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PHP75 SATISFACTION WITH MEDICATION: PRELIMINARY RESULTS FROM A NOVEL PATIENT REGISTRYTRACKING SATISFACTION WITH DIFFERENT CHRONIC MEDICATIONS
A52 HEALTH CARE USE & POLICY STUDIES— Post Marketing Studies PHP75 SATISFACTION WITH MEDICATION: PRELIMINARY RESULTS FROM A NOVEL PATIENT REGISTRY TRACKING SATISFACTION WITH DIFFERENT CHRONIC MEDICATIONS
Bharmal M1, Cascade EF2, Gemmen EK3 1 Quintiles, Falls Church, VA, USA, 2Quintiles, Inc, Falls Church, VA, USA, 3Quintiles Strategic Research & Safety, Falls Church, VA, USA OBJECTIVE: Patients are increasingly getting involved in making their treatment decisions, however, options for obtaining satisfaction information from other patients on their medications is limited primarily to on-line blogs. Using a validated PRO instrument to capture and disseminate feedback in a structured, unbiased way could be a valuable service to patients. The Treatment Satisfaction Questionnaire for Medication Version I (TSQM) is a 14-item reliable and valid instrument to assess patients’ satisfaction with medication, providing scores on four scales—side effects, effectiveness, convenience and global satisfaction. This study discusses preliminary results on satisfaction with ten different chronic medications from a novel patient registry. METHODS: The registry recruited patients from multiple sources including physicians, pharmacies, and online referrals. Patients were asked to report ongoing medications on the project website (www.iGuard.org). A sample of patients were contacted to complete the TSQM. The current analysis captures data from patients on any of the following ten chronic medications— acetylsalicylic acid, atorvastatin, simvastatin, lisinopril, metoprolol, metformin, levothyroxine, salbutamol, fluticasone/ salmeterol or sertraline (n = 495). Analyses were conducted to explore differences in patients’ satisfaction across medications. RESULTS: The mean age (SD) of the patients was 54.1 (14.2) years: 62.7% were females, 91.6% Caucasian and 3.7% black. The TSQM domains had good internal consistency with Cronbach’s alpha for all domains exceeding 0.85. The number of respondents was more than 30 for all but one medication. The mean TSQM scores ranged from 67.3 (metoprolol) to 76.1 (atorvastatin) on effectiveness, from 77.3 (metoprolol) to 95.3 (acetylsalicylic acid) on side effects, from 77.3 (salbutamol) to 87.7 (simvastatin) on convenience and from 60.9 (metoprolol) to 78.0 (levothyroxine) on global satisfaction. Differences were observed in TSQM domain scores between medications used for treating the same medical condition. CONCLUSION: Comparative data on patients’ satisfaction with medications can provide useful information to patients when starting a new medication or comparing their own experience. HEALTH CARE USE & POLICY STUDIES— Quality of Care PHP76 ALBERTA’S HEALTH SYSTEM PERFORMANCE: A BALANCED SCORECARD STUDY
Thanh NX, Jonsson E Institute of Health Economics, Edmonton, AB, Canada OBJECTIVE: The aim of this study is to evaluate Alberta’s health system performance using a balanced scorecard approach. METHODS: Comparable indicators of health outcome, quality of care and health service accessibility available on the websites of Canadian Institute of Health Information and Alberta Health and Wellness were analyzed. In total, 36 indicators of Alberta were relatively compared to the corresponding average and best numbers of Canada. RESULTS: Alberta’s health system generally performed slightly better than the country’s average (103%) but
Abstracts significantly lower than the country’s best (79%). Among the comparable indicators, 15 were under the country’s average and only 3 were equal to the best, indicating that there is a long way ahead for Alberta’s Health System to become the best in terms of comprehensive performance in Canada. The study also identified the worst five indicators of Alberta in comparison with the country’s average. They were infant mortality, potential years of life lost due to unintentional injuries, potential years of life lost due to suicides, mortality for prostate cancers, and mortality for all strokes. A further analysis on these 5 indicators across 9 regions of residence in Alberta showed that regions with the highest number (rate) of infant mortality was Capital (East Central), mortality for transport accidents was Calgary (Peach Country), mortality for falls was Capital (Palliser), mortality for suicides as well as for strokes was Capital (Aspen), and mortality for prostate cancers was Calgary (Northern Lights). CONCLUSION: We suggest that this information should be considered when setting priority for planning of the province’s health system. PHP77 EVALUATION OF THE IMPACT OF PATIENT SAFETY ACTIVITIES ON THE NUMBER OF VOLUNTARY INCIDENT REPORTS AT TEACHING HOSPITALS IN JAPAN
