Study Assessed Patient Satisfaction Research Articles

Multidimensional versus unidimensional pain scales for the assessment of analgesic requirement in the emergency department: a systematic review.

Pain is a multidimensional experience, potentially rendering unidimensional pain scales inappropriate for assessment. Prior research highlighted their inadequacy as reliable indicators of analgesic requirement. This systematic review aimed to compare multidimensional with unidimensional pain scales in assessing analgesic requirements in the emergency department (ED). Embase, Medline, CINAHL, and PubMed Central were searched to identify ED studies utilizing both unidimensional and multidimensional pain scales. Primary outcome was desire for analgesia. Secondary outcomes were amount of administered analgesia and patient satisfaction. Two independent reviewers screened, assessed quality, and extracted data of eligible studies. We assessed risk of bias with the ROBINS-I tool and provide a descriptive summary. Out of 845 publications, none met primary outcome criteria. Three studies analyzed secondary outcomes. One study compared the multidimensional Defense and Veterans Pain Rating Scale (DVPRS) to the unidimensional Numerical Rating Scale (NRS) for opioid administration. DVPRS identified more patients with moderate instead of severe pain compared to the NRS. Therefore, the DVPRS might lead to a potential reduction in opioid administration for individuals who do not require it. Two studies assessing patient satisfaction favored the short forms (SF) of the Brief Pain Inventory (BPI) and McGill Pain Questionnaire (MPQ) over the Visual Analogue Scale (VAS) and the NRS. Limited heterogenous literature suggests that in the ED, a multidimensional pain scale (DVPRS), may better discriminate moderate and severe pain compared to a unidimensional pain scale (NRS). This potentially impacts analgesia, particularly when analgesic interventions rely on pain scores. Patients might prefer multidimensional pain scales (BPI-SF, MPQ-SF) over NRS or VAS for assessing their pain experience.

Patient satisfaction with pharmaceutical services at primary healthcare centers under the Palestinian Ministry of Health

BackgroundThe measurement of patient satisfaction is a vital metric that enhances stakeholders to take proactive steps in improving the quality of healthcare services within medical care systems. This study assessed patient satisfaction receiving pharmaceutical services from primary health care centers in the Palestinian Ministry of Health (PMoH) governorate directorates in the West Bank.MethodsA total of 938 patients, all aged 18 years or older, completed a self-administered questionnaire. The assessment of general satisfaction was based on selected questions. Analyses were conducted to explore demographic characteristics. Mean and standard deviation (S.D.) were reported. Likert method was used to average scale satisfaction. To examine statistically significant differences, Chi-square analysis and binary logistic analysis were employed.Results56.8% of the survey respondents were women, 57.2% were 40 years or older, and 63.2% had graduated from high school. The general satisfaction score averaged 4.10 ± 0.77 indicating good satisfaction. Patients were satisfied with interpersonal relationships, with a mean score of 4.19 ± 0.70. However, satisfaction with therapy management was lower, with a mean score of 3.99 ± 0.77 indicating moderate satisfaction. A significant factor can affect patient’s satisfaction such as the location of the pharmacy (OR = 1.720, P = 0.012), the waiting area (OR = 1.671, P = 0.002) and the cleanness of pharmacy (OR = 2.307, P = 0.001).ConclusionThis study underlines the main components of patient satisfaction who receive pharmaceutical services in PMoH. It is highly recommended that PMoH must address patient dissatisfaction points in a total quality management plan.

Evaluation of people's satisfaction with botulinum toxin injection for facial rejuvenation based on age.

Botulinum toxin type A injections are widely used for facial rejuvenation; however, research on people's satisfaction based on age is limited. This study assessed patient satisfaction with botulinum toxin injections for forehead, glabella, and periorbital wrinkles in Birjand, Iran. The current study examined 150 people aged 18 to 70 who requested botulinum toxin type A injection in the forehead, glabellar, and periorbital area in 2022, who visited the plastic surgery clinic and the authors' offices in Birjand City. To check patients' satisfaction, Facial Lines Treatment Satisfaction (FTS) Questionnaire was used. One month after botulinum toxin type A injection, this questionnaire was completed by the clients. Also, the brand type of botulinum toxin, age, gender of the clients, frequency of visits, and complications were collected in the relevant checklist. The average age of participants was 38.8 ± 8.29 years with 73.3% being female. Masport botulinum toxin (MasoonDarou Pharmaceutical Company, I.R. Iran) was the most frequently used botulinum toxin brand at 66.7%. The average satisfaction score with the result of botulinum toxin injection in the forehead/glabella and periorbital area, in the age group under 30 years and 30-40 years, was significantly higher than in the age group over 50 years. The same indicators in the age group under 30 years old were significantly higher than in the 30-40 age group (p < 0.05). Furthermore, brand selection and the number of visits (first-time vs. second-time clients) demonstrated varied outcomes in satisfaction. There was a total of 62.7% side effects postinjection, with varying degrees of severity.

