Investigate Patient Satisfaction Research Articles

Evaluation of patient satisfaction with different hearing aids: A study of 107 patients.

We retrospectively investigated patient satisfaction with different types of hearing aids in 107 patients-60 males and 47 females, aged 8 to 84 years (mean: 53.8)-with unilateral or bilateral hearing loss, each of whom used two different hearing devices for at least 3 years per device. The International Outcome Inventory for Hearing Aids, Turkish edition (IOI-HA-TR) was used to evaluate satisfaction levels; we also calculated our own total individual subjective satisfaction (TISS) scores. We divided 16 different hearing devices into two types: device 1 and device 2; on average, device 2 had more channels, a lower minimum frequency, and a higher maximum frequency. We found that the IOI-HA-TR scores and TISS scores were higher and usage time was greater during device 2 use, and that there was a positive correlation between IOI-HA-TR and TISS scores. A total of 69 patients (64.5%) used device 2 for more than 8 hours per day, while 38 patients (35.5%) used it for 4 to 8 hours per day during the final 2 weeks of the trial. In contrast, 40 patients (37.4%) used device 1 for more than 8 hours, 50 (46.7%) used it for 4 to 8 hours, and the remaining 17 (15.9%) used it for less than 4 hours; the difference in the duration of use of the two devices was statistically significant (p < 0.001). Younger patients and patients with more education were more satisfied with their devices than were older patients and those who were not as well educated. We conclude that devices with good technologic features such as more channels, a lower minimum frequency, and a higher maximum frequency result in better hearing. Also, based on the age difference that we observed, we recommend that psychological support be provided to older patients with aided hearing to enhance their mental health and quality of life.

Determinants for patient satisfaction regarding aesthetic outcome and skin sensitivity after breast-conserving surgery.

BackgroundWith the development of new surgical techniques in breast cancer, such as oncoplastic breast surgery, increased knowledge of risk factors for poor satisfaction with conventional breast-conserving surgery (BCS) is needed in order to determine which patients to offer these techniques to. The aim of this study was to investigate patient satisfaction regarding aesthetic result and skin sensitivity in relation to patient, tumour, and treatment factors, in a consecutive sample of patients undergoing conventional BCS.MethodsWomen eligible for BCS were recruited between February 1, 2008 and January 31, 2012 in a prospective setup. In all, 297 women completed a study-specific questionnaire 1 year after conventional BCS and radiotherapy. Potential risk factors for poor satisfaction were investigated using logistic regression analysis.ResultsThe great majority of the women, 84%, were satisfied or very satisfied with the overall aesthetic result. The rate of satisfaction regarding symmetry between the breasts was 68% and for skin sensitivity in the operated breast it was 67%. Excision of more than 20% of the preoperative breast volume was associated with poor satisfaction regarding overall aesthetic outcome, as was axillary clearance. A high BMI (≥30 kg/m2) seemed to affect satisfaction with symmetry negatively. Factors associated with less satisfied patients regarding skin sensitivity in the operated breast were an excision of ≥20% of preoperative breast volume, a BMI of 25–30 kg/m2, axillary clearance, and radiotherapy. Re-excision and postoperative infection were associated with lower rates of satisfaction regarding both overall aesthetic outcome and symmetry, as well as with skin sensitivity.ConclusionsSeveral factors affect patient satisfaction after BCS. A major determinant of poor satisfaction in this study was a large excision of breast volume. If the percentage of breast volume excised is estimated to exceed 20%, other techniques, such as oncoplastic breast surgery, with or without contralateral surgery, or mastectomy with reconstruction, may be considered.Electronic supplementary materialThe online version of this article (doi:10.1186/s12957-016-1053-8) contains supplementary material, which is available to authorized users.

