Number Of Patients In Physiotherapy Services Within Specialized Home Care In Hungary Between 2010 And 2014

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PHP252 How Beneficial Is Hrqol Assessment In The Course Of Treatment Decisions In Physical Rehabilitation? Results Of Clinicians’ Perspective Meyer-Moock S, Feng Y, Kohlmann T University Medicine Greifswald, Greifswald, Germany

Objectives: Health-related quality of life (HRQoL) is an increasingly important outcome measure in the course of physical therapy. For this reason, HRQoL assessment is used by the German Social Accident Insurance at the beginning and during the course of physical rehabilitation for patients injured after accidents. However, less is known about the perspective of clinicians working in the field. In an ongoing study, we assess the benefit of using standardized HRQoL assessment and the impact of a clinician training program regarding the assessment and interpretation of HRQOL measurements.  Methods: We invited leading clinicians from 31 physical rehabilitation centers to take part in a training program which should enable the participants to interpret the results of HRQoL assessment. All clinicians in these centers were asked to complete a questionnaire regarding their knowledge of HRQoL measurement and applying results to therapy before and sometime after the training program.  Results: Overall, 236 clinicians completed the questionnaire. Nearly half of them (n= 113) are working in rehabilitations centers which take part in an existing assessment program, the other half (n= 123) was newly recruited. Overall, participants of experienced centers showed better knowledge about HRQoL measurement instruments and feel more certain in decision situations (experienced/ inexperienced): e.g. decision of therapy extension (67% / 58%), decision of therapy plan (88% / 76%). Informal feedback during the training program confirmed that HRQoL results enabled clinicians to better understand patients’ behaviors and added information for therapy decisions. This was especially important for patients with severe and complicated cases.  Conclusions: These findings illustrate the relevance of HRQoL measurement in the course of physical therapy. We found benefits in treatment decision making for clinics that historically used standardized HRQoL measurements even before participating in the training program. Using HRQoL measures to aid therapy decisions may be especially important for patients with complicated situations or severe disease. PHP253 Icpc-2 Episode-Based Health-Related Quality Of Life And Three Months Effectiveness In Three Finnish Primary Health Care Settings Soini EJ1, Heinonen J2, Miettola E2, RyynanenRyynänen O3, Koskela T4 1ESIOR Oy, Kuopio, Finland, 2School of Medicine, University of Tampere, Finland, 3Faculty of Health Sciences, University of Eastern Finland, and Unit of Primary Health Care, Kuopio University Hospital, Kuopio, Finland, 4Department of General Practice, University of Tampere, and Omapihlaja, Pihlajalinna Terveys Oy, Tampere, Finland

Objectives: Primary health care setting (PHCS) episodes can be classified using the International Classification of Primary Care (ICPC). However, health-related quality of life (HRQoL) research based on episodes has been scarce although e.g. cost-utility models would benefit from episode-based HRQoLs. Furthermore, PHCS HRQoL has been rarely studied for multiple episode chapters although many patients initiate their episode in PHCS and PHCS HRQoL is needed to capture full treatment path or episode. We study PHCS HRQoL and 3-months effectiveness classified according to the ICPC-2 chapters.  Methods: During Effective Health Centre Study three health centre’s (Pirkanmaa, Finland) unselected patients (N 519) filled EQ-5D-3L questionnaire. British time trade-off value set was used. HRQoL score difference between three months and baseline measurements was effectiveness. The minimum clinically important difference (MID) was considered to be 0.07. All analyses were done with Stata MP 14.1.  Results: Mean baseline and three month EQ-5D-3L scores for all responders were 0.74 and 0.78, respectively. Respective mean scores for patients answering to both measurements were 0.75 and 0.78. The lowest (0.64) mean baseline score was observed for patients with ICPC-2 chapter L: Musculoskeletal. The highest (0.84) mean baseline score was observed for patients with X: Female genital. The highest effectiveness (0.13) was observed for patients with D: Digestive and worst deterioration (-0.06) for patients with P: Psychological. The MID effectiveness was gained also for H: Ear, L: Musculoskeletal, R: Respiratory, and T: Endocrine, metabolic and nutritional. Effectiveness was significant for D: Digestive, L: Musculoskeletal and R: respiratory. The lowest (0.62) mean 3-month score was observed for patients with N: Neurological. The highest (0.88) mean 3-month score was observed for patients with H: Ear.  Conclusions: Different episodes demonstrate different HRQoL. Episode-based PHCS HRQoL is an important – yet, rarely done – element of real world health services research that should be incorporated in cost-utility models.