Time spent at health facility is a key driver of patient satisfaction, but did not influence retention to HIV care: A serial cross-sectional study in Mozambique.

Patient satisfaction with clinical services can have an effect on retention in HIV care and adherence to antiretroviral therapy. This study assessed patient satisfaction and its association with retention and viral suppression in Zambézia Province, Mozambique. Monthly exit interviews with persons living with HIV were completed from August 2017-January 2019 in 20 health facilities; clinical data were extracted from medical records. Regression analyses assessed the effect of satisfaction scores on retention and viral suppression, adjusting for age, sex, education, civil status, time on treatment, and site. Satisfaction scores were correlated with time spent at health facilities using generalized linear regression models. Data from 4388 patients were analyzed. Overall median satisfaction score was 75% (IQR 53%-84%); median time spent at facilities (from arrival until completion of clinical services) was 2h54min (IQR 1h48min-4h). Overall satisfaction score was not associated with higher odds of retention or viral suppression, but association was seen between satisfaction regarding attention given to patient and respect and higher odds of viral suppression. Patient satisfaction was negatively associated with time spent in facility (Spearman's correlation -0.63). Increased time spent at facility (from 1 to 3 hours) was not associated with lower retention in care (OR 0.72 [95%CI:0.52-1.01] and 0.83 [95%CI: 0.63-1.09] at 6- and 12-months, respectively), nor with a lower odds of viral suppression (OR 0.96 [95%CI: 0.71-1.32]). Strategies to reduce patient wait times at the health facility warrant continued prioritization. Differentiated models of care have helped considerably, but novel approaches are still needed to further decongest crowded health facilities. In addition, a good client-provider communication and positive attitude can improve patient satisfaction with health services, with an overall improved retention.

Outcomes of external and endonasal dacryocystorhinostomy according to a modified Lacrimal Symptom Questionnaire (Lac-Q).

Nasolacrimal duct obstruction is usually treated using endoscopic or external dacryocystorhinostomy (DCR). The anatomic outcomes of both the endoscopic and external approaches are considered excellent. However, anatomic success does not translate into patient satisfaction. The current study assessed pre- and postoperative lacrimal problems using the symptom-based Lacrimal Symptom Questionnaire (Lac-Q) and investigated patient satisfaction depending on the choice of surgical technique. A total of 112 eligible patients with lacrimal problems treated using external or endonasal DCR at the ophthalmology and ear, nose, and throat clinics at Skane University Hospital, Scania, Sweden, over a four-year period, were enrolled in this retrospective study. Patients were considered eligible if they experienced preoperative epiphora and had lacrimal duct stenosis. They were offered treatment using either external or endonasal DCR and were allowed to freely choose the technique. Exclusion criteria consisted of previous ipsilateral DCR, congenital NLDO, age < 18 years, presence of cancer, previous orbital trauma, or noncompliance with postoperative follow-up. After surgery, the patients were sent the Lac-Q to evaluate their lacrimal symptoms pre- and postoperatively. Complementary questions were added pertaining to the operative scar and the patients' overall satisfaction with the operation. In total, 67 (60%) patients with ages ranging from 18 to 88 years completed the questionnaire, 33 (49%) of whom underwent external DCR and 34 (51%) endonasal DCR. Of the 67 respondents, 51 (76%) were women and 16 (24%) were men. Patients scored preoperative lacrimal problems highly on the Lac-Q, reporting both symptomatic and social problems due to epiphora. Following surgery, the group that underwent external DCR remained home from work for 2 - 14 days (median, 3.5 days). However, 17 (52%) were retired. After the endonasal DCR, the patients remained home for 0 - 7 days (median, 2 days). Most patients were satisfied after DCR surgery, with both techniques significantly improving total, lacrimal symptom, and social impact scores (all P < 0.001). No differences in postoperative satisfaction were observed between the external DCR and endonasal DCR groups (P > 0.05). A small number of patients expressed scar-related concerns after external DCR. The patients perceived lacrimal problems as a significant symptomatic and social burden. Postoperative satisfaction and symptom relief were good regardless of the surgical approach. Further prospective studies assessing patient satisfaction and its correlation with anatomical and functional success rates after external and endonasal DCR could provide robust, practical, real-world implications.

