Positive Patient Satisfaction Research Articles

Enhanced Transconjunctival Lower Blepharoplasty: A Novel Method for Intraorbital Fat Transposition and Stabilization.

The evolution of lower blepharoplasty has shifted from simply removing of orbital septum fat to smoothing of the lid-cheek junction through fat repositioning. This paper adopts a novel technique to transpose and stabilize intraorbital fat during transconjunctival lower blepharoplasty. The tear trough and nasal alar base were filled to correct the pouch while ensuring the blood supply of the fat flap. Between September 2019 and June 2022, 104 patients aged between 22 and 49 who underwent bilateral fat flap transposition-nasal alar base filling lower blepharoplasty were selected. The surgical results were assessed by non-operative plastic surgeons according to the Hirmand grading system. Moreover, a self-satisfaction survey was conducted and patients were followed up for at least 6months to evaluate any complications and surgical outcomes. A high-frequency ultrasound imaging system was used to assess the degree of filling of the tear trough and nasal alar base. All 104 patients were followed up for at least 6months. The postoperative Hirmand grade was 0 for 96 out of 104 (92.3%) patients. In terms of self-satisfaction assessment, there were 92 out of 104 (88.5%) patients reported satisfaction. Dermatologic ultrasound showed no obvious gaps 6months after surgery. Transconjunctival fat flap transposition combined with nasal alar base filling during lower blepharoplasty has been shown to have a positive postoperative effect and high patient satisfaction. This procedure can preserve the blood supply of the fat flap, reduce the rates of fat absorption and denaturation, and improve facial contour, resulting in a satisfactory repairing effect. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Beyond shoulder arthroplasty: Applications of 3D printed patient-specific instrumentation in shoulder and elbow procedures – a systematic review

PurposeAdvancements in 3D printing technology have led to a growing interest on its application in orthopedic surgery. In the context of shoulder and elbow surgery, studies on 3D printing mostly center on surgical guides for the placement of the glenoid component in shoulder arthroplasty, but applications in non-arthroplasty procedures remain unclear. This systematic review aims to evaluate and summarize the literature on the current applications and clinical outcomes of 3D Patient-Specific Instruments (3DPSI) in non-arthroplasty procedures. We expected to find a predominant focus on corrective osteotomies with positive clinical outcomes and minimal complications. MethodsThis systematic review adhered to PRISMA guidelines. Eligibility criteria included original research studies presenting primary data on 3DPSI for shoulder and elbow procedures. Exclusions were applied to studies exclusively reporting clinical data on 3DPSI for glenoid component placement in shoulder arthroplasty. A comprehensive literature search was conducted in PubMed/MEDLINE, Scopus, MedNar, Google Scholar, OAIster, and ProQuest Dissertations & Theses. Extracted data included study characteristics, 3DPSI development details, and clinical outcomes. Risk of bias was assessed using MINORS criteria. ResultsOut of 845 initially identified records, the final analysis included 20 studies. Regarding the application of 3DPSI, 35 % of the reports addressed cubitus varus osteotomy correction, 30 % focused on clavicle malunion or nonunion, and 15 % centered on corrective osteotomies for proximal humerus malunion. Risk of bias assessment using MINORS criteria demonstrated a mean score of 9.11 out of 16 for studies without a comparator group. Results across different pathologies revealed high patient-reported outcomes (PROs), good patient satisfaction, and minimal complications, which are presented. ConclusionIn non-arthroplasty shoulder and elbow procedures, 3D Printed Patient-Specific Instrumentation have been mostly used for corrective osteotomies and demonstrates overall positive outcomes, low complications, and high patient satisfaction. Advancement in existing knowledge requires robust studies with larger cohorts and comparator groups. Level of EvidenceLevel IV. Clinical RelevanceThis study, summarizing existing data on 3D Patient-Specific Instruments (3DPSI) in non-arthroplasty shoulder and elbow procedures, offers guidance for future applications and research in this evolving field of orthopedic surgery.