A study of patients satisfaction following instrumental deliveries

A study of patient satisfaction following instrumental delivery Introduction Instrumental deliveries are common in the UK with rates between 10 and 13% nationally. Choice of instrument varies but may include ventouse or forceps with rotational instrumental deliveries via manual rotation, rotational ventouse or rotational forceps. However, instrumental deliveries are not without complications, which can confer maternal or neonatal morbidity. Acknowledged complications include vaginal tears, possibly extending to the anal sphincter/mucosa, haemorrhage, infection and is a known risk factor for shoulder dystocia. Fetal complications include subgaleal haematoma, intracranial haemorrhage, facial nerve palsy, cephalhaematoma, neonatal jaundice or retinal haemorrhage. Indications for instrumental delivery may include expedited delivery in fetal compromise, prolonged second stage of labour owing to maternal exhaustion/other reasons or safer delivery in cases where maternal pushing is not advisable. Our unit: We have performed a prospective study between October and December 2015 to investigate patient satisfaction following instrumental deliveries. This was achieved via a proforma with the first part completed by the operating physician and the second part completed by the patient in the first day following delivery. We have, on average, 4000 deliveries in our unit per annum and had 1029 deliveries in the 3-month period. There were 111 instrumental deliveries and we had a return rate of 45% (50). Results: Demographics – in the cohort 35 were primiparous, 15 were multiparous with the majority of women between the ages of 20–30. The fetal head was in the occipito-anterior position in 64% with the remainder either occipito-posterior or occipito-transverse. 46% had forceps delivery, 30% had a ventouse delivery, 18% needed a double instrumental delivery and in only 3 deliveries did the instrumental delivery fail necessitating a second stage caesarean section. The instrumental delivery was performed under a variety of analgesic techniques – 30% local perineal infiltration, 6% pudendal block and 64% regional anaesthesia (epidural or spinal anaesthetic). 30 patients had an episiotomy performed, 7 patients had a third degree tear, 1 patient had a fourth degree tear and 5 patients had major post-partum haemorrhages of >1500 ml. The overall patient satisfaction was high with 94% feeling safe, well informed and that they were treated with respect throughout. 96% were happy they received a good explanation of the procedure including rational, consent and associated risks. 94% felt comfortable throughout with supportive staff. Overall pain scores post procedure was low with only 8% stating they had moderate or severe pain post-natally. 23 of 50 women also added comments with 22 highly positive and only 1 borderline comment, which was regarding explanation by the medical staff as it was an emergency procedure. Conclusion: Overall patient satisfaction in the immediate post-partum period was high despite the aforementioned complication rates.

Patient Satisfaction with Community Health Service Centers as Gatekeepers and the Influencing Factors: A Cross-Sectional Study in Shenzhen, China.

PurposeShenzhen is the first pilot city in China implementing the gatekeeper policy, with community health service (CHS) centers as the gatekeepers. We aim to investigate patient satisfaction with this policy and its influencing factors in Shenzhen.Methods3,848 patients visiting eight CHS centers in Shenzhen of China between May 1 and July 28, 2013 were recruited. We interviewed them using a structured questionnaire to investigate their satisfaction with the gatekeeper policy of CHS. Multivariable logistic regression models were used to identify influencing factors.ResultsOf the respondents, 28.17%, 47.27% and 24.56% were satisfied with, neutral to, and not satisfied with the gatekeeper policy respectively. Patient satisfaction with this policy was found to be associated with education level, familiarity with the policy, referral experience, satisfaction with convenience of seeing a doctor, satisfaction with waiting time, satisfaction with medical facility, satisfaction with general medical practitioners’ professional skill, and proportion of expense reimbursed.ConclusionsOur investigation shows that patient satisfaction with the gatekeeper policy was low. To improve patient satisfaction, efforts should be made to increase the convenience of seeing a doctor in community, shorten waiting time, improve general medical practitioners’ professional skill, and increase proportion of expense reimbursement.