PHP254 Investigating The Perceptions Of The Greek Population Towards The Efficacy And Safety Of Generic Drugs Charonis A1, Balasopoulos T1, Naoum P1, Mavrikou M1, Karokis A2, Athanasakis K1, Pavi E1, Kyriopoulos J1 1National School of Public Health, Athens, Greece, 2MSD Greece, Athens, Greece

Objectives: Since 2010, the Memoranda of Understanding were implemented as a measure towards Greece’s fiscal adjustment. Policies on pharmaceutical spending resulted to the significant reduction of public pharmaceutical expenditure, yet, the penetration of generic drugs remained among the lowest between OECD countries, although specific targets for market shares were set. This study aims to highlight the factors that affect the Greek population’s perceptions on generic drugs.  Methods: The analysis is based on a national cross-sectional survey conducted through a representative sample of 2,003 individuals in 2015. Two ordinal logistic regression models were constructed in order to identify the determinants that affect the respondents’ beliefs regarding safety and effectiveness of generics compared to originators. A series of factors that might have an impact on the populations’

perceptions towards generics were investigated, concluding to the chosen independent variables.  Results: A positive attitude (odds ratio > 1) on the safety of generics versus originators was identified for older individuals, those with higher income and those with less bill payment difficulties, people who express trust to the medical community, persons with a positive view towards the pharmaceutical industry, those with a positive view for the drugs in general and persons who are willing to be dispensed and prescribed a generic through its active substance. Similarly, a positive attitude (odds ratio > 1) on the efficacy of generics versus originators exists for higher income individuals, those with less bill payment difficulties, persons that have a positive view for the pharmaceutical industry, those with a positive view for drugs in general, and those who concede their doctor and pharmacist to prescribe and dispense a generic. All variables are statistically significant at the .05 level.  Conclusions: Consumer preferences as derived from the perception of the population towards generic drugs should be highly considered when creating policies towards improving generic penetration in the market. PHP255 Changes In The Capacity Of Neurological And Psychiatric Inpatient Care In Hungary Between 1990 And 2014 Ágoston I1, Endrei D1, Molics B1, Szarka E1, Csákvári T2, Gyuró M1, Boncz I1 1University of Pécs, Pécs, Hungary, 2University of Pécs, Zalaegerszeg, Hungary

Objectives: The study aims at demonstrating the changes in the capacity of neurological and psychiatric inpatient care in Hungary between 1990 and 2014.  Methods: We investigated the number of beds in neurological and psychiatric wards and indices of capacity usage. Descriptive statistics was used as a statistical method in the analysis. The National Health Insurance Fund and the Central Statistics Office provided the database.  Results: 104.686 hospital beds were available for patients in Hungary 1990 and only 69.623 beds were left 2014. At the same time, the active/chronic rate of hospital beds also changed from 70%/30% to 60%/40%. The legal environment of control capacity significantly changed four times the effects of which can be observed in the changes in the number of hospital beds. Changes in the number of hospital beds in neurological and psychiatric care were different from those of the national trend, but changes in the legal environment also had an effect on the numbers. These cares lost 32% of their beds. In active psychiatry, the same rate of decrease has occurred in a shorter period of time since 2001. The number of discharged patients increased by 21% in neurology while it decreased by 31% in active psychiatry. Accordingly, the share of neurology from active beds increased from 5.61% to 6.36%. In active psychiatry, the share remained 6.9%. The number of beds for chronic patients was reduced by 12% between 1990 and 2014. However, decrease in the number of beds accounted for 60% in psychiatry in the same period. The most significant change was the Caring Development Law 2006.  Conclusions: The specializations examined show that developmental tendencies may occur in inpatient care besides identical legal conditions. Moreover, the complex issues in the changes of inpatient capacities can be understood by taking the effects of several factors into consideration. PHP256 Knowledge, Attitude And Perception Of Zika Virus Among Healthcare Students Of Medicine, Pharmacy And Dentistry Of Aimst University Iqbal MZ1, Tahir M2, Lokanayagi a/p SS1, Rahul R3, Chong LW1, Kho ZX1, Sunil Kumar P1 1AIMST University,, Bedong, Kedah Darul Aman, Malaysia, Malaysia, 2University of Veterinary & Animal Sciences Lahore, Pakistan, Lahore, Malaysia, 3Faculty of Dentistry, AIMST University, Sungai Petani, Malaysia