Interprofessional care for temporomandibular joint disorders: the patient’s perspective

The Indiana University School of Dentistry TMJ Institute is a multidisciplinary clinic designed to support the management of patients with challenging temporomandibular disorders. Professionals across dentistry, medicine, physical therapy, and social work collaborate to create a customised, interprofessional consensus to patient care. Compared with traditional, siloed healthcare models, are patients diagnosed with TMJ dysfunction satisfied with the quality of care received from an interprofessional approach? The objective of this study is to determine the level of patient satisfaction at the Institute using a 5-Point Likert scale patient questionnaire. A total of 93 questionnaires were distributed and 84 were collected. A total of 43% of patients travelled over 50 miles to be seen at the Institute. ‘Strongly agree’ was the most selected response for each prompt. The exception was whether patients preferred to meet with each clinician individually, to which ‘strongly disagree’ or ‘disagree’ was the most popular response, indicating that an interprofessional approach was preferred. The results and comments provided by patients revealed that most patients diagnosed with TMJ dysfunction were highly satisfied with the interprofessional approach used at the TMJ Institute. Our study suggests that positive patient satisfaction is an important factor in assessing the quality and efficacy of interprofessional, patient-centred clinic models.

Evaluating Patient Satisfaction With Nurse-Led Wound Care Services

Background: The increasing incidence of chronic wounds, combined with the high number of patients requiring hospital services, has led to the concept of nurse-led wound care clinics to support general practitioners in the treatment and management of wounds. Aim: This study aims to assess patients’ perception of, and satisfaction with, wound care services in a tertiary healthcare setting in Riyadh, Saudi Arabia. Methods: The study utilised a cross-sectional descriptive design and was conducted between September 2022 and October 2023, and data were collected via a client satisfaction questionnaire (CSQ-8). Results: Our findings revealed very positive responses overall. Considered together (response options 4 and 3), a majority of respondents (91.3%) rated the quality of service they received as “excellent” or “good”, and 85.6% reported receiving the kind of service they wanted. Regarding overall satisfaction, 92.5% of respondents reported being “very satisfied” or “mostly satisfied” with the overall service they received. Conclusion: This study reveals positive patient satisfaction with overall wound care services. However, there remains weakness in certain areas. This could be understood in more detail by conducting a qualitative study, so that action maybe taken to further improve the quality of healthcare services provided to patients.

Electromyographic Evaluation of Masseter and Temporalis Muscle Activity in Distal Extension Edentulous Patients After Replacing with Implants—A Prospective Clinical Trial

Aim: To assess the changes in muscle activity after replacing the missing teeth or teeth with implants in distal extension edentulous patients and to evaluate the patient’s satisfaction levels. Materials and Methods: This was a single-group experimental study, based on convenience sampling with a sample size of 40 patients. Only unilateral mandibular distal extension edentulous sites were included and endo-osseous dental implants were placed in delayed protocol. Electrical activities of the masseter and temporalis muscles were recorded at rest and clench before, immediately, and one month after the cementation using electromyography. Patient satisfaction was analyzed through a questionnaire. Descriptive statistics an inferential statistics with repeated measures of ANOVA followed by the Bonferroni post hoc test were done to analyze the study data. P value < .05 would be considered statistically significant for all the analyses. Results: Right temporalis showed significantly higher surface electromyography (sEMG) activity at one-month post cementation than baseline at rest and clench. Similarly, the left temporalis has shown significant sEMG activity at one-month post cementation than baseline at clench. However, there was no statistical difference with the right and left masseter. The implant-supported prosthesis was well received by the majority of patients. Conclusion: Definitive improvement in the electrical activity of the temporalis before and after the replacement of prosthesis was noticed with positive patient satisfaction levels with implant-supported prosthesis.

