Mean Patient Satisfaction Score Research Articles

Influence of Medical Interpreters on the Healthcare Experiences of Hospitalized Spanish-Speaking Patients.

Introduction: The perspective of hospitalized patients with limited English proficiency (LEP) in US hospitals interacting with language-discordant healthcare providers remains understudied. Our goal is to examine the inpatient experiences of Spanish-speaking patients and offer suggestions to improve patient satisfaction. Methods: A survey was administered to Spanish-speaking patients using interpreters during their admission to medicine at an urban, academic hospital. Qualitative thematic analysis of responses was conducted. Results: Thirty-six patients completed the survey. Despite limited use of interpreters, the majority of patients rated interpretation services as excellent, reported high level of involvement in care and respect of their opinions, and preferred video remote interpreting and in-person interpreters. Language barrier and cost affected patients' comfort level requesting health care services. The mean patient satisfaction score was 9.64. Patients suggested an increase in bilingual personnel, improved access to interpreters, specifically in-person. Conclusion: Although highly satisfied, patients reported inconsistent use of interpretation services in the inpatient setting and suboptimal access. Hospitals should strive to provide language-concordant care and patient-centered interpretation. Patients' understanding of their health care rights needs better assessment to ease the inpatient experience. Further research is needed to estimate the regard for autonomy by Spanish-speaking patients in their own care.

Using an intense pulsed light (IPL) module for the treatment of pigmented lesions.

Pigmented lesions are largely benign and may lead to extreme distress. Various light and lasers may be used to treat pigmentation, often Q-switched lasers are considered the method of choice, while intense pulsed light (IPL) devices may offer a less invasive treatment with a shorter downtime. The purpose of this study is to evaluate the safety and efficacy of a narrowband IPL module for the treatment of pigmented lesions. A retrospective study of 20 patients with pigmented lesions underwent treatment with an IPL module. Treatment was assessed by blinded evaluation of clinical photographs using a GAIS scale of 0-10, as well as through patient satisfaction ratings on a scale of 0-10. Throughout the treatment, pain levels and adverse events were monitored. The mean GAIS score was 7.55 ± 1.15 (mean ± SD), and the mean patient satisfaction score was 7.3 ± 1.26 (mean ± SD). There was a strong positive correlation between GAIS and patient satisfaction scores (r = 0.83), and no significant difference between them (p-value = 0.516). The number of treatments did not significantly affect GAIS and patient satisfaction scores (p-values 0.364 and 0.126). Additional positive unexpected outcomes were improved skin firmness and reduced wrinkles. The results of the study indicate that the IPL module is both safe and effective in treating pigmented lesions and may have the potential to stimulate collagen production.

Surgical Service Utilization and In-Patient Satisfaction in Surgical Service.

The patient satisfaction study is an important and commonly used valid indicator for service quality improvement in healthcare institutions. The aim of this study was to assess the service utilization and patient satisfaction in patients admitted under surgical service in Bir Hospital. A prospective cross sectional analytical study was conducted in Bir Hospital, National Academy of Medical Sciences from February 2021 till June 2023. The patient satisfaction data was collected using the SAPS scale after obtaining ethical clearance from the Institutional Review Board. Data were entered and analyzed in Statistical Package for the Social Sciences version 20.0. There were 152 patients included in the study categorized into conservative treatment group, elective surgery group and emergency surgery group. 32.9%(50) patients were "very satisfied", 62.5%(95) patients were "satisfied", 2.6%(4) were "neither satisfied nor dissatisfied" and 2%(3) were "dissatisfied" with the effect of their treatment/care. The mean satisfaction score in conservative treatment group was 22.13 ±2.53 as compared to the mean satisfaction in elective surgery group which was 21.11± 2.55 (P=0.036) and the mean satisfaction score in emergency surgery group which was 21.66 ±2.68 (P=0.64). The mean score and proportion of patient satisfaction regarding service utilization in patients admitted under surgical service were high with satisfaction score higher in emergency surgery group among the operative groups in Bir Hospital, National Academy of Medical Sciences.

Rate and Predictors of Patient Satisfaction After Total Joint Arthroplasty: A Cross-Sectional Study in a Low-to-Middle-Income Country.

