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The Experience With Health Care of Patients With Inflammatory Arthritis

A Cross-sectional Survey Using the Instrument to Evaluate the Experience of Patients With Chronic Diseases

de Toro, Javier PhD*; Cea-Calvo, Luis MD; García-Vivar, María L. MD; Pantoja, Lucía MD§; Lerín-Lozano, Cristina MD; García-Díaz, Silvia BSc; Galindo, María J. PhD#; Marín-Jiménez, Ignacio MD**; Fernández, Sabela BPharm, PhD; Mestre, Yvonne BPharm; Orozco-Beltrán, Domingo PhD††

JCR: Journal of Clinical Rheumatology: July 25, 2019 - Volume Publish Ahead of Print - Issue - p
doi: 10.1097/RHU.0000000000001155
Original Article: PDF Only

Background Patients' experience with health care is becoming a key component for the provision of a patient-centered health care model. The aim of this study was to assess the experience with health care of patients with inflammatory arthritis and patient- and health care–related factors.

Methods Patients responded to an anonymous survey provided by their treating clinical teams. The survey comprised the validated 12-item IEXPAC (Instrument to Evaluate the EXperience of PAtients with Chronic diseases) tool and demographic variables and health care–related characteristics that may affect patients' experience.

Results A total of 359 of 625 surveys were returned (response rate, 57.4%). Overall, patient responses were positive (>60% gave “always/mostly” answers) for statements assessing the interaction between patients and health care professionals or patient self-management following health care professional guidance. However, positive patient responses for items regarding patient interaction with the health care system via the internet or with other patients were less than 13%. Only 25.6% of patients who had been hospitalized reported receiving a follow-up call or visit following discharge. In the bivariate analysis, experience scores were higher (better experience) in men, those seen by fewer specialists or by the same physician, and in patients treated with a fewer number of drugs or with subcutaneous/intravenous drugs. Multivariate analyses identified regular follow-up by the same physician and treatment with subcutaneous/intravenous drugs as variables associated with a better patient experience.

Conclusions This study identified areas of care for patients with inflammatory arthritis with the potential to improve patients' experience and highlights the importance of patient-physician relationships and comprehensive patient care.

From the *Rheumatology Department, Hospital Universitario A Coruña, Universidade da Coruña, INIBIC, A Coruña

Medical Affairs, Merck Sharp & Dohme Spain, Madrid

Rheumatology Department, Basurto University Hospital, Bilbao

§Hospital El Bierzo, Ponferrada

Rheumatology Department, Manacor Hospital, Mallorca

Rheumatology Department, Hospital Transversal Sant Joan Despí Moisès Broggi-General, Consorci Sanitari Integral, Barcelona

#Internal Medicine Department, Hospital Clínico de Valencia

**Gastroenterology Department, Hospital Universitario Gregorio Marañón, Madrid

††Department of Medicine, Miguel Hernández University, Sant Joan, Alicante, Spain.

This study was funded by Merck Sharp & Dohme Spain, a subsidiary of Merck & Co., Inc., Kenilworth, NJ.

L.C.-C., S.F., and Y.M. are full-time employees at Merck Sharp & Dohme Spain. M.L.G.-V. is a consultant to Janssen, Novartis, Bristol, Sanofi, and Celgene; provides expert testimony for Celgene, Novartis, AbbVie, and Pfizer; and receives payments for lectures from Janssen, UCB, AbbVie, Celgene, Novartis, Pfizer, and Lilly; meeting expenses from Pfizer, Sanofi, Lilly, and AbbVie; grants (to her institution) from Janssen and UCB. L.P. is a consultant to UCB and receives payment for lectures from Gebro Pharma, MSD, and Roche. M.J.G. is a consultant to Gilead and Janssen and receives payments for lectures or educational presentations from Gilead, Janssen, MSD, and AbbVie and grant from Janssen. I.M.-J. is a board member of or consultant to AbbVie, Chiesi, FAES Farma, Falk-Pharma, Ferring, Gebro Pharma, Hospira, Janssen, MSD, Otsuka Pharmaceutical, Pfizer, Shire, Takeda, Tillots, and UCB Pharma; and receives payments for lectures from AbbVie, Chiesi, FAES Farma, Falk-Pharma, Ferring, Gebro Pharma, Hospira, Janssen, MSD, Otsuka Pharmaceutical, Pfizer, Shire, Takeda, Tillots, and UCB Pharma. D.O.-B. is a consultant to MSD, Sanofi, Novo Nordisk, Mundipharma, and Menarini. The other authors declare no conflict of interest.

The following patients' association participated in the design of the overall study and endorsed it: Spanish Association of Patients with Arthritis (CONARTRITIS); Spanish Association of Patients with Crohn's Disease and Ulcerative Colitis (ACCU); and the Spanish Federation of Patients with Diabetes (FEDE), and by the Spanish AIDS Multidisciplinary Society (SEISIDA). Editorial support was provided by David P. Figgitt, PhD, ISMPP CMPP, and Robert A. Furlong, PhD, Content Ed Net, with funding from MSD Spain.

Author Contributions: J.d.T., L.C.-C., M.J.G., I.M.-J., and D.O.-B. designed the study and coordinated the implementation. L.C.-C. and J.d.T. drafted the manuscript. The other authors made substantial contributions to the manuscript. All authors reviewed and approved the final version.

Correspondence: Luis Cea-Calvo, MD, Medical Affairs Department, Merck Sharp & Dohme Spain, Josefa Valcárcel 38, 28027 Madrid, Spain. E-mail:

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