Objectives: The objective of the study is to evaluate the knowledge, attitude and perception of medical, dental and pharmacy students in AIMST University on the progress of Zika Virus.  Methods: A cross-sectional observational study on a convenient random sample of 265 students from AIMST University was conducted by using pretested and validated questionnaires to gather information on the attitude, knowledge and perception of medical, pharmacy and dental students.  Results: Of the 265 respondents in AIMST University, 100 of the respondents were male (37.7%) and 165 of them were female (62.3%). For the evaluation of knowledge and perception, males (Mean rank =  15.69±2.29) were having less adequate knowledge than females (Mean rank =  15.06±2.69). Among all races that participated in the study, Indians were having the most adequate knowledge than other races on Zika Virus (Mean rank =  14.93±2.22). Among the Faculty of Medicine, Pharmacy and Dentistry, Faculty of Medicine was having the most adequate knowledge than other faculties (Mean rank = 17.0±1.01). Year 4 (Mean rank = 15.06±2.69) students were having more adequate knowledge then Year 3 students (Mean rank =  15.25±2.29).  Conclusions: Most of the students are having good knowledge

PHP257 Number Of Patients In Physiotherapy Services Within Specialized Home Care In Hungary Between 2010 And 2014 Járomi M1, Simon-Ugron Á2, Mihajlovic I3, Rátgéber L4, Juhász K5, Sebestyén A5, Endrei D1, Boncz I1, Molics B1 1University of Pécs, Pécs, Hungary, 2Babes-Bolyai University Cluj-Napoc, Cluj-Napoca, Romania, 3University of Novi Sad, Novi Sad, Serbia, 4Ratgeber Academia, Pécs, Hungary, 5National Health Insurance Fund Administration, Pécs, Hungary

Objectives: Specialized home care was introduced in primary care in Hungary 20 years ago, in 1996. The aim of our study was to investigate the number of patients in specialized home care and its distribution between nursing and physiotherapy services.  Methods: The data come from the database of the National Health Insurance Fund Administration, being the only health financing agency in Hungary, and the Central Statistics Office. We analyzed the distribution of patients in different types of home care services (nursing and physiotherapy services). The



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period between 2010-2014 was included into the nationwide analysis.  Results: The number of specialized home care rounds accounted for the values of 50441 (2010) and 63820 (2014). The rate of the number of patients amounted to approximately 55% and 45% regarding specialized care and physiotherapy services. Within physiotherapy services, the number of patients was the highest in physiotherapy opposite to electrotherapy and speech therapy- min. 22918 patients (83.62%) in 2010 and 31217 patients (88.55%) in 2014.  Conclusions: Coming from the number of patients, we can conclude that the demand for home care is constantly increasing in which physiotherapy would require more support. PHP258 Health Risk Of Drugs And Its Impact On Patient Adherence To Medical Treatment Masarykova L, Lehocka L, Olearova A, Buszekova B Comenius University in Bratislava, Faculty of Pharmacy, Bratislava, Slovakia