Dermal Thickness Increase and Aesthetic Improvement with Hybrid Product Combining Hyaluronic Acid and Calcium Hydroxyapatite: A Clinical and Sonographic Analysis.

This was a single-center, prospective, quasi-experimental study comprising 15 participants between 32 and 63 years of age. Each participant received a single-session treatment based on facial subcutaneous injections of HArmonyCa, a hybrid combination filler comprising hyaluronic acid and calcium hydroxyapatite. This study involved an intrapatient control design and a 120-day follow-up with clinical and sonographic assessment. For this purpose, standardized photographic images, high-frequency ultrasound evaluations, and physician- and patient-oriented overall aesthetic improvement scores were recorded at 0, 30, 90, and 120 following the procedure. According to our findings, 20% of the subjects had an exceptional improvement; 20%, "very improved"; and 60%, "improved." Intrapatient sonographic comparison showed a significant increase in dermal thickness, at 90 and 120 days, only on the side treated (P < 0.001). In our clinical study, a single-session treatment with a hybrid product combining hyaluronic acid and calcium hydroxyapatite resulted in positive cosmetic satisfaction and increased dermal thickness.

Patient satisfaction following short segment fusion with posterior instrumentation in thoracolumbar fractures

Background: This retrospective study assesses patient satisfaction following short-segment fusion with posterior instrumentation in thoracolumbar fractures. A total of 100 patients were enrolled in the study, which was conducted in the Department of Orthopedic KTH Hospital in Peshawar from January 2020 to January 2021. The patients were followed up at 6 weeks, 3 months and 6 months post-operatively. The satisfaction score was assessed using a visual analog scale (VAS) and divided into four categories: very satisfied, satisfied, dissatisfied and very dissatisfied. The results showed that 81% of the patients were very satisfied and 19% were satisfied with the procedure. The mean VAS score was 8.58 ± 0.67. No significant differences were found in the satisfaction scores between male and female patients (p=0.731). This study provides valuable insight into the effectiveness of short segment fusion with posterior instrumentation in the treatment of thoracolumbar fractures and highlights the importance of post-operative follow-up in determining patient satisfaction. Objection: The study provides valuable insight into the effectiveness of short-segment fusion with posterior instrumentation in the treatment of thoracolumbar fractures and highlights the importance of postoperative follow-up in determining patient satisfaction.

Patient Satisfaction With Medical and Social Concerns Addressed During Telemedicine Visits.

Purpose The use of telemedicine dramatically increased during the COVID-19 pandemic.Assessing patient satisfaction with this mode of healthcare delivery is an important metric of success as it is broadly implemented across various settings. Of additional importance are the ways social determinants of health impact health outcomes, with the first step in determining the scale of this impact being the identification of contributing factors. This study assesses patient satisfaction with the medical and social aspects of the care they receive via telemedicine at a university-affiliatedprimary care training clinic in Detroit, Michigan. Methods A survey was designed to assess patient satisfaction with the technical aspects of the visit, the visit itself, and with the social determinants screening tool used. During July 2020, 167 patients who had at least one telemedicine visit with a primary care physician from the clinic in the preceding months were contacted to assess their impression of the service provided. The responses were used to evaluate patient satisfaction with the comprehensive care provided via the telemedicine visit. Results Of the 167 patients contacted, 79 (47%) completed the survey. Respondents' age ranged from 18-74 years, with 66% identifying as femaleand 34% as male. For many, this was their first experience with telemedicine. The vast majority expressed comfort in sharing details about their health concerns via telemedicine, with only 3% reporting they were "uncomfortable." More than half of the patients (60%) felt some level of comfort with telemedicine after their first encounter; 14% stated that they were still uncomfortable, and 26% were neutral. Most of the patients (88%) asserted their willingness to participate in future telemedicine visits. Just under two-thirds (63%) of participants "strongly agreed" that concerns related to their social determinants of health were addressed, and 59% "strongly agreed" that the resources provided by their physician were helpful. Conclusion This survey evaluates multiple dimensions of patient satisfaction with their physician using technology to deliver a telemedicine visit instead of an in-office visit. Telemedicine was well received, with high satisfaction for addressing medical and social concerns. The results of this study support the use of telemedicine to assess social determinants of health in an underserved minoritized patient populationand will help physicians optimize future interactions with patients through telemedicine.