Objective This study aimed to assess the rate of patient satisfaction after primary total joint arthroplasty (TJA) using a validated satisfaction measure. Materials and methods A cross-sectional study was conducted, including all patients who underwent primary TJA between December 2021 and February 2023. The age of the study population was found to range from 23 to 86 years. Patient satisfaction was assessed using a validated tool comprising four questions and a quality of life (QoL) question. Results A total of 197 patients were included, with a mean age of 60.9 ± 12.7 years. Total knee replacement (TKR)was performed in 124 patients (62.9%), andtotal hip replacement (THR) in 73 patients (37.1%). The mean patient satisfaction score was 86.6 ± 14.4 out of a maximum of 100. A significant negative correlation was observed between the Charlson Comorbidity Index (CCI) and the overall satisfaction score (p-value = 0.029). The majority of the patients (52.3%, n = 103) answered that their QoL had greatly improved, and a similar level of improvement was noted in elderly vs. adult patients (p-value = 0.17). A significantly higher proportion of male patients reported improvement more than they ever expected compared to female patients, the majority of whom reported their QoL was greatly improved (p-value = 0.025). Conclusion Total joint arthroplasty has been shown to achieve good patient satisfaction and an improvement in QoL. However, an increased comorbidity index and female gender were identified as factors for reduced satisfaction. Hence, it is recommended to consider these factors and counsel patients accordingly based on local patient data.

Porous Tantalum Metaphyseal Cones for Severe Femoral and Tibial Bone Defects in Revision Total Knee Arthroplasty are Reliable for Fixation at Mean 5-Year Follow-Up

BackgroundPorous tantalum metaphyseal cones may facilitate reconstructions of severe bone defects during revision total knee arthroplasty (TKA), but there remains a paucity of data on their outcomes at mean 5 years of follow-up. This study reports the component survivorship, patient satisfaction, functional outcomes, radiographic osseointegration, and complications of revision TKA with porous tantalum metaphyseal cones at mid-term (mean 5-year) follow-up. MethodsThis study included 152 patients who had a mean age of 66 years (range, 33 to 86 years) undergoing revision TKA with porous tantalum metaphyseal cones. Indications for surgery included aseptic loosening (n = 87, 57.3%), second-stage reimplantation for infection (n = 42, 27.6%), osteolysis with well-fixed components (n = 20, 13.2%), and periprosthetic fracture (n = 3, 2.0%). Component survivorship, clinical outcomes, radiographic outcomes, and any complications were recorded. The mean follow-up time was 5.6 years (range, 2.2 to 13.7). ResultsSurvivorship was 100% when the end point was revision of the metaphyseal cone (no cones were revised) and 83.8% (95% confidence interval: 77.9 to 90.2%) when the end point was reoperation for any reason at 5-year follow-up. Reoperations were performed for infection (n = 10), instability (n = 4), periprosthetic fracture (n = 2), and quadriceps rupture/dehiscence (n = 3). The mean patient satisfaction score was 78.8 ± 11.3 and the mean Forgotten Joint Score was 62.2 ± 16.7 at the final follow-up. The preoperative median University of California at Los Angeles score improved from 2 (interquartile range 2 to 3) to 6 points (interquartile range 5 to 6) (P < .001), and the preoperative Oxford knee score improved from 15.2 ± 3.8 to 39.4 ± 5.1 points (P < .001) at the final follow-up. All metaphyseal cones showed radiographic evidence of osteointegration without any subsidence or loosening. ConclusionsPorous tantalum metaphyseal cones enabled robust reconstructions of severe femoral and tibial bone defects during revision TKA. These reconstructions were associated with excellent survivorship, improvements in functional outcomes, and reproducible radiographic osseointegration at mean 5-year follow-up. The most common reasons for reoperation were infection and instability.

Assessment of Quality of Pain and Patient Satisfaction using ASSIST Questionnaire Following Intraperitoneal Instillation of Ropivacaine Compared with the Addition of Adjuncts Ketamine versus Dexmedetomidine in Laparoscopic Cholecystectomy patients

Assessment of Quality of Pain and Patient Satisfaction using ASSIST Questionnaire Following Intraperitoneal Instillation of Ropivacaine Compared with the Addition of Adjuncts Ketamine versus Dexmedetomidine in Laparoscopic Cholecystectomy patients

Characteristics and outcomes of patients enrolled in the Connect 360 benralizumab patient support programme in the UK: a retrospective cohort study

BackgroundPatient support programmes (PSPs) allow patients with chronic diseases to receive treatment and support at home. This study describes the Connect 360 PSP delivery and impact on patient-reported outcomes, satisfaction...