Comparing importance and performance from a patient perspective in English general practice: a cross-sectional survey

Patient experience and satisfaction are important indicators of quality in health care. Little is known about where to prioritize efforts to improve patient satisfaction. To investigate patient satisfaction with primary care, as part of the Quality and Costs of Primary Care in Europe study in England, identifying areas where improvements could be made from patients' perspectives. We conducted a questionnaire survey of general practice patients in three English regions. Patient Values questionnaires assessed what patients thought was important, and Patient Experience questionnaires rated performance of primary care. Fifteen attributes of care were compared using Importance Performance Analysis, a method that simultaneously represents data on importance and performance of a service, enabling identification of its strengths and weaknesses. Patients rated both 'relational' and 'functional' aspects of care as important. Satisfaction with general practice could be improved by concentrating on specific aspects of access (ensuring that patients know how to access out-of-hours services and find it easy to get an appointment), and one aspect of empowerment (after their visit, patients feel able to cope better with their health problem/illness). However, for other attributes (e.g. proximity of the practice to a patient's house or, a short waiting time when contacting the practice), investing additional resources is not likely to increase patient satisfaction. Attributes needing most improvement concerned access to primary care and patient empowerment. More research is needed to identify how to improve access without generating unnecessary additional demand or compromising continuity of care.

A Prospective Study Comparing Quality of Life and Cosmetic Results between Single-Port and Conventional Laparoscopic Cholecystectomy

Background: Multiple studies from the last five years have demonstrated that single-incision laparoscopic surgery cholecystectomy (SILS) is not only feasible but also produces a result comparable with that of conventional laparoscopic cholecystectomy (CLC). Methods and results: In this bicentric study, we used the Short Form (36) (SF-36) and Nottingham Health Profile (NHP) surveys to estimate and compare the post-operative quality of life up to the 28th post-operative day for 66 patients who had undergone either CLC (n = 32) or SILS (n = 34). Additionally, we investigated patient satisfaction with the cosmetic results after one year. The curves summarizing the eight sections in the physical sum scale and in the mental sum scale (SF-36) were the same within the confidence interval with a confidence level of 95%. Thus, post-operative quality of life could be assumed to be equivalent for the two groups. Evaluation of the NHP survey produced similar results. The perceived cosmetic results were significantly better for the SILS group (1.3 on a scale of 1 - 5 with 1 being the best) than for the CLC group (1.9) (p = 0.016). Conclusions: This study did not demonstrate better quality of life for the single-port procedure as it had been expected. Instead, the single-port procedure produced subjectively better cosmetic results.

Patient Satisfaction with the New Interferon Beta-1b Autoinjector (BETACONNECT™).

IntroductionMultiple sclerosis (MS) typically requires life-long management with disease-modifying therapies (DMTs). Many DMTs require regular self-injection, and can be associated with injection site reactions, pain, and needle/injection phobia—but these can be addressed by improvements in autoinjector design. The aim of this study was to investigate patient satisfaction and preference for BETACONNECT™ (Bayer Pharma AG), a novel interferon beta-1b autoinjector.MethodsPatients in Germany performing self-injections using BETACONNECT took part in the study. Data were collected through an online 15-min structured survey. Participants rated their experience with BETACONNECT on a 6-point scale and those satisfied with BETACONNECT were asked to describe the reason using a free-text box.ResultsOne-hundred and eighteen patients with MS completed the survey. Ninety percent preferred BETACONNECT to their previous injection method (only 4% previously used manual injections, so most had previously used other autoinjectors). Ninety-two percent were very confident/confident in their ability to perform an injection using BETACONNECT. The most common free-text responses to “Why are you satisfied with the BETACONNECT™ autoinjector?” were ease of use (46%), less irritation/pain at the injection site (33%), and smoother injections (24%). Features considered most useful were automated injections (98%), adjustable injection speed (98%), and adjustable injection depth (98%). Ninety-seven percent thought it was easy to know when an injection was complete and 95% agreed/strongly agreed it was easy to learn to use the autoinjector. Seventy-three percent agreed that the quietness and effortlessness of the BETACONNECT reduced their level of injection anxiety, 92% that its size and shape makes it easy to handle during injections, and 67% that it decreases injection site pain. Eighty percent of those using the reminder function thought they were less likely to miss an injection.ConclusionPatients with MS self-injecting interferon beta-1b expressed a high level of satisfaction and preference for BETACONNECT. Thus, BETACONNECT represents a valid option to improve patients’ overall injection experience.FundingBayer HealthCare Pharmaceuticals.Electronic supplementary materialThe online version of this article (doi:10.1007/s40120-015-0036-y) contains supplementary material, which is available to authorized users.