Racial Disparities in Patient-Provider Communication During Telehealth Visits Versus Face-to-face Visits Among Asian and Native Hawaiian and Other Pacific Islander Patients With Cancer: Cross-sectional Analysis.

Telehealth visits increase patients' access to care and are often rated as "just as good" as face-to-face visits by oncology patients. Telehealth visits have become increasingly more common in the care of patients with cancer since the advent of the COVID-19 pandemic. Asians and Pacific Islanders are two of the fastest growing racial groups in the United States, but there are few studies assessing patient satisfaction with telemedicine among these two racial groups. Our objective was to compare satisfaction with communication during telehealth visits versus face-to-face visits among oncology patients, with a specific focus on Asian patients and Native Hawaiian and other Pacific Islander (NHOPI) patients. We surveyed a racially diverse group of patients who were treated at community cancer centers in Hawaii and had recently experienced a face-to-face visit or telehealth visit. Questions for assessing satisfaction with patient-physician communication were adapted from a previously published study of cancer survivors. Variables that impact communication, including age, sex, household income, education level, and cancer type and stage, were captured. Multivariable logistic models for patient satisfaction were created, with adjustments for sociodemographic factors. Participants who attended a face-to-face visit reported higher levels of satisfaction in all communication measures than those reported by participants who underwent a telehealth encounter. The univariate analysis revealed lower levels of satisfaction during telehealth visits among Asian participants and NHOPI participants compared to those among White participants for all measures of communication (eg, when asked to what degree "[y]our physician listened carefully to you"). Asian patients and NHOPI patients were significantly less likely than White patients to strongly agree with the statement (P<.004 and P<.007, respectively). Racial differences in satisfaction with communication persisted in the multivariate analysis even after adjusting for sociodemographic factors. There were no significant racial differences in communication during face-to-face visits. Asian patients and NHOPI patients were significantly less content with patient-physician communication during telehealth visits when compared to White patients. This difference among racial groups was not seen in face-to-face visits. The observation that telehealth increases racial disparities in health care satisfaction should prompt further exploration.

Factors Associated with patient satisfaction towards a prison detention Clinic Care among male drug-using inmates

This study assessed patient satisfaction and its associated factors among male drug-using inmates utilizing a prison detention clinic in Taiwan. A cross-sectional design and structured questionnaire were employed to recruit 580 drug-using inmates into the study. The Patient Satisfaction Questionnaire Short Form (PSQ-18), developed by the RAND Corporation, was used as the basis for the short scale of patient satisfaction, and the research data were analyzed using the SPSS for Windows 20.0 statistical software package. The results showed that the research subjects had low patient satisfaction in all the factors assessed compared with the scale’s general norms. Among the original seven satisfaction subscales in this study, the highest score was for the financial aspects, and the lowest was for the amount of time spent with doctors. This study also investigated satisfaction with medical lab exams and the pharmacy at the prison’s clinic, and the satisfaction scores were higher than the original seven subscales. In multiple logistic regression analyses, the final model indicated that the inmates undergoing observed rehabilitation (OR = 13.837, 95% CI = 2.736–69.983) were more likely satisfied with prison detention clinic c than those serving prison sentences. Those inmates with custodial deposits (high vs. low; OR = 1.813, 95% CI = 1.038–3.168), and meet their physical health needs (met vs. unmet; OR = 4.872, 95% CI = 2.054–11.560) had significant correlated with detention clinic care satisfactory level. Although there is only one study setting cannot give a generalizability for people who are incarcerated in Taiwan, this study highlights that the prison authorities should scrutinize factors associated with detention clinic care satisfaction, such as the type of inmate, economic status in the prison, self-reported health status, and their physical health needs, to increase the level of patient satisfaction.