The transverse upper gracilis flap for autologous breast reconstruction: patient satisfaction outcomes from a single centre experience.

The transverse upper gracilis (TUG) flap procedure is an alternative procedure for autologous breast reconstruction, that is indicated in patients with a low body mass index (BMI) and small to moderate sized breasts. We investigated patient satisfaction of all TUG flap breast reconstructions at Royal Free Hospital. A retrospective review of all patients who had undergone a TUG flap procedure was performed using Electronic Patient Records between October 2010 and October 2021 in Royal Free Hospital. We collected patient demographic data and surveyed our cohort by telephone, investigating patient satisfaction with a 31-item questionnaire. From 2010 to 2021, 57 TUG procedures for autologous breast reconstruction were carried out on 36 patients. One patient died 6 years postoperatively. Patient age ranged from 29-74 with an average of 49.5 years. Also, 3/57 flaps failed, and 1 patient died 6 years postoperatively. Twenty one out of 35 patients responded to the telephone call survey. Out of the survey respondents 11/21 underwent unilateral breast reconstruction and 10/21 underwent bilateral breast reconstruction. The BODY-Q scale in appraisal of thighs reported an overall patient satisfaction mean score of 75.6±27.4 points. The BREAST-Q scale in breast satisfaction reported an overall patient satisfaction mean score of 61.5±24.1 points. Overall, 19/21 of patients were satisfied with the outcome of the TUG procedure. Royal Free Hospital reported excellent patient satisfaction scores. The TUG procedure is a suitable method for patient's undergoing autologous breast reconstruction. However, patient expectations regarding breast satisfaction should be managed.

Efficacy of Eutectic Mixture of Local Anesthetics (EMLA) Versus Ice as Topical Anesthetics Prior to Long Buccal Nerve Blocks: A Prospective Comparative Study.

Background Dental extraction is one of the common procedures in the field of dentistry. However, fear and anxiety about local anesthetic injections are unavoidable for most patients.Topical anesthetics, distraction techniques, acupuncture, and the application of heat or cold have been used in practice to alleviate injection-related pain. The specific aim of this study was to compare the pain-relieving efficacy of eutectic mixture of local anesthetics (EMLA) vs. ice during the administration of a long buccal nerve block (LBNB) before dental extraction. Materials and Methods In total, 20 healthy adult patients who required bilateral mandibular posterior teeth extraction under local anesthesia were enrolled.The study was conducted in the Department of Oral and Maxillofacial Surgery, Saveetha Dental College and Hospitals, Chennai, from January 2023 to May 2023. It was a prospective split-mouth study in which each participant was divided into two groups according to the operative site: Group 1, which received a 5% EMLA cream, and Group 2, which received an application of ice before administration of LBNB. There was a one-week interval between the two interventions. The levels of pain and satisfaction were assessed using the visual analogue scale (VAS) and pain perception was evaluated by the sound, eye, motor (SEM) scale. Mann-Whitney U test was applied for the statistical analysis. Results The study included a total of 20 participants, with 14 being male and six being female. The mean age of the study population was 42 ± 15 years. When analyzing the pain scores using the VAS, it was found that Group 1 had a mean score of 2.4 ± 0.44, while Group 2 had a mean score of 3.0 ± 0.44. This differencebetween the two groups wasstatistically significant (P = 0.001). It was also found that the mean patient satisfaction score for Group 1 was 9.8 ± 0.22 and for Group 2 was 9.2 ± 0.40 which wasstatistically significant (p = 0.003). Similarly, Group 1 had a mean SEM score of 1.1 ± 0.1, while Group 2 had a mean SEM score of 1.30 ± 0.46 which was also statistically significant (P =0.016). Conclusion The study results revealed that EMLA has asignificant advantage over ice in terms of lower levels of pain, more patient satisfaction, and higher comfort levels.EMLA can be considered the first choice of topical anesthetics, however, ice is recommended in resource-constrained dental set-upsas it is cost-effective.

Patient and Family Satisfaction in the Intensive Care Unit of a Quaternary Care Center.