Exploring the Influence of Decisionmaking Style and Financial Status of Cancer Patients on Varied Cultural Aspects of Decision Process

Though many studies have linked shared decision-making with positive patient outcomes and patient satisfaction, there is less research on the practicality and feasibility of such an approach, specifically, in India. Recent findings indicate that contextual constraints of the patients and family caregivers are fused with and inevitably shape their decision-making style. This study investigates the influence of individual (paternalistic and shared decision-making style) and contextual (financial status of the patients) factors on certain cultural aspects of decision process, namely, trust in doctors, patient’s agency, emotional distress and attribution of responsibility. Data were collected using a survey questionnaire from a sample of 306 participants. Linear mixed models were used to analyse the responses. The results indicate that a shift towards shared approaches does yield qualitatively superior outcomes in terms of increased trust in doctors and patients’ agency along with reduced emotional distress. The study also emphasises the role of cultural metaphysical beliefs in attributing responsibility for treatment decisions. Further, low financial status was found to be associated with higher trust in doctors, lower patient agency, and increased emotional distress for both patients and family caregivers. The move towards shared decision-making, considering the contextual realities of patients, could be instrumental in addressing critical issues, such as prevalence of collusion, superficial role of informed consent, and high reliance on doctors’ authority or expertise.

Streamlining lung cancer management in Nova Scotia amid COVID-19: pooled triaging for expedited curative-intent oncologic surgery.

The effect of the COVID-19 pandemic on the diagnosis and management of lung cancer in Canada is not fully understood. We sought to quantify the provincial volume of diagnostic imaging, thoracic surgeon referrals, time to surgery after referral, and pathologic staging for curative surgery in the context of the pandemic, as well as explore the effect of a pooled patient model, which was implemented to prioritize surgeries for lung cancer and mitigate the effects of the pandemic. We conducted a retrospective cohort study of patients who underwent diagnostic imaging in Nova Scotia and were subsequently referred to a thoracic surgeon at the province's only tertiary care centre for surgical management of their primary lung cancer before (Mar. 1, 2019, to Feb. 29, 2020) and during (Mar. 1, 2020, to Feb. 28, 2021) the COVID-19 pandemic. We conducted a survey to capture the patient and surgeon experience with a pooled patient model of managing surgical oncology cases. Compared with the pre-COVID-19 period, the overall volume of chest radiography and chest computed tomography decreased by 30.9% (p < 0.001) and 18.7% (p = 0.002), respectively, in the COVID-19 period. Thoracic surgeon referrals, operative approach, extent of resection, length of hospital stay, and pathologic staging did not significantly differ. Time from referral to surgery was significantly shorter during the COVID-19 period (mean 196.8 d v. 157.9 d, p = 0.04). A pooled patient approach contributed to positive patient satisfaction. The COVID-19 pandemic was associated with reductions in rates of diagnostic imaging and referrals to thoracic surgeons for management of pulmonary cancer. A pooled patient model was used to mitigate the effects of the pandemic on lung cancer management and was positively received by patients. An extended study period is needed to determine the full effect of this redistribution of resources.

The Mediating Effect of Patient Satisfaction in The Effect of Service Quality on Patient Loyalty

Background: Pharmaceutical services are a form of health service that directly connects patients with pharmaceutical preparations. The quality of service greatly determines the level of patient satisfaction. Service quality and patient satisfaction are factors that influence patient loyalty. Method: The data analysis technique that will be used to test this research uses the Partial Least Square (PLS) method which is operated using SMARTPLS 4.0. Results: Service quality has a significant effect on patient satisfaction and patient loyalty, patient satisfaction has a significant effect on patient loyalty, and service quality has a significant effect on patient loyalty which is mediated by patient satisfaction. Conclusion: When a hospital provides better quality service than before, it will have an impact on high patient satisfaction and patient loyalty. The more positive patient satisfaction is, the more patient loyalty will increase. When service quality is improved, a positive perception of patient satisfaction arises, which can encourage increased patient loyalty.