Patient Satisfaction with Once-Daily Single-Tablet Darunavir, Cobicistat, Emtricitabine, and Tenofovir Alafenamide (DRV/c/FTC/TAF): A Real-World Study of Patient Self-Reported Outcomes in HIV-1-Diagnosed Adults.

PurposeHuman immunodeficiency virus (HIV)-1 infection remains a concern. As patient adherence to antiretroviral therapy is essential to avoid drug resistance and virologic failure, greater understanding of patient treatment satisfaction may help facilitate ongoing medication use.Patients and MethodsAn online survey was conducted through the Carenity US HIV platform (04/07/2020–05/26/2020). Eligible respondents were adults with HIV-1 registered on the platform who were receiving darunavir/cobicistat/emtricitabine/tenofovir alafenamide (DRV/c/FTC/TAF) and living in the United States. This descriptive study assessed patient satisfaction with DRV/c/FTC/TAF and HIV-related symptoms at baseline and follow-up (4–6 weeks). Two HIV patient-reported outcomes tools were completed at both time points: the HIV Treatment Satisfaction Questionnaire (HIVTSQs; range: 0–60 points [higher score indicates greater satisfaction]) and the HIV Symptom Distress Module (HIV-SDM; range: 0–80 points [lower score indicates lower distress]).ResultsOf 100 respondents from across the United States who completed the survey at baseline, mean age was 39 years, 69 were male, 48 were Caucasian, 76 were HIV treatment-experienced, and 24 were HIV treatment-naïve. Of baseline respondents, 46 completed the follow-up survey. In the overall population, treatment discontinuation between baseline and follow-up was low (6.5%: 3/46 respondents at follow-up). Mean total HIVTSQs score at baseline was 50.2 with the highest proportion of respondents satisfied regarding their willingness to continue DRV/c/FTC/TAF (79%) and to recommend DRV/c/FTC/TAF to other patients (76%). Among all baseline respondents, mean total HIV-SDM score was 23.5. On average, respondents experienced 10.7 overall symptoms (grades 1–4) and 3.8 bothersome symptoms (grades 3–4). Both satisfaction rate and occurrence of symptoms with DRV/c/FTC/TAF were stable between baseline and follow-up.ConclusionDRV/c/FTC/TAF therapy was associated with high patient satisfaction and patients taking DRV/c/FTC/TAF had a moderate HIV symptom burden. Patient experience and health-related quality of life during HIV therapy are important metrics that may help healthcare providers increase patient adherence.

Scar satisfaction assessment after conventional thyroidectomy: follow-up results.

SUMMARYObjectiveWith the introduction of remote access thyroidectomy questions regarding patient satisfaction after trans-cervical thyroidectomy has been raised in several publications. As far as neck scars are concerned, patient satisfaction in the early post-operative period and long term are different. This study assessed patient satisfaction regarding their neck scar in the early post-operative period and at long term follow-up.MethodsRetrospective study. Patients underwent total thyroidectomy by single surgeon. Scar satisfaction scores assessed at different time intervals (< 6 weeks, 6 months, 2 years and 5 years after procedure). Scores of patients aged < 35 years and > 35 years were compared. Patient and observer scar assessment scales (PSAS, OSAS) and patient satisfaction score (PSS) were used.Results595 patients were included (443 females and 152 males, age 19-77 years). Improvement was observed in the PSAS (13.5 ± 2.3 at 6 weeks; to 4.32 ± 1.37 at 5 years; p < 0.05) and OSAS (7.32 ± 1.35 to 4.18 ± 1.51; p < 0.05). PSS improved over time from 1.8 ± 0.8 to 0.92 ± 0.66 (p < 0.05). The satisfaction scores were higher in patients < 35 years (p = 0.003). The scores indicated excellent patient satisfaction and are similar to those published in the literature regarding minimally invasive surgery (MIS).ConclusionsProper incision placement and suturing resulted in excellent patient satisfaction regarding scars after conventional thyroidectomy.