The study was a cross-sectional survey of adult patients and families treated between December 1, 2022 and April 30, 2023 in the ICU at Pakistan Kidney and Liver Institute and Research Center (PKLI-RC), Lahore, Pakistan. We used family satisfaction in ICU 24 (FS-ICU 24) to measure satisfaction in a number of domains on a scale of 1-5 (1 = Very Dissatisfied, 5 = Fully Satisfied). Of the 330 patients admitted to ICU during the study period, all patients and/or one of their family members (100%) participated in the study. Out of these, 209 (63%) were male. The mean age was 42 ± 15 years, and the overall mean patient and family satisfaction scores were 4.69 ± 0.69 and 4.55 ± 0.52, respectively. The mean score in all domains was > 4, with the exception of pain management in which it was 3.98 ± 0.53. Patients and their families' satisfaction is an important measure of ICU quality. Not only the patients and their families were satisfied with our ICU quality of care but they also appreciated involvement in the decision-making process and quality assessment. There is a need for further research for improvement in the pain domain.

Outcomes of Surgically Treated Purely Ligamentous Stage II Lisfranc Injuries.

Low-energy stage II Lisfranc injuries are rare, and treatment can be operative or nonoperative based on a surgeon's assessment of midfoot stability. No previously published patient-reported outcome measures (PROMs) data for Lisfranc injuries isolates purely ligamentous stage II injuries. The purpose of this study was to analyze PROMs for patients who underwent operative management of stage II Lisfranc injuries. Thirty-nine patients (39 feet) with confirmed Nunley-Vertullo stage II Lisfranc injuries between May 2012 and February 2022 were identified through a retrospective chart review. PROMs that were analyzed were the visual analog scale (VAS) pain scale, Veterans RAND 12-Item Health Survey (VR-12), Foot and Ankle Ability Measure (FAAM), and patient satisfaction. Thirty-two open reduction internal fixations (ORIFs) and 7 fusions were performed. The mean latest follow-up was 44.6 (range, 12-92) months. There were 2 complications (5%, 2/39) that required a revision procedure. Twenty-six patients (67%, 26/39) underwent secondary surgery to remove retained hardware. The mean time to hardware removal was 3.97 (range, 2.70-7.47) months. The overall mean patient satisfaction score with overall medical care including clinical visits and interactions with medical staff personnel was 93.6/100. All PROMs (VAS, VR-12, FAAM) demonstrated statistically significant improvement (P < .05) from preoperative (injury) values to latest follow-up postinjury values. Patients who were treated surgically with stage II purely ligamentous Lisfranc injuries via the methods used were found to mostly undergo hardware removal and have high levels of overall satisfaction with their process of medical care. Level IV, retrospective case series.

An Evaluation of the Efficacy and Acceptability of Basal Implants in Traumatically Deficient Ridges of the Maxilla and the Mandible.

Background and objective Rehabilitation of edentulous jaw areas is a complex procedure that has witnessed numerous advancements in technique and materials for better functional and aesthetic outcomes over the years. Dental implants have emerged as a cutting-edge, cost-effective, and non-invasive alternative to traditional removable partial dentures (RPDs), fixed partial dentures (FPDs), and full dentures. In this study, the basal implant was tested in traumatically deficient ridges on the mandible and the maxilla to determine its effectiveness and acceptability. Materials and methods The purpose of this research was to determine whetherbasal implants might be successfully used to restore traumatized ridges in the maxilla and mandible. Eleven individualsaged 20-55 years participated in the trial, and a total of 30 implants were used. All patients were evaluated for pain, soft tissue health around the basal implant, and patient satisfaction, with follow-ups on the third dayand at threeand six months postoperatively. Results The mean pain score measured using the visual analog scale(VAS)of patients during follow-ups was 2.00 ±1.15 on the third day, 0.40 ±0.84 at three months, and 0.00 ±0.00 at six months postoperatively. The mean gingival index score of patients was 1.30 ±0.48 on the third day, 0.10 ±0.31 at three months, and 0.00 ±0.00 at six months postoperatively. The mean patient satisfaction score was 34.77±5.54 on the third day, 41.11 ±6.27 at three months, and 40.7 7±10.91 at six months postoperatively. The mean immediate postoperative marginal bone levelwas 12.33 ±2.26 mm, and it was 10.85 ±2.29 mm after six months postoperatively. The mean preoperative crestal bone level was 10.76 ±1.77 mm and it was 9.70 ±1.79 mm after six months postoperatively. Conclusion Due to the fact that basal implantology does not involve extensive augmentation procedures necessary for the placement of conventional implants, it plays an important role in the rehabilitation of edentulous maxillary and mandibular arches, especially intraumatic, moderate to severely atrophic maxillary and mandibular arches.