Objectives: Patient adherence is a  basic determinant of any successful treatment.  Medication non-adherence is a  serious problem influencing not only a patient, but also healthcare systems. The main aim of research was to obtain information about the impact of drug risk, associated with the occurrence of drugrelated problems (mainly adverse drug reactions), on patient adherence to drug treatment.  Methods: By a questionnaire survey and applying statistical methods, it was found how the occurrence of adverse drug reactions and patient information leaflet about adverse drug reactions could contribute to patient adherence to drug treatment.  Results: In total, 215 respondents were included. There were 69.3% of females and 30.7% of males. According to age, the biggest group of respondents consisted of those aged from 51 to 60 (24%). The most common chronical disease was hypertension followed by osteoporosis and some other diseases, such as gastrointestinal diseases, polyneuropathy and rheumatic diseases. The first question of the questionnaire was about adverse drug reactions after taking medications, which experienced 55.3% of the respondents. And 86.3% of the respondents took their prescribed medications following recommended treatment regimens. Mostly, pharmacists or GPs provided information about that (38.6%). Taking prescribed medications at the wrong time confessed 60.5% of the respondents. The information on adverse drug reactions in written form discouraged 31.6% of the respondents from taking medications. The most common reason to non-adherence, or better to say, to quit taking prescribed medications was the awareness of ADRs (44%).  Conclusions: The research shows that the risk of drugs associated with potential drug-related problems (mainly adverse drug reactions) contributes significantly to patient poor adherence to drug treatment, according to 44% of the respondents. It is a lot and can be enhanced by providing more information on ADRs for patients by pharmacists or general practitioners. PHP259 Tasks Involved In Platelet Production And Transfusion From The U.S. Hospital Perspective: Two Process Frameworks Prioli KM, Lyons NM, Pizzi LT Thomas Jefferson University, Philadelphia, PA, USA

Objectives: Platelet production (PP) and transfusion are complex processes, largely due to pathogen testing. Pathogen reduction (PR) is a new technology that has the potential to improve PP efficiency by simplifying these processes. Objectives of this project were to 1) develop frameworks detailing tasks involved in each process: one from the hospital blood donor center (BDC) perspective describing PP tasks, and the other from the hospital transfusion service (TS) detailing tasks for platelet procuring and administration (PA); and 2) assess the impact of PR on these processes.  Methods: Identification of tasks involved in producing and procuring conventional (non-PR) platelets was informed through literature review and discussion with clinical experts. Major tasks were identified in both processes, along with possible branching of pathways within each process. The frequency of tasks was assessed for conventional vs. PR PP, with categorization by type to identify which task groupings were major contributors to the complexity of the process.  Results: Major PP tasks include apheresis donation, processing, bacterial culturing, infectious disease testing, storage, shipping to hospital, and returns. PP comprises 14 tasks with conventional platelets vs. 12 tasks with PR platelets. Major PA tasks include receipt of shipment, storage, point-of-issue (POI) bacterial testing, physician ordering, administration to patient, and adverse event (AE) management. PA comprises 15 tasks with conventional platelets vs. 13 tasks with PR platelets. POI is task-intensive, requiring up to 6 additional steps per test repeated every 24 hours, ranging from 2-6 tests/platelet unit depending on platelet age. Noninfectious AE tasks are similar for both conventional vs PR however infectious AE are expected to be reduced or eliminated with PR.  Conclusions: The PP frameworks can be used in hospital operations research to simplify and improve PP efficiency. PR platelets represent a means of reducing tasks, and potentially costs, of producing and administering platelets.

PHP260 Automation Of Hospital Medication Distribution Systems In The Us Badawoud EM1, Seoane-Vazquez E1, Alhamdan HS2, Jacobson S1 University, Boston, MA, USA, 2King Abdulaziz Medical City, Jeddah, Saudi Arabia

1MCPHS

Objectives: To describe trends in the utilization of medication distribution automation systems in hospital pharmacies in the US in the period 1975-2011 To describe trends in the number of studies assessing the costs and benefits associated with the automation of medication distribution systems published in journal articles in the period 1975-2011.  Methods: Data were collected from the American Society of Health-System Pharmacists (ASHP) national surveys of pharmacy practice in hospital settings. A systematic review identified published studies assessing the cost and benefits associated with the utilization of medication

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distribution automation systems. We used descriptive analysis to present trends in the utilization of automation in medication distribution systems in the US hospitals using the information derived from the ASHP surveys. Descriptive analysis was also used to describe the trends in the quantity and quality of the economic studies published in journal articles. We also assessed the correlation between the number of studies published in the economic literature about medication distribution automation technologies and the percentage of the hospitals reporting the use of each technology.  Results: At the end of 1990, the majority of hospitals used unit dose dispensing with the assistance of computerized systems. In the 2000s, hospitals started to use decentralized distribution technologies and robotics for supporting medication dispensing activities. The implementation of new pharmacy technologies in the hospital was not preceded by the publication of peer-reviewed journal articles confirming the benefits and associated costs of the technologies.  Conclusions: US hospitals have experienced important changes in their drug distribution systems that have affected the dispensing of drugs. There is a need for better evidence of the costs and benefits of new technologies used in hospital drug distribution systems that could be used to inform decisions about the implementation of those technologies. PHP261 Assessment Of Knowledge, Attitude And Practice (Kap) Of Pharmacist Regarding Adverse Drug Reaction (Adrs) And Pharmacovigilance In Public Hospitals Quetta Anwer M, Haq N, Nasim A University of Balochistan, Quetta, Pakistan