ASSESSMENT OF PATIENT SATISFACTION WITH AN E-FOLDER AND NON- E-FOLDER SYSTEMS IN TWO DISTRICT HOSPITALS IN THE EASTERN REGION OF GHANA

Background: A patient satisfied with care will translate into increased facility utilization and reflect organizational efficiency. Among several listed indicators, waiting time on a visit and staff interaction with him/her is a lasting impression that affects the out-patients’ satisfaction. The E-folder is proposed as one of the measures of improving patient satisfaction at the outpatient clinic.&#x0D; Objectives: This study assessed patient satisfaction at the outpatient department in an E- folder and non E-folder systems; specifically, average time spent by patients to assess full care, determine factors influencing patient waiting time, assess impact of electronic folder use on patient provider-relationship and patient’s satisfaction with care.&#x0D; Methods: The study used a cross-sectional design and was conducted in Kade and New Tafo government hospitals, in the Eastern Region of Ghana. Observational time and motion study with exit interview were employed to collect quantitative data, using an observational record sheet and a semi structured questionnaire as tools respectively. A sample size of 422 was used with consecutive sampling of outpatients as target group. Patients selected were followed as they moved though the various sections of the OPD and stationed research assistants in each section recorded time in and out. The pharmacy was used as final section but patients who did not use the pharmacy were exited in the last section visited. Interviews were conducted at this point Data was entered in Microsoft Office Excel 2013 version and imported into STATA SE version 15 for analysis. T-test, Pearson’s Chi-square and binary logistic regression model were used to analyst data. All significance level was set at a 0.05 alpha level and 95% confidence interval of estimates provided. Findings were compared between facilities.&#x0D; Results: Average total waiting time was 236.15 ± 81.28 for E-Folder facility and 365.83 ± 122.25 non-E-folder facility. The main cause of prolong waiting time was ‘Queue not followed accordingly (75.6%) and Many patients in queue (84/6%) in No- E-folder facility with percentages of 25.8% and 35.8% in E-folder facility. Both facilities rated patient provider relationship ‘Good’ with over 80%. Overall satisfaction with care was 76.5% (E- Folder) and 50.5% (Non -E-Folder).&#x0D; Conclusion: Total waiting time exceeds recommended 90-120 minutes. Time is the most significant indicator of patient satisfaction. The Type of record system has significant influence on patient satisfaction.&#x0D; Recommendation: The E-folder system coupled with a multi-unit and managerial effort, are recommended as means of improving patient satisfaction.

Colostomy and quality of life after spinal cord injury: systematic review.

BackgroundSpinal cord injury (SCI) has a significant impact on the quality of life (QoL) of affected patients. The aim of this review was to determine whether colostomy formation improves QoL in patients with SCI.MethodsThe Cochrane Register, MEDLINE, Embase and CINAHL were searched using medical subject headings. The search was extended to the reference lists of identified studies, ClinicalTrials.gov and the WHO International Clinical Trials Registry. All clinical trials that included spinal injury and QoL, time spent on bowel care, and patient satisfaction with stoma were assessed.ResultsA total of 15 studies were found (including 488 patients with a stoma), of which 13 were retrospective cross‐sectional studies and two were case–control studies, one of which was prospective research. Nine of 11 studies focusing on QoL reported that patients' QoL was improved by the stoma, whereas the remaining two studies found no difference. Time spent on bowel care was significantly reduced in all 13 studies that considered this outcome, with patients reducing the average time spent on bowel care from more than 1 h to less than 15 min per day. All 12 studies assessing patient satisfaction with their stoma reported high patient satisfaction.ConclusionStoma formation improves QoL, reduces time spent on bowel care, and increases independence. Stoma is an option that could be discussed and offered to patients with spinal cord injury.

Patient Perceived Value of Referral to Maternal and Fetal Medicine Subspecialists [25M

INTRODUCTION: Maternal and fetal morbidity and mortality is a national and public health concern. One of the most critical factors to quality maternal fetal care for high-risk pregnancies is access to specialty tertiary care. Our center serves 25. This study assessed patient satisfaction of high-risk pregnancies referred for consultation to the High-Risk Pregnancy Services at a tertiary care center in the US. METHODS: Prospective pre and post surveys were administered to pregnant women referred to the High-Risk antenatal clinics. This study was IRB approved. All patients consented to participate in this study. RESULTS: 50 women completed the pre-visit and post-visit surveys. The average GA at referral was 21 3/7 weeks. The wait time for scheduled appointment from the initial referral was 2.5 weeks. Patients traveled 57.5 ± 32.3 minutes. 45% of the patients reported not understanding the reason for referral. 60% expressed a desire to see a physician after completion of their ultrasound. On post-visit survey, patient’s perceived anxiety was significantly reduced (P=.007). In 16% the ultrasound findings were different from the local findings. 88% of patients indicated a better understanding of pregnancy issues as well as management of their pregnancy. 67.5% rated their overall satisfaction as excellent, 25% as good and 1% as fair. CONCLUSION: Not all referred women fully understand the role of a maternal fetal specialist, nonetheless, following the referral appointment and consultation, majority expressed better understanding and felt reassured regarding their pregnancy care. This survey indicates a need for and easy availability of maternal fetal expertise to all pregnant women.

