was the Treatment Satisfaction Questionnaire for Medication, version II. One-way analyses of covariance were performed to examine differences in treatment satisfaction between patients who received antipsychotic polypharmacy compared to antipsychotic monotherapy while controlling for the effects of clozapine, antipsychotic dose, and use of long-acting injectable antipsychotics. Results: Twenty percent of patients in this sample received 2 antipsychotic agents; in half of those patients, this involved a combination with clozapine. Polypharmacy resulted in less satisfaction with side effects compared to monotherapy (P = .002). No difference was found in perceived effectiveness (P = .168) or overall medication satisfaction (P = .379). Conclusions: These results confirm that antipsychotic polypharmacy is common in a random in- and outpatient sample. Patients who receive 2 antipsychotic agents are just as positive about the effectiveness and ease of use of and overall satisfaction with their medication compared to those who receive antipsychotic monotherapy. They are, however, less satisfied with perceived side effects of their medication, which may indicate that side effect profiles of antipsychotic combinations are less favorable.

Evaluation of treatment satisfaction misalignment between Japanese psoriasis patients and their physicians – Japanese psoriasis patients and their physicians do not share the same treatment satisfaction levels

Objectives High treatment satisfaction in both patients and physicians is an important factor in improving quality of life in psoriasis patients. This study aimed to evaluate treatment satisfaction alignment between psoriasis patients and physicians and to identify factors associated with satisfaction misalignment, especially “physician-predominant” misalignment. Methods This is a nationwide multicenter cross-sectional study. Subjects were paired moderate to severe psoriasis outpatients and their physicians. Treatment satisfaction was evaluated on a scale from 0 to 10. Subjects were defined as “misaligned” when the difference in treatment satisfaction was over ±1 between the patient–physician pair. Results A total of 425 pairs were collected from 54 facilities in Japan. The mean patient age and disease duration were 56.5 years and 18.7 years, respectively. The mean physician age was 50.6 years and 69.6% of physicians specialized in psoriasis. Treatment satisfaction misalignment was found in 49.9% of the patient–physician pairs. Among misaligned pairs, 43.6% were “physician-predominant” pairs. In the multivariate logistic regression analyses, “treatment is effective” was the most important reason for treatment satisfaction (odds ratio [OR]: 35.5; 95% confidence interval [CI]: 5.43, 231.78). Symptoms in the genital area (OR: 10.2; 95% CI: 2.55, 40.93) and lack of understanding of treatment options by patients (OR: 7.5; 95% CI: 2.19, 25.94) were key factors leading to “physician-predominant” status. Conclusions The results suggest that genital psoriasis plays an important role in treatment satisfaction from the patient perspective, and illustrate the importance of communication between patients and physicians which potentially resolves these factors and improves misalignment.

Effects of overactive bladder on treatment-related behaviour and quality of life in an Eastern European country: findings from the LUTS POLAND Study

IntroductionThe aim of this study was to investigate treatment-related behaviour and quality of life of a Polish population that reported symptoms of overactive bladder (OAB) syndrome. The analysis also evaluated the impact of individual lower urinary tract symptoms and their specific bother on treatment seeking, treatment receiving, treatment satisfaction, and treatment continuation, in the same population.Material and methodsThe participants were aged ≥ 40 years with possible diagnosis of OAB based on a score of ≥ 8 on the OAB-V8 questionnaire. Respondents used Likert-like scales to rate the frequency and symptom-specific bother of individual lower urinary tract symptoms. Regression models were constructed to analyse all associations.ResultsOf 6005 participants, 33.9% (n = 2041) had a possible diagnosis of OAB. Almost 40% (n = 810) were seeking treatment, and most participants received treatment (37.7%, n = 770). There was no difference between individuals in urban and rural areas. Prescribed drugs were the most common treatment for OAB symptoms. We did not observe differences in treatment satisfaction or dissatisfaction between men and women, but statistically more men than women continued their treatment. Symptoms of all categories, not only storage, but also voiding, and post-micturition, were associated with a negative effect on an individual’s treatment-related outcome. Finally, OAB had a negative effect on quality of life because 43% (n = 878) of persons with possible OAB had concerns about their quality of life related to their urinary condition.ConclusionsThis study is the first Eastern European population-representative analysis of treatment-related behaviours for OAB. Our study highlights the importance of patient education about the condition and treatment options.