Fukuda H, Imanaka Y, Hirose M, Hayashida K Kyoto University, Kyoto, Japan OBJECTIVE: To assess the effectiveness of hospital-wide patient safety activities in order to improve incident reporting systems. METHODS: A questionnaire was administered to all 1039 teaching hospitals in Japan. The number of incident reports was measured by type of profession and the volume of human resources used for patient safety activities during the 6 months in 2006 was inquired. To control the barriers of incident reporting among health care staff and hospital characteristics, we also collected institutional data regarding system design of incident reporting in each hospital, hospital ownership, and hospital size. We measured the amount of patient safety activities for the following domains: meetings and conferences, internal audits, and staff education. The activity volumes were then divided into two categories: above and below the median. Poisson regression with overdispersion was used to perform multivariate analyses of the incident reports. RESULTS: We received 418 replies (40.2%) out of the 1039 institutions. We excluded hospitals with missing data, resulting in final respective samples sizes of 234 and 233 for the number of incident reported by doctor and nurse, respectively. The use of online reporting appeared to increase the number of incident reports by doctors (21.2%, P < 0.05), while reducing time required to report the incident (24.3%, P < 0.05). Moreover, in hospitals that implemented more staff education for doctors, reporting significantly increased by over 30% (P < 0.01). In contrast, nurses were encouraged only by online reporting. Staff education for nurses was not significant factor, though the point estimates tended towards an increased number of incident reports. CONCLUSION: In accordance with “theory-based” findings in past literature, our findings have shown that patient safety program for staff education might increase the number of incident reports, even if we controlled factors regarding system design of incident reporting, by the analysis of the “empirical” data of a nation-wide multi-centre study.
Bharmal M1, Cascade EF2, Gemmen EK3 1 Quintiles, Falls Church, VA, USA, 2Quintiles, Inc, Falls Church, VA, USA, 3Quintiles Strategic Research & Safety, Falls Church, VA, USA OBJECTIVE: Patients are increasingly getting involved in making their treatment decisions, however, options for obtaining satisfaction information from other patients on their medications is limited primarily to on-line blogs. Using a validated PRO instrument to capture and disseminate feedback in a structured, unbiased way could be a valuable service to patients. The Treatment Satisfaction Questionnaire for Medication Version I (TSQM) is a 14-item reliable and valid instrument to assess patients’ satisfaction with medication, providing scores on four scales—side effects, effectiveness, convenience and global satisfaction. This study discusses preliminary results on satisfaction with ten different chronic medications from a novel patient registry. METHODS: The registry recruited patients from multiple sources including physicians, pharmacies, and online referrals. Patients were asked to report ongoing medications on the project website (www.iGuard.org). A sample of patients were contacted to complete the TSQM. The current analysis captures data from patients on any of the following ten chronic medications— acetylsalicylic acid, atorvastatin, simvastatin, lisinopril, metoprolol, metformin, levothyroxine, salbutamol, fluticasone/ salmeterol or sertraline (n = 495). Analyses were conducted to explore differences in patients’ satisfaction across medications. RESULTS: The mean age (SD) of the patients was 54.1 (14.2) years: 62.7% were females, 91.6% Caucasian and 3.7% black. The TSQM domains had good internal consistency with Cronbach’s alpha for all domains exceeding 0.85. The number of respondents was more than 30 for all but one medication. The mean TSQM scores ranged from 67.3 (metoprolol) to 76.1 (atorvastatin) on effectiveness, from 77.3 (metoprolol) to 95.3 (acetylsalicylic acid) on side effects, from 77.3 (salbutamol) to 87.7 (simvastatin) on convenience and from 60.9 (metoprolol) to 78.0 (levothyroxine) on global satisfaction. Differences were observed in TSQM domain scores between medications used for treating the same medical condition. CONCLUSION: Comparative data on patients’ satisfaction with medications can provide useful information to patients when starting a new medication or comparing their own experience. HEALTH CARE USE & POLICY STUDIES— Quality of Care PHP76 ALBERTA’S HEALTH SYSTEM PERFORMANCE: A BALANCED SCORECARD STUDY