Satisfação dos pacientes atendidos em Clínica de Atenção Básica Odontológica

ABSTRACT The interaction between dental students and patients is essential for practical and realistic learning, providing community services, and establishing a dental school clinic. Simultaneously, studies on public healthcare user satisfaction are crucial, contributing to corrective measures planning based on obtained information. The study aimed to understand the demographic and economic profile of patients treated at the Basic Dental Care Clinic of a public university and to assess patient satisfaction with the services and infrastructure. A cross-sectional observational study was conducted, collecting socioeconomic and general health data from patients through dental anamnesis. Validated questionnaires were used: Questionnaire for User Satisfaction with Public Oral Health Services, covering seven quality dimensions, and the Pompeu Questionnaire, addressing dental care aspects. Responses were tabulated for descriptive statistical analysis. Results: Questionnaire for User Satisfaction with Public Oral Health Services results indicate high patient satisfaction in various dimensions, such as human relations, treatment effectiveness, accessibility, and technical-scientific quality. The Pompeu Questionnaire reinforces these findings, emphasizing the students’ and professors’ receptiveness, effective guidance on oral care, and a high clinic recommendation rate by patients. In summary, both questionnaires reveal an overall positive patient satisfaction. In the study’s context, the majority of patients treated in the mentioned clinic expressed satisfaction with the physical structure, service, and dental treatment offered.

Nurse-delivered endothermal venous ablation: 12 years’ experience at a single UK centre

Background: Despite new evidence supporting early assessment and intervention for patients with venous disease, there remain significant barriers to service delivery in the UK. The aim of this report is to describe the innovative delivery of a venous service through advanced nursing practice. Single-centre data are presented from 12 years of nurse-delivered venous interventions. Methods: An existing nurse specialist was trained to (1) receive and vet referrals, (2) assess patients and (3) perform endovenous laser ablation (EVLA) and foam sclerotherapy. Consultant surgeons provided mentoring and assessment over a 10-month period, with ongoing team support thereafter. Qualifications were obtained in medical ultrasound and prescribing. Procedures were performed under local anaesthesia in a clinical treatment room setting. Audit data were maintained throughout. Complications were reported via risk management systems. Results: Between 2012 and 2023, 6655 referrals were vetted and, of these, 3710 (56%) were seen and assessed. Of the 3710 assessed, 2148 (58%) patients (median (IQR) age 51 (40–53) years, 55% female) underwent nurse-delivered EVLA of the great (84%) or small (16%) saphenous vein. Complications were recorded for 25 cases (1.2%). Median waiting time before the nurse-delivered service was 53 weeks (2011). Across the reported period of nurse-delivered service, this reduced to a median of 17 weeks. In 2023, median (IQR) waiting time for the venous leg ulcer cohort was 7 (3–11) weeks. Early follow-up showed vein closure rates of 95%. High levels of patient satisfaction were recorded: where a score of 10 was most satisfied, the median (IQR) satisfaction score for clinical outcome was 8 (6–8) and satisfaction with a nurse-delivered service was also 8 (7–8). Conclusions: The venous service within this single UK centre is being delivered through advanced nursing practice, improving waiting times and access to intervention. A significant efficiency in consultant surgeon time is being realised, increasing the capacity of the vascular unit. A low complication rate and positive patient satisfaction suggests that nurse-delivered EVLA is a safe innovation in service delivery.

Association Between Online Reviews of Substance Use Disorder Treatment Facilities and Drug-Induced Mortality Rates: Cross-Sectional Analysis