Predicting factors of patient satisfaction after varicose vein surgery at a university hospital in Nepal

IntroductionVaricose veins are a common vascular problem with a high prevalence, yet they are often neglected. The main objective of this study was to explore the patient satisfaction after varicose vein surgery, along with its predicting factors. To our knowledge, no similar study has been conducted in Nepal to date. MethodologyThis retrospective cross-sectional study included patients who underwent varicose vein surgery at Dhulikhel Hospital from September 2019 to February 2020. The satisfaction level after the surgery was assessed using a 10-point Likert scale questionnaire during a telephone interview with their verbal consent. Descriptive statistics and linear regression were performed to identify the predicting factors of patient satisfaction. ResultsAmong a total of 84 patients interviewed, 53.6% were male. The mean age of the participants was 43.13 ± 13.62 years. The mean patient satisfaction score was 42 ± 5.5, with nursing service, discharge teaching and hospital service being the highest scoring items in terms of patient satisfaction. Linear regression revealed age ≤40 years as a predictor of higher patient satisfaction (β=0.258, p=0.015) while early stage of varicose veins (β=-0.233, p=0.026) and duration of post-operative follow-up (β=-0.25, p=0.021) were negative predictors of patient satisfaction. This means that patients with C2-C3 venous disease and longer duration of postoperative follow-up tended to have lower satisfaction scores. ConclusionThe overall patient satisfaction following varicose vein surgery was very good, and the major predictors of better satisfaction were age ≤40 years, C4-C6 clinical classification of venous disease and the shorter duration of follow-up after surgery.

Eight Hours Versus twenty four hours Postpartum Magnesium Sulphate for Prophylaxis in Women with Pre-Eclampsia

Aim: To compare the outcome of 8 hours versus 24 hours postpartum magnesium sulphate for eclampsia prophylaxis in women with moderate to severe pre-eclampsia. Study design: Randomized control trial Place and duration of study: The study was conducted in Gynecology and Obstetrics Department, MCH -1, PIMS Hospital, Islamabad from August 2020- Jan 2021 Methodology: After getting approval from hospital ethical committee and informed consent from patients the randomized controlled trial was conducted. The sample size was calculated by using WHO sample size calculator and total sample size was 108 patients that were selected after fulfilling of selection criteria. Complete history, physical examination, laboratory investigations and sonographical evaluation was performed for the selected women. The selected women were randomly assigned to either group A or B using a random list developed by lottery method. Group A received MgSO4 for 8 hour (8micro drops/min) and Group B received MgSO4 for 24 hours only (8micro drops/min). The primary outcome was occurrence of eclamptic fits and secondary outcomes were ambulation time, initiation of breast feeding, patient’s hospital stay and patient satisfaction in both groups. Data was analyzed by using SPSS version 21.0. P-value &lt;0.05 was considered significant Results: Women in both groups had similar demographic profile. Baseline patients’ characteristics (systolic BP, diastolic BP, Hb, ALT and uric acid, urinary protein) were also similar in both groups. Main symptoms were headache, blurred vision and epigastric pain in both groups Eclamptic fits in the first 72 hours were not observed in both groups. In group A patients, mean ambulation time was 10.6±1.1 hours and in group B it was 18.8±7.5 hours (P=0.001). In group A patients, mean time to initiate breast feeding was 14.6 ± 1.9 hours and in group B it was 24.3±8.3 hours (P=0.001). In group A patients, mean duration of hospital stay was 2.8±0.43 days and in group B it was 3.4±0.49 days (P=0.001). In group A patients, mean patient satisfaction score was 8.9±1.1 and in group B it was 4.5±1.8 (P=0.001). Clinical implication:Less risk of side effects observed and less monitoring required. Conclusion:Both the dosing regimens were equally effective and eclamptic fits in the first 72 hours were not observed in both groups. Mean ambulation time, mean time to initiate breastfeeding and mean duration of hospital stay was significantly shorter in patient treated with MgSO4 for 8 hours compared to those treated with MgSO4 for 24 hours. Patients treated with MgSO4 for 8 hours demonstrated better satisfaction when compared to those treated with MgSO4 for 24 hours. Keywords: Postpartum magnesium sulphate, eclampsia, prophylaxis, pre-eclampsia. Ambulation time, Breastfeeding

A Comparative Study of Ultrasound-Guided Quadratus Lumborum Block and Transversus Abdominis Plane Block for Postoperative Analgesia Following Total Abdominal Hysterectomy.