Wellbeing and clinical videoconferencing satisfaction among patients in psychotrauma treatment during the coronavirus pandemic: cross-sectional study

ABSTRACT Background: The coronavirus pandemic appears to put psychiatric patients with pre-existing symptomatology at risk of symptom increase, but evidence is scarce. While the pandemic and stringent governmental measures have accelerated the use of clinical videoconferencing (VCT), patient satisfaction with VCT is unclear. Objective: Aim of the study was to assess the wellbeing of patients in psychotrauma treatment during the coronavirus pandemic and to evaluate their use of and satisfaction with VCT. Method: This study used data from a routine outcome monitoring assessment completed by patients in treatment at a specialized psychotrauma institute and administered before the easing of governmental measures in June 2020. Wellbeing (Brief Symptom Inventory, Cantril Ladder, perceived stress level, and symptom change), VCT use and VCT satisfaction, and their association with demographic variables (gender, age, education level, and refugee status) were analysed. Results: Of the 318 respondents (response rate 64.5%), 139 (43.7%) reported a symptom increase, which was associated with a higher coronavirus-related stress level and general psychopathology as well as lower life satisfaction. There were significant effects of age and education level on wellbeing. VCT was reported to have been used by 228 (71.7%) patients. VCT satisfaction ratings were higher among women and those with lower levels of stress (r = −.20, p < .01) and general psychopathology (r = .21, p < .01). No difference in treatment satisfaction was found between patients who used VCT versus those who did not (mean difference = −.09 95% CI: −.79 to .62, p = .81). Conclusions: The coronavirus pandemic has aggravated mental health complaints according to a substantial percentage of patients in psychotrauma treatment. Although VCT was found to be acceptable, face-to-face treatment may remain necessary for specific target groups with limited access to VCT (such as refugees) and patients with high levels of general psychopathology.

999-P: Six Months At-Home Hybrid Closed-Loop vs. Manual Insulin Delivery with Finger-Stick Blood Glucose Monitoring in Adults with Type 1 Diabetes: A Randomized Controlled Trial

Background: Few long-term RCTs compare Hybrid Closed Loop (HCL) insulin delivery to manual (non-HCL) insulin dosing in type 1 diabetes (T1D). Objective: To examine glycemic and psychosocial outcomes in adults with T1D using HCL vs. manual insulin dosing with self-monitoring of blood glucose (SMBG) for 6 months. Methods: Adults using multiple daily injections or pumps with SMBG were randomized 1:1 after insulin dose optimization to 26 weeks of HCL (Medtronic 670G) or continuation of current therapy. The primary outcome was time in target range (70-180mg/dL) with masked CGM during the final 3 weeks. Secondary outcomes included other CGM metrics, HbA1c, treatment satisfaction (DTSQs) and diabetes distress (PAID). Intention to treat analysis was performed with ANCOVA or rank sum test. Results: HCL and control groups were well balanced at baseline (Table). At 26 weeks, mean (95% CI) CGM time in range with HCL was greater by 14.8% (11.1, 18.5), with reduced high and low glucose time, and lower HbA1c. There were no between-group differences in treatment satisfaction or diabetes distress (Table). Conclusions: HCL provided a significant and sustained glycemic benefit compared with standard therapy. Results will inform potential users and health professionals and a cost-benefit analysis may facilitate HCL access. Disclosure S.A. McAuley: Advisory Panel; Self; Medtronic. Research Support; Self; Medtronic, Roche Diabetes Care. Speaker’s Bureau; Self; Lilly Diabetes, Roche Diabetes Care. M.H. Lee: Research Support; Self; Medtronic. Speaker’s Bureau; Self; AstraZeneca, Medtronic. B. Paldus: Research Support; Self; JDRF. Speaker’s Bureau; Self; Australian Diabetes Society, Medtronic. S. Vogrin: None. M.B. Abraham: Speaker’s Bureau; Self; Lilly Diabetes. L. Bach: None. M. Burt: None. N. Cohen: Advisory Panel; Self; Abbott, AstraZeneca, Boehringer Ingelheim Pharmaceuticals, Inc., Lilly Diabetes. Research Support; Self; Ypsomed AG. Speaker’s Bureau; Self; Novo Nordisk A/S. P.G. Colman: None. E.A. Davis: None. C. Hendrieckx: None. M. de Bock: None. J. Holmes-Walker: None. J. Kaye: Advisory Panel; Self; Abbott. Speaker’s Bureau; Self; AstraZeneca, Boehringer Ingelheim Pharmaceuticals, Inc., Eli Lilly and Company, Novo Nordisk Inc. K. Kumareswaran: None. R. MacIsaac: None. R.W. McCallum: None. C.M. Sims: Stock/Shareholder; Self; Medtronic. J. Speight: Research Support; Self; Abbott, AstraZeneca, Medtronic, Sanofi-Aventis. Speaker’s Bureau; Self; American Diabetes Association, Australian Diabetes Society, Roche Diabetes Care. S. Stranks: Advisory Panel; Self; AstraZeneca, Boehringer Ingelheim Pharmaceuticals, Inc., Lilly Diabetes, Sanofi-Aventis. S. Trawley: None. V. Sundararajan: None. G. Ward: None. A.C. Keech: Advisory Panel; Self; Amgen, Kowa Research Institute, Inc. Consultant; Self; Sanofi-Aventis. Speaker’s Bureau; Self; Abbott, Amgen. A. Jenkins: Advisory Panel; Self; Abbott, Medtronic. Research Support; Self; Abbott, GlySens Incorporated, Medtronic, Sanofi-Aventis. T. Jones: Other Relationship; Self; Medtronic. D.N. ONeal: None.