Patient satisfaction survey for HAM-net registrants

Patient registries can foster communication between doctors and patients who have rare diseases. In order to succeed in the long term, the managers of the registry must work to raise the satisfaction of the registrants. We conducted a satisfaction survey for the HTLV-1 associated myelopathy (HAM) patient registry known as “HAM-net.” Based on the data we collected, we made several alterations, mainly to the newsletter and website. This year we repeated the survey to determine if our alterations were beneficial or not by assessing changes in satisfaction levels. We surveyed 368 patients registered to HAM-net, inquiring about their general impression of HAM-net, the requisite telephone interviews, the newsletter, and the website. The response rate was 74.7%, and 198 registrants responded to the satisfaction survey both times. The number of individuals satisfied with HAM-net in general improved from 63.6% to 77.3% of registrants. More specifically, satisfaction with the newsletter rose dramatically but no significant change was observed for the website. Therefore we concluded that focusing on the newsletter is currently the best way to improve patient satisfaction. For example, we deduced that it is beneficial to increase the volume and quality of the articles. On the other hand, we could not demonstrate that frequently updating the website was beneficial to the patients. We inferred that the website must be improved to be more appealing and useful to the patients. In this study, we showed that properly investigating patient satisfaction using a detailed questionnaire can produce the data necessary to improve patient satisfaction levels. The best way to preserve a good relationship with the registered patients in the long term is to prioritize understanding the patients’ needs and continuously work to improve their satisfaction.

Influence of aesthetic dental and facial measurements on patient satisfaction between genders in Indian patients

PurposeThe purpose of the present study was to investigate patients satisfaction and correlate the variability of aesthetic dental and facial measurements by the maxillary anterior teeth appearance in different gender group among Indian patients. Materials and methodsThe dental and facial measurements were made on 80 Indian subjects: Central incisor width/length ratio, gingival zenith displacements, the upper lip height, intercommisural width, maximum maxillary central incisal at rest and smile were measured. All the patients rated their satisfaction with the dental appearance on the visual-analogue scale. All the parameters have been analyzed with respect to gender. ResultsThe great majority of the participants were completely satisfied with their dental appearance (p > 0.05). In the men, maximum maxillary central incisal display at rest and intercommisural width during smile showed statistical significant difference. In women, the combination of central incisor width/length ratio, intercommissural width at rest and smile, and maximum maxillary incisal display measurements were statistically significant. ConclusionsWithin the population tested, the results suggest that the use of aesthetic dental and facial measurement may serve as an aesthetic guideline. The gingival architecture should be considered in aesthetic anterior oral rehabilitation.

AB032. Penile rehabilitation using Vacuum Erection Device for erectile dysfunction after radical prostatectomy