Total abdominal hysterectomy (TAH) results in remarkable postoperative pain.Truncal nerve blocks like the quadratus lumborum (QL)blockand transversus abdominis plane (TAP) block are described to combat this pain. The aim of the present study was to compare the effectiveness of the QL block with the TAPblock in terms of numeric rating scale (NRS) scores as the primary outcome for postoperative pain in TAH. The secondary outcome was time of the first analgesic demand, totalanalgesic demandsrequiredin 24 hr, and patient satisfaction level. Seventy patientsofAmerican Society of Anesthesiologists(ASA) physical status classI andII, aged35-65 years with a body mass index (BMI) 18-30 kg/m2planned forelective TAH under spinal anaesthesiawere randomly allocated into two groups.Group Q received QL blockandGroup T received TAP block under ultrasound guidance with 40 ml of 0.25% bupivacaine ofwhich 20 ml was injected on either side. Demographic data of both groups was comparable. The NRS pain score was significantly lower in Group Qcompared to Group Tat the fourthand sixthhour. The mean first analgesic demand was significantlyearlyin Group Tcompared toGroup Q (5.69 ± 0.87 hr vs. 11.23 ± 2.22 hr) and total analgesic demands were significantly greater in Group T thanGroup Q. The mean patient satisfaction score was significantly highin Group Qcompared to Group T (5.8 ± 0.41vs. 4.74 ± 0.44). The combined posterior and anterior approach of the QL block may represent a more efficacious alternativeto the TAP block in patients afterTAH.Further studies are recommended to evaluate the ideal dose, volume and approach for the QL block.

Abstract P6-05-58: Comparing Patient-Reported Outcomes for Same-day Discharge and Inpatient Admission After Mastectomy

Abstract Background: Same-day discharge after mastectomy has been demonstrated to be safe in appropriately selected candidates. However, the association between same-day discharge after mastectomy and quality of life (QOL) is unclear. Patient-reported outcome (PRO) measures represent important indicators of QOL among patients undergoing treatment for breast cancer. In this study, we aimed to evaluate the effect of same-day discharge after mastectomy on PROs. Methods: We performed a retrospective review of a prospectively collected, longitudinal PRO registry of female breast cancer patients treated at an academic breast center between June 2019 and June 2022. Patients were invited to complete the BREAST-Q module, a validated PRO questionnaire measuring QOL domains such as psychosocial wellbeing, physical wellbeing, satisfaction with their surgeon, and satisfaction with their medical team. Preoperative and 2-week postoperative questionnaire responses were analyzed in this study. Patients who had a mastectomy with or without reconstruction were included in this analysis. Those who underwent immediate reconstruction with autologous tissue were excluded as these operations are not conducive to same-day discharge. Patients were divided into two groups: the first was discharged on the date of surgery while the second was admitted to the hospital for a minimum of one night. Clinical and demographic factors were collected from a review of the electronic medical record. The primary endpoints were mean satisfaction scores as well as differences between postoperative and preoperative scores for the psychosocial and physical wellbeing domains. T-tests were used to evaluate differences between groups. A multiple regression model was fit to adjust for the effects of relevant clinical and demographic factors. Results: A total of 104 patients within the registry underwent mastectomy during the study period and were offered questionnaires. Of these, 58 completed both the preoperative and 2-week postoperative questionnaire (56% response rate); 20 (34%) in the same-day discharge group and 38 (66%) in the inpatient admission group. The groups were similar in age, stage, American Society of Anesthesiologists’ classification group, body mass index, frequency of unplanned readmission or reoperation, and receipt of bilateral mastectomy, axillary lymph node dissection, post-mastectomy reconstruction, and neoadjuvant chemotherapy. Mean patient satisfaction scores and mean changes in psychosocial and physical wellbeing scores were similar between the groups 2 weeks after surgery (Table 1). After controlling for age, type of reconstructive operation, receipt of unplanned reoperation, and preoperative score, same-day discharge did not have a significant effect on satisfaction with the surgeon (Beta=-4.3, p=0.37), satisfaction with the medical team (Beta=0.2, p=0.97), physical wellbeing score (Beta=-0.1, p=0.99), or psychosocial wellbeing score (Beta=8.0, p=0.15). Conclusions: Patients who are discharged from the hospital on the same day of a mastectomy display similar levels of satisfaction with their care team and similar short-term trends in physical and psychosocial wellbeing compared to those who are admitted to the hospital. While further data are being accrued, these early results suggest patients tolerate same-day discharge after mastectomy well. Table 1 Patient-reported outcomes at 2 weeks after mastectomy for patients discharged on the date of surgery compared to those admitted inpatient Citation Format: Sudheer Vemuru, Kathryn Colborn, Laura Leonard, Victoria Huynh, Christodoulos Kaoutzanis, Justin Cohen, David Mathes, Nicole Christian, Gretchen M. Ahrendt, Christine M. Fisher, Simon Kim, Sarah Tevis. Comparing Patient-Reported Outcomes for Same-day Discharge and Inpatient Admission After Mastectomy [abstract]. In: Proceedings of the 2022 San Antonio Breast Cancer Symposium; 2022 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2023;83(5 Suppl):Abstract nr P6-05-58.