Female patients are less satisfied with biological treatment for psoriasis and experience more side-effects than male patients: results from the prospective BioCAPTURE registry.

Female sex has been reported as a predictor for treatment discontinuation with biological therapies for psoriasis, although reasons remain unclear. It can be hypothesized that lower satisfaction with biological treatment in women might add to the lower drug survival rates. To identify possible differences in satisfaction with biological treatment between female and male patients using the Treatment Satisfaction Questionnaire for Medication (TSQM). Data of psoriasis patients treated with biologics were obtained from the prospective, multicentre, daily-practice BioCAPTURE registry. Longitudinal TSQM data were analysed by linear mixed models. Relevant patient characteristics were incorporated as possible confounding factors. Post hoc analysis of adverse events was performed in order to investigate differences between sexes. We included 315 patients with 396 corresponding treatment episodes (137 adalimumab, 90 etanercept, 137 ustekinumab, 24 secukinumab and 8 infliximab). Almost forty per cent of the patients were female. Women had significantly lower baseline PASI scores (P=0.01). Longitudinal analyses demonstrated lower TSQM scores for 'side-effects' (P=0.05) and 'global satisfaction' (P=0.01) in female patients compared with male patients over 1year of treatment. Women reported more relevant adverse events in the context of biologic treatment compared to men (rate ratio 1.79; P<0.001), with more fungal (rate ratio 2.20; P=0.001) and herpes simplex infections (rate ratio 3.25; P=0.005). This study provides a prospective, longitudinal analysis of treatment satisfaction with biologics in female and male patients with psoriasis. Women were slightly less satisfied with treatment regarding side-effects and global satisfaction. Differences in treatment satisfaction and side-effects might add to the fact that women discontinue biological treatments more often.

Quality of Life, Psychological Functioning, and Treatment Satisfaction of Men Who Have Undergone Penile Prosthesis Surgery Following Robot-Assisted Radical Prostatectomy

BackgroundPenile prosthesis surgery is last-line treatment to regaining erectile function after radical prostatectomy (RP) for localized prostate cancer. AimsTo assess quality of life, psychological functioning, and treatment satisfaction of men who underwent penile implantation after RP; the psychosocial correlates of treatment satisfaction and sexual function after surgery; and the relation between patients’ and partners’ ratings of treatment satisfaction. Methods98 consecutive patients who underwent penile implantation after RP from 2010 and 2015 and their partners were invited to complete a series of measures at a single time point. Of these, 71 patients and 43 partners completed measures assessing sexual function, psychological functioning, and treatment satisfaction. Proportions of patients who demonstrated good sexual function and satisfaction with treatment and clinical levels of anxiety and depression were calculated. Hierarchical regression analyses were conducted to determine psychosocial factors associated with patient treatment satisfaction and sexual function and patient-partner differences in treatment satisfaction. OutcomesPatients completed the Expanded Prostate Cancer Index Composite Short Form (EPIC-26), Erectile Dysfunction Inventory of Treatment Satisfaction (EDITS), Prostate Cancer-Related Quality of Life Scale, Self-Esteem and Relationship Questionnaire (SEAR), Generalized Anxiety Disorder–7 (GAD-7), and Patient Health Questionnaire–9 (PHQ-9). Partners completed the GAD-7, PHQ-9, EDITS (partner version), and SEAR. Results94% of men reported satisfaction with treatment (EDITS score > 50). 77% of men reported good sexual function (EPIC-26 score > 60). Lower depression scores were associated with higher sexual confidence and sexual intimacy, and these were correlated with better treatment satisfaction and sexual function. Patients experienced higher sexual relationship satisfaction (median score = 90.6) than their partners (median score = 81.2), but there was no difference in treatment satisfaction between groups. Higher patient treatment satisfaction was more likely to be reported for couples whose depression scores were more similar. Clinical ImplicationsIt is important to provide preoperative penile implant counseling and encourage patients to seek postoperative counseling if needed. Strengths and LimitationsThis is one of the first Australian-based studies comprehensively assessing treatment satisfaction and psychosocial health of men after penile prosthesis surgery after RP. This was a retrospective cross-sectional study, so there is a possibility of recall bias, and causal associations could not be determined. ConclusionMen in this Australian series who underwent penile prosthesis surgery after RP generally reported good sexual function and treatment satisfaction. Nevertheless, patient and partner mental health influenced their reported experience of the treatment.Pillay B, Moon D, Love C, et al. Quality of Life, Psychological Functioning, and Treatment Satisfaction of Men Who Have Undergone Penile Prosthesis Surgery Following Robot-Assisted Radical Prostatectomy. J Sex Med 2017;14:1612–1620.