Thanh NX, Jonsson E Institute of Health Economics, Edmonton, AB, Canada OBJECTIVE: The aim of this study is to evaluate Alberta’s health system performance using a balanced scorecard approach. METHODS: Comparable indicators of health outcome, quality of care and health service accessibility available on the websites of Canadian Institute of Health Information and Alberta Health and Wellness were analyzed. In total, 36 indicators of Alberta were relatively compared to the corresponding average and best numbers of Canada. RESULTS: Alberta’s health system generally performed slightly better than the country’s average (103%) but
Abstracts significantly lower than the country’s best (79%). Among the comparable indicators, 15 were under the country’s average and only 3 were equal to the best, indicating that there is a long way ahead for Alberta’s Health System to become the best in terms of comprehensive performance in Canada. The study also identified the worst five indicators of Alberta in comparison with the country’s average. They were infant mortality, potential years of life lost due to unintentional injuries, potential years of life lost due to suicides, mortality for prostate cancers, and mortality for all strokes. A further analysis on these 5 indicators across 9 regions of residence in Alberta showed that regions with the highest number (rate) of infant mortality was Capital (East Central), mortality for transport accidents was Calgary (Peach Country), mortality for falls was Capital (Palliser), mortality for suicides as well as for strokes was Capital (Aspen), and mortality for prostate cancers was Calgary (Northern Lights). CONCLUSION: We suggest that this information should be considered when setting priority for planning of the province’s health system. PHP77 EVALUATION OF THE IMPACT OF PATIENT SAFETY ACTIVITIES ON THE NUMBER OF VOLUNTARY INCIDENT REPORTS AT TEACHING HOSPITALS IN JAPAN
Fukuda H, Imanaka Y, Hirose M, Hayashida K Kyoto University, Kyoto, Japan OBJECTIVE: To assess the effectiveness of hospital-wide patient safety activities in order to improve incident reporting systems. METHODS: A questionnaire was administered to all 1039 teaching hospitals in Japan. The number of incident reports was measured by type of profession and the volume of human resources used for patient safety activities during the 6 months in 2006 was inquired. To control the barriers of incident reporting among health care staff and hospital characteristics, we also collected institutional data regarding system design of incident reporting in each hospital, hospital ownership, and hospital size. We measured the amount of patient safety activities for the following domains: meetings and conferences, internal audits, and staff education. The activity volumes were then divided into two categories: above and below the median. Poisson regression with overdispersion was used to perform multivariate analyses of the incident reports. RESULTS: We received 418 replies (40.2%) out of the 1039 institutions. We excluded hospitals with missing data, resulting in final respective samples sizes of 234 and 233 for the number of incident reported by doctor and nurse, respectively. The use of online reporting appeared to increase the number of incident reports by doctors (21.2%, P < 0.05), while reducing time required to report the incident (24.3%, P < 0.05). Moreover, in hospitals that implemented more staff education for doctors, reporting significantly increased by over 30% (P < 0.01). In contrast, nurses were encouraged only by online reporting. Staff education for nurses was not significant factor, though the point estimates tended towards an increased number of incident reports. CONCLUSION: In accordance with “theory-based” findings in past literature, our findings have shown that patient safety program for staff education might increase the number of incident reports, even if we controlled factors regarding system design of incident reporting, by the analysis of the “empirical” data of a nation-wide multi-centre study.