Satisfaction and adherence with glatiramer acetate 40mg/mL TIW in RRMS after 12 months, and the effect of switching from 20mg/mL QD

BackgroundPatient satisfaction with treatment in relapsing-remitting multiple sclerosis (RRMS) has a direct impact on adherence to treatment and, consequently, upon treatment outcomes and costs. Patient-reported outcomes (PROs) are a common method for determining patient satisfaction in MS and other diseases. MethodsThe 12-month, open-label, Phase IV CONFIDENCE study assessed patient satisfaction and treatment adherence, using PROs, as well as safety outcomes in patients with RRMS treated with glatiramer acetate (GA). In the previously reported (Cutter et al., 2019) initial 6-month core phase of the study, patients were randomized to receive three-times-weekly (TIW) GA 40 mg/mL (GA40; n = 431) or once-daily GA 20 mg/mL (GA20; n = 430). In the 6-month, single-arm extension phase, 789 patients completing the core phase were treated with GA40 to determine whether benefits observed in the core phase were sustained during the extension phase, to ascertain if switching from GA20 to GA40 resulted in PRO changes, and to assess safety outcomes. ResultsSuperior PRO scores for patient satisfaction with treatment, patient perception of treatment convenience, and symptomatic changes (fatigue impact and mental health) observed in the GA40 group versus the GA20 group in the core phase were all maintained in the extension phase. Treatment adherence, significantly greater in the GA40 versus the GA20 group in the core phase, was sustained in patients continuing to receive GA40 in the extension phase, while those who switched from GA20 to GA40 increased their adherence during the extension phase. Safety variables remained consistent throughout the study, with no notable changes observed in patients switching from GA20 to GA40. ConclusionsData from the extension phase of the CONFIDENCE study show that the benefits associated with GA40 treatment in terms of medication satisfaction, treatment convenience perception, symptomatic changes in fatigue impact and mental health status, and treatment adherence were maintained over a 12-month observation period. These results confirm the preferential utility of GA40 versus GA20 in clinical practice, with no additional safety concerns associated with switching from GA20 to GA40.

Satisfaction of Nigerian patients with health services: a protocol for a systematic review

BackgroundPatient-based assessment of health services is becoming popular in measuring the standard of care. Both quantitative and qualitative methods are available. Patient satisfaction surveys are commonly used to record the experiences of patients in hospitals, whereas qualitative designs (e.g., interviews and focus group discussions) are used less frequently. To date, there has been no systematic review published devoted to patient satisfaction with health services in Nigeria. We aim to (1) systematically analyze relevant quantitative studies to pinpoint excellent procedures in measuring patient satisfaction with health services, (2) to investigate if a reference method (gold standard method) exists, and (3) to identify relevant topics which are recognized by patients as important for the delivery of a high-quality health service in Nigeria.MethodsSearches of eight electronic journal databases, including MEDLINE, EMBASE, CINAHL, PsycINFO, AJOL, CDSR, DARE, and HTA will be conducted to identify studies assessing patient satisfaction with health services in Nigeria. The searches will be supported by manual searches in reference lists of relevant primary studies and systematic reviews. The review will be limited to studies published since 2007. After a stepwise screening process by two reviewers, data from included studies will be extracted and reviewed. The COSMIN RoB checklist will be used to critically appraise included studies. We will carry out an extensive data synthesis to answer the review questions.DiscussionThe intended systematic review will provide information on how the satisfaction of patients with health services has earlier been described and assessed in Nigerian studies. It will establish if a gold standard method exists and synthesize information on topics which might be of special interest to patients. Review findings will enrich the debate on patient-centered care and overall performance of health quality standards in Nigeria.Systematic review registrationPROSPERO CRD42018108140

Looking Through a Different Lens: Patient Satisfaction With Telemedicine in Delivering Pediatric Fracture Care.