ObjectiveErectile dysfunction (ED) is one of the most common complications of radical prostatectomy (RP), and seriously affecting the quality of life for patients after RP. At present, more and more doctors and patients increasingly accept and use penile rehabilitation therapies to treat ED post-RP. Among them, the vacuum erectile device (VED), a non-invasive means, can improve hypoxia within the penis and inhibit smooth muscle cell apoptosis and cavernous fibrosis. We summarize the efficacy of VED for treatment of ED after RP, and investigate patient compliance and satisfaction.MethodsOne group of 259 patients undergoing RP, including 143 cases of open RP, 116 cases of laparoscopic RP. All patients used VED (Osbon, Timm Medical, Inc.) for rehabilitation within 3 months after RP. Another group undergoing RP but not using VED was control. IIEF-5 scores, length and circumference of penis and SEP3 percentage were compared between these groups before and after RP. The compliance of VED and satisfaction for rehabilitation were also compared.ResultsThe IIEF-5 score after 6 months rehabilitation was significantly higher in the patients using VED than that in the controls (P<0.05).The shortening of penile length and circumference after VED were also significantly lower than that of the control group (P<0.05). The average length using VED was 10 months (1-18 months), and IIEF-5 score and penile length and circumference were higher in those using VED more than 1 year than those using less than six months (P<0.05). The SEP3 and satisfaction rate were significantly higher in 172 cases undergoing neurovascular-bundle-sparing RP than controls (P<0.05).ConclusionsThe early use of VED rehabilitation can improve erectile function for RP patients, help to preserve the length and reduce the shrinkage of penis. Long-term use of VED can have better results.

Perceptions of health care providers and patients on quality of care in maternal and neonatal health in fourteen Bangladesh government healthcare facilities: a mixed-method study.

BackgroundBangladesh has achieved remarkable progress in healthcare with a steady decline in maternal and under-5 child mortality rates in efforts to achieve Millennium Development Goals 4 and 5. However, the mortality rates are still very high compared with high-income countries. The quality of healthcare needs improve to reduce mortality rates further. It is essential to investigate the current quality of healthcare before implementing any interventions. The study was conducted to explore the perception of healthcare providers about the quality of maternal and neonatal health (MNH) care. The study also investigated patient satisfaction with the MNH care received from district and sub-district hospitals.MethodologyBoth qualitative and quantitative methods were used in the study. Two district and 12 sub-district hospitals in Thakurgaon and Jamalpur in Bangladesh were the study settings. Fourteen group discussions and 56 in-depth interviews were conducted among the healthcare providers. Client exit interviews were conducted with 112 patients and their attendants from maternity, labor, and neonatal wards before being discharged from the hospitals. Eight physicians and four anthropologists collected data between November and December 2011 using pretested guidelines.ResultsThe hospital staff identified several key factors that affected the quality of patient care: shortage of staff and logistics; lack of laboratory support; under use of patient-management protocols; a lack of training; and insufficient supervision. Doctors were unable to provide optimal care because of the high volume of patients. The exit interviews revealed that 85 % of respondents were satisfied with the hospital services received. Seven out of 14 respondents were satisfied with the cleanliness of the hospital facilities. More than half of the respondents were satisfied with the drugs they received. In half of the facilities, patients did not get an opportunity to ask the healthcare providers questions about their health conditions and treatments.ConclusionThe quality of healthcare is poor in district and sub-district hospitals in Bangladesh because of the lack of healthcare personnel and logistic support. An integrated quality improvement approach is needed to improve MNH care service in district and sub-district hospitals in Bangladesh.

Patient satisfaction from two studies of collaborative doctor-pharmacist prescribing in Australia.

Pharmacist prescribing has been introduced in several countries and is a possible future role for pharmacy in Australia. To assess whether patient satisfaction with the pharmacist as a prescriber, and patient experiences in two settings of collaborative doctor-pharmacist prescribing may be barriers to implementation of pharmacist prescribing. Surveys containing closed questions, and Likert scale responses, were completed in both settings to investigate patient satisfaction after each consultation. A further survey investigating attitudes towards pharmacist prescribing, after multiple consultations, was completed in the sexual health clinic. A surgical pre-admission clinic (PAC) in a tertiary hospital and an outpatient sexual health clinic at a university hospital. Two hundred patients scheduled for elective surgery, and 17 patients diagnosed with HIV infection, respectively, recruited to the pharmacist prescribing arm of two collaborative doctor-pharmacist prescribing studies. Consultation satisfaction response rates in PAC and the sexual health clinic were 182/200 (91%) and 29/34 (85%), respectively. In the sexual health clinic, the attitudes towards pharmacist prescribing survey response rate were 14/17 (82%). Consultation satisfaction was high in both studies, most patients (98% and 97%, respectively) agreed they were satisfied with the consultation. In the sexual health clinic, all patients (14/14) agreed that they trusted the pharmacist's ability to prescribe, care was as good as usual care, and they would recommend seeing a pharmacist prescriber to friends. Most of the patients had a high satisfaction with pharmacist prescriber consultations, and a positive outlook on the collaborative model of care in the sexual health clinic.