Background Drug-induced mortality across the United States has continued to rise. To date, there are limited measures to evaluate patient preferences and priorities regarding substance use disorder (SUD) treatment, and many patients do not have access to evidence-based treatment options. Patients and their families seeking SUD treatment may begin their search for an SUD treatment facility online, where they can find information about individual facilities, as well as a summary of patient-generated web-based reviews via popular platforms such as Google or Yelp. Web-based reviews of health care facilities may reflect information about factors associated with positive or negative patient satisfaction. The association between patient satisfaction with SUD treatment and drug-induced mortality is not well understood. Objective The objective of this study was to examine the association between online review content of SUD treatment facilities and drug-induced state mortality. Methods A cross-sectional analysis of online reviews and ratings of Substance Abuse and Mental Health Services Administration (SAMHSA)–designated SUD treatment facilities listed between September 2005 and October 2021 was conducted. The primary outcomes were (1) mean online rating of SUD treatment facilities from 1 star (worst) to 5 stars (best) and (2) average drug-induced mortality rates from the Centers for Disease Control and Prevention (CDC) WONDER Database (2006-2019). Clusters of words with differential frequencies within reviews were identified. A 3-level linear model was used to estimate the association between online review ratings and drug-induced mortality. Results A total of 589 SAMHSA-designated facilities (n=9597 reviews) were included in this study. Drug-induced mortality was compared with the average. Approximately half (24/47, 51%) of states had below average (“low”) mortality rates (mean 13.40, SD 2.45 deaths per 100,000 people), and half (23/47, 49%) had above average (“high”) drug-induced mortality rates (mean 21.92, SD 3.69 deaths per 100,000 people). The top 5 themes associated with low drug-induced mortality included detoxification and addiction rehabilitation services (r=0.26), gratitude for recovery (r=–0.25), thankful for treatment (r=–0.32), caring staff and amazing experience (r=–0.23), and individualized recovery programs (r=–0.20). The top 5 themes associated with high mortality were care from doctors or providers (r=0.24), rude and insensitive care (r=0.23), medication and prescriptions (r=0.22), front desk and reception experience (r=0.22), and dissatisfaction with communication (r=0.21). In the multilevel linear model, a state with a 10 deaths per 100,000 people increase in mortality was associated with a 0.30 lower average Yelp rating (P=.005). Conclusions Lower online ratings of SUD treatment facilities were associated with higher drug-induced mortality at the state level. Elements of patient experience may be associated with state-level mortality. Identified themes from online, organically derived patient content can inform efforts to improve high-quality and patient-centered SUD care.

Effectiveness and Safety of Burr Hole Evacuation in Chronic Subdural Hematoma Patients – Experience from a Low-Income Country

Background: In contemporary neurosurgery, burr holes are fundamental in cranial procedures, primarily for the evacuation of chronic subdural hematomas (CSDH). CSDH is prevalent, and its clinical course, though not life-threatening, carries morbidity and mortality risks. This study evaluates the effectiveness and safety of Burr Hole Evacuation (BHE) for CSDH, aiming to assess clinical outcomes, immediate postoperative complications, and patient satisfaction. Methodology: This retrospective cohort study analyzed data from patients who underwent BHE for CSDH between March 2015 and August 2023. Inclusion criteria encompassed well-documented CSDH diagnoses, comprehensive medical records, and primary BHE cases, excluding previous neurosurgical interventions and pediatric cases. Data included patient demographics, clinical presentation, imaging findings, surgical details, post-operative outcomes, and patient satisfaction. Analysis was performed using SPSS version 25. Results: The study included 86 patients, predominantly male (85%) with a mean age of 54 years. Clinical presentations varied, with headaches (85%) being the most common symptom. CT scans were pivotal for diagnosis, revealing hypodensities primarily over the convexity. BHE was performed without complications, resulting in favorable post-operative outcomes (93% significant recovery, 7% extended hospital stays). No intraoperative or post-operative mortality occurred, and there were no recurrent hematomas. Patient satisfaction with BHE was high (97%). Conclusion: BHE is a viable primary surgical intervention for CSDH in low-income settings, with positive outcomes, safety, and patient satisfaction. Further studies and collaborative efforts are essential to enhance neurosurgical treatment in these settings and explore long-term outcomes.

Can Antibiotic Stewardship Be Achieved by Utilizing the Stewardship Through Educating Patients (S.T.E.P.) Process?