Introduction:Telemedicine may transform health care by overcoming geographical and travel-associated barriers to patient care. This study assesses patient satisfaction with telemedicine for fracture care.Methods:Two groups of patients were compared from suburban/rural Pennsylvania. One group reported to a regional medical center for real-time video consultation with a pediatric orthopaedic surgeon facilitated by a physician's assistant. The other group underwent conventional outpatient clinic visits at a tertiary care hospital. The distance between the tertiary care hospital and the regional medical center was 69 miles. New or follow-up fracture patients not living in the vicinity of either medical center were included. A satisfaction survey and questionnaire were administered to both groups at the end of their visit.Results:One hundred sixty-seven patients returned the questionnaires (66 conventional and 101 telemedicine). Telemedicine visits decreased indirect and direct costs (P = 0.032). Travel costs and travel times were lower (P < 0.001) in the telemedicine group. Patient satisfaction was similar. Only 8 of 101 patients in the telemedicine cohort preferred their next visit to be a conventional follow-up.Discussion:Utilization of video consultation and trained physician assistants to provide pediatric orthopaedic care across suburban/rural areas can increase pediatric orthopaedic surgeon access and decrease travel costs while maintaining patient satisfaction.

Direct-to-implant Breast Reconstruction with Autoderm.

Background:Traditional transverse mastectomies yield suboptimal results in women with higher body mass index, wide breast footprint, and ptotic breasts. An option for this patient population is a reduction-pattern style mastectomy, and recruiting an inferiorly based dermal flap using the lower mastectomy flap. This is analogous to a vascularized dermal matrix supporting the lower pole of the implant, termed “Autoderm” breast reconstruction. This allows for aesthetically appealing skin reduction mastectomies with the added safety of a vascularized dermal flap to facilitate an immediate direct-to-implant breast reconstruction. This study assesses patient satisfaction using the validated BRECON-31 questionnaire to enhance shared-decision making with women contemplating breast reconstruction.Methods:A 2-year retrospective review of women who underwent Autoderm direct-to-implant breast reconstruction comparing patients who underwent unilateral and bilateral reconstruction in terms of characteristics, complications, and BRECON-31 scoring.Results:Overall patient scores were high (81.6 of 100). In particular, women scored very high on self-image (85.0), arm concerns (86.4), intimacy (87.4), satisfaction (88.3), and expectations subscales (85.5). Women choosing bilateral reconstruction outperformed unilateral reconstruction in every subgroup, but only attained statistical significance in the “self-consciousness” subgroup. Compared with a historical cohort of a mix of implant reconstruction types, Autoderm patients showed improved satisfaction (88.3 versus 82.5; P = 0.07) and breast appearance (73.9 versus 66.8; P = 0.06), approaching significance. Safety was demonstrated by low major complications (4.7%) and low implant loss rates (2.3%).Conclusions:Autoderm breast reconstruction is a safe option in women with large, ptotic breasts, with patients reporting high satisfaction using a validated instrument.

Impact of Pharmacist-Led Diabetes Management in Primary Care Clinics.

Current literature supports pharmacists effectively lower hemoglobin A1c (HbA1c) in diabetic patients. Little data exists on pharmacists' effects on comorbidity management, patient satisfaction, or the financial viability of these positions. This study looked to assess the impact of pharmacists on diabetes management compared to usual care. This multi-site, two-part study includes a retrospective chart review of patients referred to the pharmacist versus usual care within a large academic health system. The pharmacists collaborated under a consult agreement with primary care physicians. The second part of the study assessed patient satisfaction through an abbreviated CG-CAHPS survey. A total of 206 patients with diabetes for an average of 12 years were included. The average patient age was 62 years with 60% of patients identifying as female and 81% as African-American. Patients were enrolled in a 2:1 fashion with 138 patients in the pharmacist-management group. Average baseline HbA1c was 10.1% in the pharmacist-management group and 9.3% in the usual care group (p= 0.0125). At 6 months, the mean change in HbA1c was -2.17% and 0.48% for the intervention and control groups respectively (p < 0.001). Pharmacists are effective at lowering HbA1c in primary care clinics, and patients were highly satisfied with these services. While direct revenue from this service did not meet cost, the pharmacist did positively affect outcomes that contribute to reimbursement.