Perceived quality of life by patients with immune-mediated inflammatory diseases treated with biological therapies. SACVINFA study.

OBJECTIVES: To evaluate health-related quality of life perceived by patients with the most prevalent immune-mediated inflammatory diseases in Spain: inflammatory bowel disease (IBD), psoriasis (Ps), psoriatic arthritis (AP), rheumatoid arthritis (RA), and spondyloarthropathies (SpAs), and to determine the factors that influence patient quality of life. METHODS: The SACVINFA study (SA=satisfaction, CV=quality of life, IN=immune-mediated, FA=pharmacy) consisted of an observational study conducted in 4 hospitals in the Community of Madrid. A cross-sectional analysis was made for adult patients diagnosed with an immune-mediated inflammatory disease who attended the Pharmacy Service. Quality of life was assessed using the EQ-5D-5L questionnaire (mobility, self-care, usual activities, pain/discomfort, and anxiety/depression) and specific questionnaires: SIBDQ-9, DLQI, PsAQoL, QoL-RA, and ASQoL. RESULTS: A total of 578 patients were analysed (inflammatory bowel disease=25.3%; psoriasis=19.7%; spondyloarthropathies=18.7%; rheumatoid arthritis=18.5%; psoriatic arthritis=17.8%). The mean age (standard deviation) was 49.8 (12.3) years and 50.7% were male. The average score (standard deviation) for the global EQ-5D-5L was 0.771 (0.2) and the mean (standard deviation) visual analogue scale score was 71.5 (20.0). Type of immune-mediated inflammatory diseases was associated with differences in quality of life showing psoriasis and inflammatory bowel disease higher values of EQ5D-5L than psoriatic arthritis, rheumatoid arthritis, and spondyloarthropathies, p<.05 in all comparisons. Patients with RA, IBD, and Ps achieved 70% of the maximum score, while patients with PsA and SpAs did not reach 50% of the maximum possible score. Female gender, a state of moderate/severe disease severity, an older age, and a higher number of previous treatments were correlated with worse quality of life. Conversely, persistence to current treatment correlated with better quality of life. CONCLUSIONS: Patients with immune-mediated inflammatory diseases have markedly affected quality of life, mainly in the pain/discomfort dimension, especially in those immune-mediated inflammatory diseases with a rheumatological component.

Evaluation of the hospital care quality perceived by patients with immune-mediated inflammatory diseases from the pharmacy service. SACVINFA study.

WHAT IS KNOWN AND OBJECTIVE: Immune-mediated inflammatory diseases (IMIDs) are a group of chronic and highly disabling diseases. The objective is to evaluate the satisfaction with the health care received by patients with the most prevalent IMIDs in Spain: inflammatory bowel disease (IBD), psoriasis (Ps) psoriatic arthritis (PsA), rheumatoid arthritis (RA) and spondyloarthropathies (SpAs), and to determine the factors that influence patient satisfaction. METHODS: This was an observational, cross-sectional, multicentre study in a real-world evidence context conducted in the Pharmacy Service in four hospital centres of the Community of Madrid that belong to the National Health System. The study included adult patients diagnosed with an IMID who had attended the Pharmacy Service at least three times. The patients were grouped according to the main IMID. Health care satisfaction was evaluated using the chronic patient experience assessment (IEXPAC) questionnaire. The responses to IEXPAC are grouped into three factors: productive interactions, new relational model and patient self-management, with a total score from 0 (worst) to 10 (best experience). Health-related quality of life (HRQoL) was also evaluated using the EQ-5D-5L questionnaire, and pharmacological adherence was evaluated through the Morisky-Green test. RESULTS AND DISCUSSION: A total of 578 patients were analysed (IBD = 25.3%; Ps = 19.7%; SpAs = 18.7%; RA = 18.5%; PsA = 17.8%). The mean age (SD) was 49.8 (12.3) years and 50.7% were male. The average score (SD) for the total IEXPAC sample was 6.6 (1.9). RA was the IMID with the lowest score, at 5.83 (2.0), significantly lower than the scores of Ps (SD) [7.01 (1.7); p = 0.003], IBD [6.83 (1, 9); p = 0.012] and SpAs [6.80 (1.6); p = 0.001]. Productive interactions (SD) [8.5 (1.8)] and patient self-management (SD) [7.3 (2.3)] were the factors with the highest scores, and the new relational model had the lowest score (SD) [3.2 (2.7)]. Male gender, a longer time interval between medication administrations and a higher HRQoL were correlated with better patient satisfaction. Current biological therapy (according to the Anatomical Chemical classification system) also had a significant influence; patients treated with tumour necrosis factor inhibitors and interleukin inhibitors showed greater satisfaction than those treated with selective immunosuppressants. WHAT IS NEW AND CONCLUSION: The IEXPAC results show high general satisfaction with care quality reported by patients with IMIDs treated in the Pharmacy Service. However, there are areas of improvement in care quality specially health professional-patient communication, such as increasing access to information, and promoting and facilitating relationships with patients in similar conditions.

Nivel de riesgo y casos incidentes de úlceras por presión en pacientes hospitalizados en los servicios de medicina de un Hospital Nacional / Risk level and incident cases of pressure ulcers in hospitalized patients at a medicine unit from a public hospital

Objetivo: determinar el nivel de riesgo e incidencia de £lceras por presión en pacientes hospitalizados. Material y métodos se desarrolló el estudio de tipo descriptivo prospectivo longitudinal de tendencia, en los servicios de medicina del Hospital Arzobispo Loayza en una población de 151 pacientes quienes fueron seleccionados de forma aleatoria utilizando como criterios de inclusión, el déficit de movimiento y la alteración de conciencia, alteración en el control de esfínteres y alteración de la nutrición. La técnica utilizada fue la observacional, la cual se realizó diariamente valorando el estado del paciente, tanto en el momento del ingreso como durante su estancia hospitalaria; como instrumento se utilizó una lista de chequeo elaborada considerando la escala de valoración de riesgo de £lceras por presión ESCALA DE NORTON para poder evaluar el nivel de riesgo de los pacientes. Para medir la variable incidencia de £lceras por presión se utilizó la fórmula estadística probabilística. Para determinar el nivel de riesgo y la incidencia de £lceras por presión se aplicó la prueba estadística de X2. RESULTADOS: muestran que el nivel de riesgo a £lceras por presión encontrado en la población de pacientes hospitalizados en el servicio de medicina, fue de Alta a Muy alta y en las dimensiones estado físico, actividad incontinencia reporto un estado regular.

Objective: The aim of the project was to determine the risk level and incident of pressure ulcers. Material and methods: A prospective, longitudinal, descriptive study was conducted at Arzobispo Loayza Hospitalïs Medicine unit. A random sample of 151 who fulfilled the inclusion criteria, movement deficit and altered state of consciousness, alteration in sphincter control and nutrition. An observational technique was used every day to assess the patients during admission and hospital stay. A check list created by the researchers considering the The Norton Scale for Predicting Pressure Ulcer Risk. A probability statistical analysis of the quantitative data was conducted. The X2 statistical test was used to determine the risk level and incident cases of pressure ulcers. Results: The pressure ulcers risk level found in the medicine unitïs hospitalized patients was high and very high; in physical state dimension and incontinence activity the state was regular.