Pulse Dye Laser Therapy for Spider Naevi

Aims: The aim of this study was to determine the treatment outcome of spider naevi using pulse dye laser (PDL) therapy. Patients and Methods: This was a retrospective study reviewing the results of PDL on spider naevi in 49 consecutive patients undergoing PDL for spider naevi, between 15 October 2003 and 19 August 2008. A questionnaire was used to investigate patient satisfaction and recurrence. Results: There was improvement seen in all patients with complete resolution in 31 patients (76%) and 67 lesions (82%). There was a high level of satisfaction with the treatment with 30 patients (78%) being very satisfid and six (15%) satisfid with the result. Hypopigmentation occurred in one patient. Two patients (4.9%) with a total of four lesions developed recurrence in two lesions only. Conclusions: PDL is an effective and safe treatment of spider naevi.

A systematic review of questionnaires to assess patient satisfaction with limb orthoses.

Assessment of patient satisfaction with orthosis is a key point for clinical practice and research, requiring questionnaires with robust psychometric properties. To identify which validated questionnaires are used to investigate patient satisfaction with orthosis in limb orthotics and to analyse (1) their main fields of clinical application, (2) the orthosis-related features analysed by the questionnaires and (3) the strength of their psychometric properties. Systematic review. A literature search using MEDLINE (PubMed), Cumulative Index to Nursing and Allied Health Literature (CINAHL) and Scopus databases for original articles published within the last 20 years was performed. A total of 106 papers pertaining to various clinical fields were selected. The main features of patient satisfaction with orthosis analysed were as follows: aesthetic, ease in donning and doffing the device, time of orthotic use and comfort. Of the questionnaires used to investigate patient satisfaction with orthosis, only four are adequately validated for this purpose: two for generic orthotic use (Quebec User Evaluation of Satisfaction with assistive Technology 2.0 and Client Satisfaction with Device of Orthotics and Prosthetic Users' Survey) and two for specific application with orthopaedic shoes (Questionnaire for the Usability Evaluation of orthopaedic shoes and Monitor Orthopaedic Shoes). Further development, refinement and validation of outcome measures in this field are warranted. Given the importance of analysing patient satisfaction with orthosis (PSwO), appropriate instruments to assess outcome are needed. This article reviews the currently available instruments and reflects on how future studies could be focused on the development, refinement and validation of outcome measures in this field.

Patient satisfaction with double-door laminoplasty for cervical compression myelopathy.

Patient satisfaction with posterior laminoplasty for cervical compression myelopathy is not yet established. Moreover, postoperative patient-reported outcomes (PROs) associated with patient satisfaction remain unclear. This study aimed to investigate patient satisfaction after double-door laminoplasty for cervical compression myelopathy, and to identify the postoperative patient-reported outcomes associated with patient satisfaction. This retrospective study included 97 patients with cervical compression myelopathy who underwent double-door laminoplasty between 2002 and 2010 in our institution [mean follow-up: 58 months (range 12-123 months)]. We assessed postoperative PROs from questionnaires administered before surgery and at the latest follow-up. These questionnaires included the Neck Disability Index, physical and mental component summary of Short Form-36, EuroQol-5 dimension, Japanese Orthopaedic Association Cervical Myelopathy Evaluation Questionnaire (JOACMEQ), and a numerical rating scale of pain or numbness in the neck, arms, and scapular lesion. Satisfaction was evaluated on the basis of a seven-point scale. Patients were divided into two groups: satisfied (very satisfied, satisfied, slightly satisfied) and dissatisfied (neither satisfied nor dissatisfied, slightly dissatisfied, dissatisfied, very dissatisfied). All PROs and the effectiveness of surgical treatment assessed by JOACMEQ were compared between both groups. The satisfied group comprised 69 patients (71 %). Univariate analysis revealed a significant difference in scapular pain, Neck Disability Index, physical component summary of Short Form-36, postoperative mental component summary of Short Form-36, and improvement of lower extremity function postoperatively between both groups. Multivariate analysis revealed that there was a significantly higher proportion of patients with improved lower extremity function in the satisfied group than in the dissatisfied group. In conclusion, 71 % of the patients who underwent double-door laminoplasty for cervical compression myelopathy were satisfied. The findings of this study, which examines the association between patient satisfaction and PROs, suggest that improvement in lower extremity function following surgical intervention affects patient satisfaction in those with cervical compression myelopathy.

