Background and importance Immune-mediated inflammatory diseases (IMIDs) are a group of disabling chronic diseases.
Aim and objectives To assess the satisfaction with healthcare by patients with the most prevalent IMIDs, inflammatory bowel disease (IBD), psoriasis (Ps), psoriatic arthritis (PsA), rheumatoid arthritis (RA) and spondyloarthropathies (ESART), and to determine the factors that influence patients’ satisfaction.
Material and methods Observational, prospective, multicentre, real-world evidence study, conducted in four Spanish hospitals. Patients with IMIDs who had attended at least three visits to the Pharmacy Department were included. Sociodemographic, clinical and pharmacotherapeutic data were collected from medical records. Care satisfaction was assessed using the Instrument for the Evaluation of the Experience of Chronic Patients (IEXPAC) questionnaire. Responses to IEXPAC are grouped into three factors: productive interactions, new relational model, and patient self-management, scored from 0 (worst) to 10 (best experience). Health-related quality of life (HRQoL) was assessed using the EQ-5D-5L questionnaire.
Results A total of 578 patients were analysed (IBD=25.3%; Ps=19.7%; ESART=18.7%; RA=18.5%; Ps=17.8%): mean age 49.8 (12.3) years and 50.7% were male. The mean score for IEXPAC was 6.6 (1.9). RA obtained the lowest score, 5.83 (2.0), with statistically significant differences observed versus Ps (7.01 ± 1.7; p=0.003), IBD (6.83 ± 1.9; p=0.012) and ESART (6.80 ± 1.6; p=0.001). Productive interactions (8.5 ± 1.8) and patient self-management (7.3 ± 2.3) were the highest scoring factors and the new relational model the lowest (3.2 ± 2.7). Male versus female gender (7.0 (1.7 vs 6.1 (1.9), p<0.001), longer interval between medication intake (Pearson correlation coefficient (PCC)=0.133, p<0.002) and higher HRQoL (PCC=0.176, p<0.001) were significantly related to better patient satisfaction. Current biologic therapy also significantly influenced patients on treatment with tumour necrosis factor inhibitors (6.6 (1.9)) and interleukin inhibitors (6.7 (1.8)), who expressed higher satisfaction than those on selective immunosuppressants (5.7 (1.9)) (p=0.025).
Conclusion and relevance The results of IEXPAC show a high overall satisfaction with the quality of care by patients with IMIDs seen in the pharmacy service. However, there are areas for improvement to offer better quality of care, namely to inform about health and social resources, access to information via the internet about their disease, and fostering and facilitating relationships with patients in similar conditions.
Conflict of interest No conflict of interest
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