A non-randomized, controlled, interventional study to investigate the effects of community pharmacists’ cognitive behavioral therapy–based interventions on medication adherence and relevant indicators in patients with depression

BackgroundThe prevalence of depression is increasing in Japan. Pharmacists play an important role in helping patients use medicines effectively. Several studies had investigated the impact of community pharmacists on patient adherence to antidepressant therapy, and their results indicated that further study was warranted.MethodsThis study was conducted from June 2019 to May 2020 using a cluster non-randomized, open-label, parallel-group design. Four community pharmacy stores in Osaka and Hyogo Prefectures, Japan, participated in the study, and enrolled patients with unipolar depression. In the intervention group (IG), patients received cognitive behavioral therapy (CBT)-based medication support, and their medication adherence and adverse drug reactions were monitored by telephone. In the control group (CG), the pharmacists engaged in routine interactions with the study participants. Before participating in this study, the intervention-group pharmacists attended a 5-hour training session on CBT-based medication support. The primary outcome of this study was medication adherence, assessed using the Drug Attitude Inventory (DAI)-10. Secondary outcomes included the changes from baseline at 6 months in the following variables: the Patient Health Questionnaire (PHQ)-9 total score, the EQ-5D-5 L (Euro-QOL 5 dimensions 5 levels) score, patient satisfaction, and the Pharmacists’ Confidence Scale about Medication Consultation for Depressive Patients (PCMCD) score.ResultsFour pharmacies (two in IG and two in CG) completed the intervention period. Results were obtained from 19 patients in the IG and 12 patients in the CG. In the IG, the mean DAI-10 score increased from 4.941 at baseline to 6.105, the mean PHQ-9 score decreased from 9.263 to 8.625, and the mean patient satisfaction score increased from 39.947 to 42.211. In the CG, the mean DAI-10 score decreased from 6.333 to 4.167, the mean PHQ-9 score increased from 9.333 to 12.923, and the mean patient satisfaction score decreased from 38.929 to 38.167.ConclusionCBT-based medication support provided by community pharmacists may improve patient medication adherence to antidepressant therapy and symptoms. Such support can be expected to facilitate better treatment of depressed patients and may also allow the duration of treatment to be shortened.Trial registrationUMIN000037954, Date of first registration: 17/06/2019.

Telemedicine in an Otolaryngology Clinic Serving the Incarcerated Population.

There is a paucity of data investigating the effect of implementation of telehealth on vulnerable populations, particularly the incarcerated. Our objective is to evaluate patient and physician satisfaction with telehealth (telephone visits) used in an outpatient otolaryngology clinic serving the incarcerated population. Incarcerated patients who were served by otolaryngologists via telephone visits from a large tertiary care center from June 2021 to January 2022 were included (n = 20) in this pilot study. Patient and physician satisfaction with the encounters were evaluated using the Telehealth Satisfaction Questionnaire and a modified physician satisfaction questionnaire, respectively. Consultations for various otolaryngological complaints were completed via telephone for incarcerated patients including hearing loss, tinnitus, facial fracture, dysphonia, and tonsillitis. Mean patient and physician satisfaction scores were high at 4.25 ± 0.12 and 4.65 ± 0.13 respectively (score range 1-5). Patient satisfactions subdomain scores were 3.92 ± 0.13 for quality of care provided, 3.99 ± 0.13 for similarity to face-to-face encounter, and 4.2 ± 0.17 for perception of the interaction. Imaging or audiogram was available prior to appointment in 60% of cases, with labs, imaging, or audiogram ordered after in 40% of cases and initial pharmaceutical treatment provided to 10% of patients. 45% of patients required follow up in-person, while 40% were discharged pro re nata, and 15% were followed up with another phone visit. There was no statistically significant association between demographic or clinical characteristics and patient or physician satisfaction scores. Consultations for various otolaryngological complaints were completed via telephone with high patient and physician satisfaction within an incarcerated population in this pilot study. Telephone visit is likely a feasible alternative format that can advance otolaryngological care. Studies with larger sample sizes are required to ensure quality of care and advance social justice for this chronically underserved population.