Patient-reported outcomes in topical field treatment of actinic keratosis in Swedish and Danish patients

Topical treatments in dermatology can be long, complex and lead to nonadherence and nonpersistence to prescribed treatment. Clinical efficacy observed in randomized clinical trials (RCT) may therefore be reduced in real-world clinical practice. The objective of this study was to analyze patient-reported treatment adherence, treatment satisfaction and health-related quality of life (HRQoL) with topical treatments of actinic keratosis (AK) in routine clinical practice in Denmark and Sweden. Adult patients prescribed field-directed topical AK treatments with diclofenac gel, imiquimod or ingenol mebutate per routine clinical practice were eligible for the observational RAPID-ACT study. Data were collected through physician and patient questionnaires that included validated instruments to measure treatment satisfaction (TSQM-9), treatment adherence (MMAS) and HRQoL (EQ-5D-5L, EQ-VAS, AKQoL). In total, 446 patients from Denmark and Sweden were included. Ingenol mebutate patients reported a higher satisfaction with treatment effectiveness compared to patients treated with diclofenac (p = .006) while no other differences in treatment satisfaction could be determined. Treatment adherence was generally high, but higher for ingenol mebutate compared to both diclofenac (p < .001) and imiquimod (p = .007), possibly due to shorter treatment duration. No differences in improved HRQoL were found. More research is needed about the link between treatment adherence and real-world effectiveness.

What Influences Treatment Satisfaction in Patients with Personality Disorders? A Naturalistic Investigation in a Hospitalization Setting.

Treatment satisfaction of different mental disorders is still poorly understood, but of high clinical interest. Inpatients of a general psychiatric care hospital were asked to fill out questionnaires on satisfaction and clinical variables at admission and discharge. On the basis of an exploratory approach, differences in treatment satisfaction among diagnostic groups were examined by means of one-way analysis of variance. Potential associated clinical and socio-demographic variables were studied using multi/univariate tests. Patients with personality disorders (n=18) showed a significantly lower treatment satisfaction (ZUF-8, Zurich Satisfaction Questionnaire) and a slightly lower improvement of symptoms (CGI, Clinical Global Impression) and global functioning (GAF, Global Assessment of Functioning scale) than that of other diagnostic groups (n=95). Satisfaction in patients with personality disorders correlated much stronger with the symptom improvement and slightly with the functioning level than in patients without personality disorders. Interestingly, in patients with personality disorders psychopharmacological treatment in general (present versus not present) was independent from satisfaction. This exploratory investigation suggests that a lower satisfaction of patients with personality disorders in a general psychiatric hospital is mainly based on a reduced improvement of the symptoms and of the global functioning level.

What influences treatment satisfaction in patients with personality disorders? A naturalistic investigation in a hospitalization setting

Treatment satisfaction of different mental disorders is still poorly understood, but of high clinical interest. Inpatients of a general psychiatric care hospital were asked to fill out questionnaires on satisfaction and clinical variables at admission and discharge. On the basis of an exploratory approach, differences in treatment satisfaction among diagnostic groups were examined by means of one-way analysis of variance. Potential associated clinical and socio-demographic variables were studied using multi/univariate tests. Patients with personality disorders (n=18) showed a significantly lower treatment satisfaction (ZUF-8, Zurich Satisfaction Questionnaire) and a slightly lower improvement of symptoms (CGI, Clinical Global Impression) and global functioning (GAF, Global Assessment of Functioning scale) than that of other diagnostic groups (n=95). Satisfaction in patients with personality disorders correlated much stronger with the symptom improvement and slightly with the functioning level than in patients without personality disorders. Interestingly, in patients with personality disorders psychopharmacological treatment in general (present versus not present) was independent from satisfaction. This exploratory investigation suggests that a lower satisfaction of patients with personality disorders in a general psychiatric hospital is mainly based on a reduced improvement of the symptoms and of the global functioning level.