Despite research and efforts to mitigate bacterial resistance, antibiotic overprescribing continues to occur, often due to real or perceived expectations of patients. Objective: The purpose of this study was to determine: (1) if there's an associationbetween the provider's patient education efforts and the patient'ssatisfaction, and(2) the research participant's subsequent behaviorconcerning antibiotic prescriptions, byutilizing the Stewardship Through Educating Patients (S.T.E.P.) process for positive prescriptive change.The S.T.E.P. programfeatures straightforward, simple education viaface-to-face counseling at patient encounters, along with presenting applicable printed educational pamphletsfrom the Centers for Disease Control and Prevention (CDC).These two interventions were utilized in this study with research participants from the healthcare provider, with education focused onappropriate antibiotic use in the treatment of adults diagnosed with common illnesses such as an upper respiratory infection (the common cold), acute sinusitis, and acute bronchitis, which oftentimes are viral in origin. This Quality Improvement (QI) interventional study utilized the researcher'sdirect face-to-facepatient education and CDC printed materials as a measure of antibiotic prescribing as a primary outcome, with patient satisfaction as a secondary outcome via convenience sampling of 40 hospital employees who utilized a free hospital-based employee healthcare clinic. Patient-teaching by this study'sresearcher, along with supplemental printed patient education material from the CDC thatwere given to research participants during an initial medical encounter, were effective interventions used in reducing antibiotic prescribing, as evidenced by a positive patient satisfaction in 95% of research participants. Antibiotic use in the treatment of adults diagnosed with common illnesses such as an upper respiratory infection (the common cold), acute sinusitis, and acute bronchitis, may be safely reduced by using a combination of patient-education and clinician intervention.

Three Pedicle-Based Nipple-Sparing Skin-Reducing Mastectomy Combined with Prepectoral Implant-Based Breast Reconstruction.

Nipple-sparing mastectomy (NSM) and immediate breast reconstruction have demonstrated positive aesthetic outcomes and high patient satisfaction. However, challenges arise when performing NSM on patients with large and ptotic breasts because of the higher risk of nipple-areola complex (NAC) necrosis. This study proposes a new technique: the three pedicle-based nipple-sparing skin-reducing mastectomy (TP-NSSRM), combined with direct-to-implant (DTI) breast reconstruction, aimed at reducing complications. A prospective study was conducted from November of 2021 to April of 2022, enrolling patients with large and drooping breasts requiring mastectomy for breast cancer treatment or risk reduction. Patient selection criteria included a sternal notch-to-nipple distance of greater than or equal to 23 cm, grade 3 ptosis, and eligibility for immediate prepectoral DTI breast reconstruction. Patient satisfaction was assessed using BREAST-Q modules. Seventy-two TP-NSSRM procedures combined with immediate DTI-based breast reconstruction were performed on a total of 45 patients. High patient satisfaction was observed, and statistically significant improvements were noted in postoperative BREAST-Q scores ( P = 0.001). The complication rate was low, and preservation of the nipple-areola complex was achieved in all cases. The TP-NSSRM technique offers a potential solution for patients with large and drooping breasts undergoing NSM. It aims to minimize complications and achieve satisfactory outcomes. This study demonstrates favorable results in terms of patient satisfaction and quality of life. Further research and long-term follow-up are necessary to validate these findings and evaluate the long-term outcomes of this technique. Therapeutic, IV.

Survivorship analysis of CAD-CAM total shoulder replacement.

Glenoid bone loss represents a challenge in shoulder arthroplasty and often precludes standard implants. The CAD-CAM total shoulder replacement (TSR) is an option in these cases. This study aimed to assess survivorship and long-term patient outcomes of the CAD-CAM TSR. Fifty-eight patients that underwent a CAD-CAM TSR by three surgeons at a single tertiary referral centre between 2009 and 2017 were reviewed. The mean follow-up was 70 months (28-130). Data was collected on survivorship, range of movement, Oxford shoulder score (OSS, 0-48), subjective shoulder value (SSV, 0-100%), pain score (0-10), and overall patient satisfaction. CAD-CAM TSR was undertaken as a primary procedure in 28% (n = 16) for end-stage arthritis with severe glenoid bone loss, and as a revision procedure in 72% (n = 42). Of the total, 17% (n = 10) required component revision at a mean of 24 months (4x prosthesis loosening, 3x infection, 3x periprosthetic fracture). Forward elevation improved from 45° ± 27° to 59° ± 29° (P = 0.0056), abduction from 43° ± 29° to 55° ± 26° (P = 0.034) and external rotation from 8° ± 11° to 16° ± 14° (P = 0.031). OSS improved from 15 ± 8 to 29 ± 9 (P = 0.0009), SSV from 18 ± 16 to 62 ± 23 (P < 0.0001), and pain score from 8 ± 2 to 2 ± 2 (P < 0.0001). 88% of patients would undergo the procedure again. CAD-CAM TSR is reserved for complex cases involving severe glenoid bone loss, offering significant improvements in pain and function with overall positive patient satisfaction.