Objectives: To assess the knowledge, attitude and practice (KAP) of Pharmacist regarding adverse drug reaction (ADRs) and pharmacovigilance in public hospitals Quetta.  Methods: A cross sectional and questionnaire- based study design was used among the professional pharmacists in seven public hospitals of Quetta city, who were performing their duties in hospital as pharmacist and chief pharmacist. A total of 26 questionnaires were present in survey comprised of (knowledge 7, Attitude 10, practice 9) for the assessment of pharmacists (KAP). A total of 140 questionnaires were distributed to the pharmacists. The completion of the questionnaire by pharmacist was taken as their consent to participate in the study. 127 pharmacists filled and returned the questionnaires at given time.  Results: The results of knowledge, attitude and practice about pharmacovigilance and ADR reporting system were very promising. Based on majority of respondents were male dominated (n=  89(70.1%). Majority of participants (n=  68 (53.5%) having age ranges between 24 – 34 years and experience group (n=  62(50%) between 4-7 years. having Current position (n=  123(96.9%) were hospital pharmacist. Overall knowledge score of all the responding professional pharmacists (127), about two thirds 85 (69.9%) of the respondents had poor knowledge on the pharmacovigilance and ADR reporting system, while 41 (31.1%) had adequate knowledge about it. Among the 127 professionals, 103 (81.1%) had positive attitude, while 24 (18.9%) had negative attitude regarding pharmacovigilance and ADR reporting system. Moreover, majority of the respondents 102 (80.3%) had poor practice and 25(19.7%) of respondents had good knowledge about it.  Conclusions: The pharmacist working in different hospitals of Quetta has poor knowledge, negative attitude and poor practice towards pharmacovigilance and ADR reporting. Establishment of pharmacovigilance Centre in facility and availability of ADR reporting form is necessary.

PHP262 Pretesting An E-Based Version Of The Oxford Participation & Activities Questionnaire (Ox-Paq) Kelly L1, Dummett S1, Dawson J1, Churchman D2, Fitzpatrick R1, Jenkinson C1, Morley D1 1University of Oxford, Oxford, UK, 2Clinical Outcomes at Oxford University Innovation, Oxford, UK

Objectives: The Oxford Participation & Activities Questionnaire (Ox-PAQ) is a new patient-reported outcome measure, theoretically grounded in the World Health Organisation International Classification of Functioning, Disability and Health. The measure is specifically designed for the assessment of participation and activity in patients experiencing a range of health conditions. Initial validation of the Ox-PAQ was based on a paper-based postal survey. The objective of this study was to pretest an e-based version of the measure for use on a range of electronic devices.  Methods: Cognitive interviews with people with multiple sclerosis (MS) and Parkinson’s disease (PD) were conducted to assess the usability and acceptability of the e-based Ox-PAQ. Participants completed the measure in the presence of a researcher who noted any potential difficulties which were discussed both during and after the interview. Participants were recruited via the MS Society and Parkinson’s UK.  Results: Six participants, four with MS and two with PD, completed the e-based Ox-PAQ. Two completed the measure on a personal computer, two on an iPad and two on a laptop. During the interview process two adjustments were made. Firstly, the progress bar that allows respondents to track their survey progress was moved to a more prominent position on the screen. Secondly, font colours were adjusted from red to green to indicate acceptance of information and consent statements. Participant comments were largely positive regarding presentation, ease of completion and time taken to complete the measure.  Conclusions: The e-based Ox-PAQ appears both usable and acceptable to participants on a range of electronic devices. It is currently being incorporated in a large-scale online survey to assess the responsiveness of the measure. PHP263 Exploring The Socioeconomic Impact Of Post Approval Change Requirements For Vaccines Angelis A, Lange A, Kanavos P London School of Economics and Political Science, London, UK