Defensive high-anxious individuals with chronic back pain demonstrate different treatment choices and patient persistence

The aim of this study is to determine whether the experience of, and response to chronic back pain was different for defensive high-anxious individuals than other personality types (defensive high-anxious, high-anxious, repressor and low-anxious). Participants (n=111) were recruited from a heterogeneous sample of individuals who had reported back pain within the last 6months. Self-report measures of trait anxiety and defensiveness were used to determine personality type. In addition, pain, treatment history, disability, depression and satisfaction with treatment were recorded. Despite reporting similar levels of pain to other personality groups, defensive high-anxious individuals reported significantly greater disability and depression (p<0.01). Of the defensive high-anxious individuals, 92% sought more than one intervention. In comparison, repressors predominantly self-managed their pain with only 10% utilising more than one intervention. Surprisingly, there were no differences in treatment satisfaction between the four groups. The present study suggests that personality type is an important factor influencing patients’ treatment options, with defensive high anxious individuals substantially more likely to seek multiple interventions and remain within the care system. The present study provides a basis for future research into the role of personality type in the management of chronic pain.

Analysis of the characteristics of medicine taking in patients with gastroesophageal reflux disease in Beijing

Objective To investigate the characteristics of medicine taking,the type and ratio of long-term medication and treatment satisfaction in patients with gastroesophageal reflux disease (GERD),to analyze the effects of GERD combined with functional bowel disease (FBD) on the treatment satisfaction,and to compare the changes of type of medication and treatment satisfaction in patients with GERD in recent years.Methods From April to June in 2011,the questionnaire survey was conducted in gastroenterology clinic of People's Hospital of Peking University.The incidence of typical GERD symptoms was investigated by a validated reflux disease questionnaire (RDQ),the score between one and five was considered there might be reflux symptoms and the score over 12 was diagnosed as GERD.FBD was diagnosed according to Rome Ⅲ criteria.The information of GERD related medication taking within one year before the survey,long-term medication taking (≥ 1 year)and the treatment satisfaction of patients whose RDQ score over zero was recorded and compared with the data collected in the same method in 2004.The chi-square test was performed for data statistical analyses with SPSS 17.0 software.Results Among 1074 patients who completed questionnaire survey in 2011,the percentage of patients with reflux symptoms was 32.7％ (351/1074),the percentage of diagnosed GERD was 10.0％ (107/1074),and GERD combined with FBD was 25.2％ (27/107) of GERD.A total of 304 cases (86.6％) of patients with reflux symptoms had information of medication taking; 78.0％ (237/304) of whom had taken GERD related medication within one year before the survey.The rate of GERD related medication taking especially proton pump inhibitor (PPI) and antiacid medication taking increased along with RDQ score (x2 =24.2,13.1 and 18.2,all P＜0.05).A total of 104 cases of GERD patients had information of medication taking; 88.5 ％ (92/104) GERD patients had taken GERD related medication within one year before the survey,52.9％ (55/104) GERD patients had taken PPI medication,30.8％ (32/104) needed long-term medication and 20.2％ (21/104) needed longterm PPI treatment.There was no significant difference in treatment satisfaction between different RDQ score ranges (x2 =3.3,P＞0.05).Among GERD patients who appraised the effects of treatment,the percentage of satisfied,acceptable and not satified with the treatment was 37.1％(26/70),48.6％ (34/70)and 14.3％(10/70),respectively.There was no significant difference in treatment satisfation between GERD with and without FBD (x2 =3.1,P＞0.05).In 2011,the rates of medication taking (88.5％,92/104) and PPI taking (52.9％,55/104) in GERD patients significantly increased compared with those in 2004 (57.3％,98/171; 7.6％,13/171,x2 =29.4,71.4,both P＜0.05).The percentage of treatment satisfaction in 2011(37.1％,26/70) increased compared with that in 2004(25.7％,18/70,x2 =12.8,P＜0.01).Conclusions Some of patients with GERD symptoms need long-term medication,especially PPI treatment.In recent years,the rate of medication taking in GERD patients increased in outpatients department,PPI taking significantly increased and the treatment satisfaction also increased.Maybe the treatment satisfaction is not affected by GERD combined with FBD. Key words: Gastroesphageal reflux; Intestinal disease; Administration, oral; Patient satisfaction