The Effect of a Myomectomy on Myoma-related Symptoms and Quality of Life: A Retrospective Cohort Study

Although it is assumed that myomectomy improves uterine myoma-related symptoms such as pelvic pain and heavy menstrual bleeding (HMB), validated measures are rarely reported. This study aimed to verify the effect of myomectomy on myoma-related symptoms. A retrospective cohort study. A university-affiliated hospital. Our study included 241 patients with a myoma diagnosis and received a myomectomy between 2004 and 2018. Data were collected from the patient medical file and patients responded in 1 questionnaire. Transcervical resection of myoma (TCRM) and laparoscopic or abdominal myomectomy (LAM). One year after TCRM, a significant number of women experienced symptom improvement for pelvic pain (79% [19/24, p=.01]) and HMB (89% [46/52, p <.001]). For other myoma-related symptoms, abdominal pressure (43%, 10/23), sexual complaints (67%, 2/3), infertility (56%, 10/18), and other complaints (83%, 5/6), improvements were not statistically significant. One year after LAM, a significant number of women experienced symptom improvement for pelvic pain (80%, 74/93), HMB (83%, 94/113), abdominal pressure (85%, 79/93), sexual complaints (77%, 36/47), and other complaints (91%, 40/44). One year after myomectomy, 47% (30/64) (TCRM) and 44% of women (78/177) (LAM) described no myoma-related symptoms. Most women (82% [172/217]) were satisfied with the postoperative result after 1 year and 53% (114/217) would have liked to receive the myomectomy earlier in life. Average quality of life (measured on a 10-point Likert scale) increased from 6.3 at baseline to 8.0 at 1 year after TCRM and from 6.2 to 8.0 1 year after LAM, resulting in a difference of 1.7 points (p <.001; 95% confidence interval, 1.1-2.3) and 1.9 points (p <.001; 95% confidence interval, 1.4-2.3), respectively. One year after myomectomy, most women have benefited from myomectomy, concluded by a significant number of women who experienced myoma-related symptom improvement, positive patient satisfaction, and a significant improvement in reported quality of life. Validation of results after conventional treatment such as myomectomy is essential in counseling patients for surgical treatment in today's evidence based practice. In addition, it is necessary to make an adequate comparison with new treatment options for myomas. To provide this, further research should preferably be conducted prospectively or by randomization.

Patient satisfaction with pharmacist-led chronic care management services combined with medication synchronization.

Chronic care management (CCM) improves clinical outcomes, enhances patients' adherence with medical treatments, reduces overall cost, and increases patient satisfaction. However, multiple reports have indicated the underutilization of CCM. Implementation literature has emphasized feasibility and different approaches to providing pharmacist-led CCM. This article examines patient acceptability and provides an innovative implementation approach combining both CCM and medication synchronization (MedSync) services. To introduce CCM services to underserved Medicare beneficiaries at a federally qualified health center, the pharmacy department of a federally qualified health center (FQHC) pilot tested a program whereby pharmacists provided CCM to Medicare beneficiaries enrolled in the MedSync service offered by the FQHC's in-house pharmacies. Both services were provided during the same phone call by the pharmacist. After successful completion of the pilot program, a retrospective chart review and patient satisfaction survey were conducted to enhance the quality of the service. A total of 49 patients were enrolled in the CCM program at the time of data collection. Overall, participants were satisfied with the service. The average number of medications per patient was 13.7. Pharmacists were able to identify an average of 4.8 medication-related problems (MRPs) per patient. Most of the MRPs (62%) were resolved directly by the pharmacists via education, over-the-counter medication adjustments, or interventions under consult agreements. In addition to positive patient satisfaction, pharmacists were able to identify and address a significant number of MRPs when providing CCM.