Patient satisfaction with physiotherapy services in an Asian country: A report from Sri Lanka

Abstract Patient satisfaction is an important indicator of the quality of care provided to recipients of health services. In Sri Lanka, there is a dearth of research on patient satisfaction, particularly in the arena of physiotherapy services. Such research is important to address any issues in the physiotherapy service, such that patients' needs are better catered for, as well as to improve the marketability of physiotherapy services. The present study aimed to investigate patient satisfaction with the physiotherapy treatment received at a large government hospital in Sri Lanka. A cross-sectional survey study was conducted on a sample of 150 patients receiving physiotherapy treatment using a self-administered questionnaire. This was followed by a focus group discussion. Results indicated that the majority of patients were satisfied with the treatment received. Information on selected correlates of patient satisfaction such as physiotherapist-related factors, patient-related factors, nature of the physiotherapist–patient interaction, professionalism of the service provided, and the logistics of the treatment environment was discussed.

A Survey of the Pain Management of Acute Painful Crisis among Patients with Sickle Cell Disease at Two Centres in Jamaica.

The aim of this survey was to establish the pain management approaches to acute painful crisis (APC) in sickle cell patients at two healthcare facilities and to compare with available guidelines. A multi-centre observational survey of the management of APC in sickle cell patients was conducted. Data were collected at the Sickle Cell Unit (SCU), Tropical Medicine Research Institute (TMRI) and Accident and Emergency Department (A&E), University Hospital of the West Indies. One hundred episodes of uncomplicated APC involving 81 patients managed at the SCU clinic and 64 episodes at the A&E in a total of 28 patients were included in the data set. Drugs used at the SCU included oral morphine, codeine and paracetamol and intramuscular diclofenac. At the A&E, parenteral morphine and pethidine were most commonly used. At the SCU, the mean time to initiation of analgesics was 38 minutes (IQR 25 to 50 minutes); at the A&E, this was 111 minutes (IQR 50 to 150 minutes). At the SCU, the mean duration of stay (DOS) was 2.9 hours (IQR 1.9 to 3.8 hours) with 94% of the patients being discharged home. At the A&E, the mean DOS was 13.0 hours (IQR 8.3 to 16.9 hours) with 93% of the patients being discharged home. The A&E patient group contained multiple high frequency presenters. Documentation of pain severity scores was inconsistent. The findings of the survey indicate that the management of APC at the two centres is substantially different. Further study is required to investigate patient satisfaction, centre preference and analgesic therapy efficacy.