Treatment of bipolar clavicle injury with internal plating: a case series and literature review

BackgroundBipolar clavicle injury is a rare injury involving any combination of dislocation and/or fracture at both ends of the clavicle. Most reports of bipolar clavicle injury have been based on a single case, and treatment of this injury remains controversial. The present study was performed to evaluate the efficacy of surgical management with internal plating for bipolar clavicle injuries.MethodsWe performed internal plating to treat seven consecutive bipolar clavicle injuries with different injury patterns from May 2013 to June 2021. A clavicle hook plate was used for five sternoclavicular joint injuries (including a revision surgery) and three acromioclavicular joint dislocations, a T plate was used for one sternoclavicular joint injury, and an anatomic plate was used for one distal clavicle fracture. At follow-up, radiographs were assessed for bone alignment, joint congruity, fracture union or malunion, and implant failure or migration. Clinical evaluation included determination of the Disability of the Arm, Shoulder, and Hand (DASH) score; Constant–Murley score; visual analog scale (VAS) score; and complications.ResultsThe patients were regularly followed up after the operation, and functional parameters were assessed over time. At a mean follow-up of 28.1 ± 22.0 months, each fracture had solid bone union, and each dislocation showed no sign of recurrent instability. The mean shoulder forward flexion was 159.3° ± 7.9°, and the mean DASH score was 8.8 ± 5.1. The mean Constant–Murley score was 88.9 ± 7.9, with six cases assessed as excellent and one case assessed as good. The mean VAS score was 1.0 ± 1.5, and the mean patient satisfaction score was 9.3 ± 0.8. No complications occurred, and each patient was able to resume their preinjury daily activity and was highly satisfied with their treatment.ConclusionsIn the present study, internal plating for bipolar clavicle injury allowed early mobilization and resulted in good joint function. We recommend fixation of the more severely affected side first because the other side may be passively reduced and acquire stability once the more severely affected side has been fixed. Internal fixation of the other end may therefore be unnecessary unless residual instability exists.

Botulinum toxin-A in the treatment of upper facial wrinkles: efficacy comparison of different formulations

Objective: It is suggested that different formulations of botulinum toxin-A (BoNT-A) used for the same indication might be a factor affecting patient satisfaction. This study aimed to assess patient satisfaction levels in treating upper facial wrinkles (UFW) using various BoNT-A formulations and their association with age and gender. Materials and Methods: This retrospective study included 600 UFW patients treated with different formulations of BoNT-A. The BoNT-A formulations included three different groups: onaBoNT-A (ONA, n:200), aboBoNT-A (ABO, n:200), and praBoNT-A (PRA, n:200).In the patient files or records, satisfaction levels from the BoNT-A application were scored as follows: 1: not satisfied, 2: slightly satisfied, 3: satisfied, 4: very satisfied, 5: completely satisfied. Results: The mean patient satisfaction scores were similar in the ONA and ABO groups, but higher in the PRA group (4.4±0.5 vs. 4.3±0.6 vs. 4.0±0.9, P &lt;0.001, respectively). The mean satisfaction score of the patients aged 18-30 and those aged &gt;60 were lower than the other age groups. Among all patients in the 41-50 age range, the patient satisfaction score was higher in the ONA group than the ABO and PRA group. In all female patients, the mean satisfaction score was lower in the PRA group compared to the ONA and ABO groups (P &lt;0.001), Conclusions: While various BoNT-A formulations are generally associated with high patient satisfaction in the treatment of UFW, this can vary depending on age ranges and gender. Evaluating patient-related factors such as age and gender can contribute to the treatment planning for UFW and enhancing treatment adherence.