P-023 PATIENT SATISFACTION AFTER INGUINAL HERNIA SURGERY: LITERATURE REVIEW OF AN OVERLOOKED PATIENT-REPORTED OUTCOME MEASURE

Abstract Aim Patient satisfaction after inguinal hernia surgery is currently underappreciated and not as well studied as other patient reported outcome measures (PROMs) on this topic. Our study aims to review the literature and summarize available data. Materials &amp; Methods A literature review was conducted using Medline focusing on patient reported satisfaction after elective, inguinal hernia surgery in adults (&amp;gt;18 years old). All inguinal hernia repair techniques were considered, but small sample sizes (&amp;lt;100 patients) and short follow-up periods (&amp;lt;6 months) were excluded. The methodology and results of the remaining articles were reviewed. Due to heterogeneity of reporting between articles, only a descriptive analysis was performed. Results The available data from 15 out of 358 articles was withheld for further analysis. Unfortunately it has become apparent patient reported outcome measures regarding satisfaction lack validation and yield considerable heterogeneity, as 53% of all included studies used an asymmetrical response questionnaire. Resulting in an overwhelmingly positive patient satisfaction, be it with wide ranges (78–100% more than averagely satisfied, compared to 0–15% less than averagely satisfied). The number of patients not willing to undergo inguinal hernia repair again ranges from 1–16. Conclusion Our study demonstrates patient reported satisfaction is not uniformly surveyed and remains unvalidated. Further research on patient reported satisfaction would benefit from standardization and validation, while using a symmetrical and balanced 5-point Likert or 11-point NRS scale at regular post-operative intervals with addition of open questions to evaluate patient satisfaction after inguinal hernia surgery.

Ambulatory Care Pharmacists' Perception of Telehealth Services in the Wake of the COVID-19 Pandemic: Identifying Barriers and Best Practices for the Older Patient and Beyond

Background Telehealth practice in the ambulatory care pharmacy setting has seen extensive expansion because of the COVID-19 pandemic. Historically, evaluations of pharmacy-driven telehealth services have shown positive patient outcomes and high patient satisfaction, but little was known about pharmacist provider satisfaction. Additionally, barriers to telehealth practice have been highlighted with the widespread expansion of telehealth. With the push to continue high rates of telehealth use postpandemic, evaluation of current ambulatory care pharmacist telehealth practices is needed. Objective This study aimed to evaluate ambulatory care pharmacists' perception of the telehealth services they provide, including barriers patients experience, solutions to address these barriers, and perceptions of the quality of care provided through telehealth. Methods Ambulatory care pharmacists in Washington State were recruited to participate in a 16-item key informant interview. The Technology Acceptance Model was the theoretical framework applied to the interview questions and used to evaluate common themes emerging from the interviews. Results Common themes from the interviews included positive and negative attributes to telehealth care, pharmacist preferences for a video telehealth platform, technology access and use barriers for patients accessing telehealth, technology support from the provider's organization as an avenue to address these barriers, and patient-specific characteristics allowing high-quality health care through telehealth. Conclusion Using these described common ideals, ambulatory care pharmacist telehealth best practices can be developed, including a personalized approach to this care. As we emerge from the COVID-19 pandemic, actively addressing common barriers as well as successfully identifying appropriate telehealth candidates will be essential in providing high-quality virtual care.

Ethics Considerations in Laws Restricting Incapacitated Patients' Access to ECT.

Electroconvulsive therapy (ECT) is a safe and effective treatment used for numerous psychiatric conditions. While many patients for whom ECT is indicated are able to give voluntary informed consent, some lack decision-making capacity (DMC), at least temporarily. Case reports from numerous countries involving ECT for patients who lack DMC indicate overall positive outcomes and high patient satisfaction with results comparable with those of consenting patients; some patients regain DMC with ECT. Laws and regulations pertaining to ECT vary widely around the world and across the United States. Many United States jurisdictions over-regulate ECT relative to other interventions with comparable risks and potential benefits. While laws restricting whether and under what circumstances patients who lack DMC may receive ECT likely are aimed at protecting incapacitated persons, such laws sometimes undermine important ethics obligations and should be re-evaluated.