Patient perspective on the management of atrial fibrillation in five European countries

BackgroundLong-term management of chronic conditions, such as atrial fibrillation (AF), require frequent interactions with the healthcare systems. The multinational EUropean Patient Survey in Atrial Fibrillation (EUPS-AF) was conducted to investigate patient satisfaction with AF management in different of five European healthcare systems at a time of changing treatment paradigms for stroke prophylaxis, prior to the advent of newer oral anticoagulants.MethodsAdults (>18 years) were recruited at random from the total populations of France, Germany, Italy, Spain and the UK using a randomized telephone dialling system. At least 300 respondents per country reporting to have a diagnosis of AF or receiving oral anticoagulation therapy for suspected AF or to have a heart rhythm disturbance completed a structured telephone interview.ResultsMost respondents were satisfied with their treatment for AF over the previous 12 months, with 85.5% (n = 1289) rating their care as good or better. Suboptimal clinical practices, however, were identified in several key areas. Coordination of primary and secondary care and a lack of patient engagement and support were particular issues, especially for those patients likely to have extensive contact with their healthcare system.ConclusionsIn the context of Europe-wide guidelines for management of AF, most patients with AF were satisfied with their care, but for a greater proportion of patients, some aspects are unsatisfactory. Patient-centred surveys, such as the EUPS-AF, are crucial for understanding the factors that contribute to patient satisfaction and compliance with long-term treatment for chronic conditions.

A rapid genetic counselling and testing in newly diagnosed breast cancer is associated with high rate of risk-reducing mastectomy in BRCA1/2-positive Italian women

Risk-reducing mastectomy (RRM) decreases breast cancer (BC) risk in BRCA1/2 mutation carriers by up to 95%, but the Italian attitude towards this procedure is reluctant. This is an observational study with retrospective design, using quantitative and qualitative research methods, aimed at evaluating the attitude towards RRM by rapid genetic counselling and testing (RGCT), at the time of BC diagnosis, compared with traditional genetic counselling and testing (TGCT), after previous BC surgery. Secondary aims were to investigate patient satisfaction after RRM and the rate of occult tumour in healthy breasts. A total of 1168 patients were evaluated: 1058 received TGCT, whereas 110 underwent RGCT. In TGCT, among 1058 patients, 209 (19.7%) mutation carriers were identified, with the rate of RRM being 4.7% (10 of 209). Conversely in RGCT, among 110 patients, 36 resulted positive, of which, 15 (41.7%) underwent bilateral mastectomy at the BC surgery time, showing an overall good satisfaction, measured by interpretative phenomenological analysis 12 months after the intervention. Our study shows that RGCT in patients with a hereditary profile is associated with a high rate of RRM at the BC surgery time, this being the pathway offered within a multidisciplinary organization.

Factors influencing patient satisfaction with antimuscarinic treatment of overactive bladder syndrome: Results of a real‐life clinical study

To investigate patient satisfaction with antimuscarinic treatment of overactive bladder syndrome, and to identify factors having a significant influence on satisfaction. A cross-sectional questionnaire survey was carried out to assess treatment satisfaction among male and female patients with overactive bladder (age ≥20 years) in the Hokuriku district of Japan. The overactive bladder symptom scores, treatment efficacies, adverse events (dry mouth and constipation), and patient satisfaction scores were investigated and compared among patients using different antimuscarinic therapeutics. In total, 977 survey respondents (52.6% men; mean age 73.6 years) received antimuscarinic treatment. The mean overactive bladder symptom score of these patients was 6.17; in addition, 32.3% patients were satisfied with their treatment, but 33.1% were dissatisfied. Factors having a significant influence on treatment satisfaction were sex (men were less satisfied), efficacy, adverse events and the overactive bladder symptom score. Constipation negatively influenced patient satisfaction to a greater extent than did dry mouth. Patient satisfaction varied according to the drug used. Constipation was less severe with the immediate-release-type agents (imidafenacin and oxybutynin) than with the extended-release-type (propiverine, solifenacin or tolterodine). Just one-third of Japanese Hokuriku patients with overactive bladder seem to be satisfied with their antimuscarinic treatment. Patient satisfaction is impaired by poor efficacy and the presence of adverse events; furthermore, constipation should be recognized as an adverse event that negatively influences patient satisfaction to a greater extent than dry mouth. Patient satisfaction differs according to the antimuscarinic agent used, with higher patient satisfaction being associated with less severe constipation.