Abstract
Patient involvement in the improvement of health care is important for the best long-term treatment outcomes. Our objective is to assess patient satisfaction with offered care service and to identify parameters which influence the adherence to long-term therapy. A prospective single-center study based on the administration of a structured interview to multiple sclerosis (MS) patients attending our MS Centre with mild and moderate disabilities. The interview regarding clinical parameters, quality of life and satisfaction of care service was structured in three parts with multiple-choice answers to close- or open-ended questions. Patient satisfaction was evaluated by the concordance between the level of patient attention and judgment regarding the services offered. The impact of all variables on the adherence to therapy and on the perceived utility of treatment was evaluated. The concordance between patient attention and judgment on health care services resulted statistically significant for almost all parameters. The perceived utility of treatment was significantly correlated to patients feeling confident in the clinical staff, to their perception of being involved in therapeutic decision (p < 0.05), and associated to therapy adherence (p = 0.0001). In a multivariate model, the adherence to therapy resulted associated to possibility of choosing the physician (p = 0.037) and inversely to therapy duration (p = 0.001). Our conclusion reveals that, to improve the adherence to long-term therapy and the perceived utility of treatment, a particular attention should be devoted to physician–patient relationship.
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References
European MS Platform (2007) Code of good practice in MS. revised (2008). http://ms-in-europe.com/w3p_dokumentearchiv/1code08.pdf
Wensing M, Elwyn G (2002) Research on patients’ views in the evaluation and improvement of quality of care. Qual Saf Health Care 11:153–157
Associazione Italiana Sclerosi Multipla (AISM) (2002) Sclerosi Multipla: la qualità dei Servizi. http://allegati.aism.it/manager/UploadFile/2/libro%20bianco%202002%20qualità%20dei%20servizi.200954_16314.pdf
Benedict RH, Wahlig E, Bakshi R, Fishman I, Munschauer F, Zivadinov R, Weinstock-Guttman B (2005) Predicting quality of life in multiple sclerosis: accounting for physical disability, fatigue, cognition, mood disorder, personality, and behavior change. J Neurol Sci 231:29–34
McCabe MP, McKern S (2002) Quality of life in patients with multiple sclerosis: the impact of fatigue and depression. J Neurol Sci 205:51–58
Fruehwald S, Loeffler-Stastka H, Eher R, Saletu B, Baumhackl U (2001) Depression and quality of life in multiple sclerosis. Acta Neurol Scand 104:257–261
Janssens AC, van Doorn PA, de Boer JB, Kalkers NF, van der Meche FG, Passchier J, Hintzen RQ (2003) Anxiety and depression influence the relation between disability status and quality of life in multiple sclerosis. Mult Scler 9:397–403
Kvale S, Brinkman S (2008). Interviews, 2nd Edition. SAGE, Thousand Oaks
Lindlof TR, Taylor BC (2002). Qualitative Communication Research Methods, 2nd Edition. SAGE, Thousand Oaks
Freeman J, Thompson A (2000) Community services in multiple sclerosis: still a matter of chance. J Neur Neurosurg Psychiatry 69:728–732
Somerset M, Campbell R, Sharp DJ, Peters TJ (2001) What do people with MS want and expect from health-care services. Health Expect 4:29–37
Forbes A, While A, Mathes L, Griffiths P (2006) Health problems and health related quality of life in people with multiple sclerosis. Clin Rehabil 20:67–78
Forbes A, While A, Taylor M (2007) What people with multiple sclerosis perceive to be important to meeting their needs. J Adv Nurs 58:11–22
Stockl KM, Shin JS, Gong S, Harada AS, Solow BK, Lew HC (2010) Improving patient self-management of multiple sclerosis through a disease therapy management program. Am J Manag Care 16:139–144
Gottberg K, Einarsson U, Ytterberg C, Fredrikson S, von Koch L, Holmqvist LW (2008) Use of health care services and satisfaction with care in people with multiple sclerosis in Stockholm County: a population-based study. Mult Scler 14:962–971
Ytterberg C, Johansson S, Gottberg K, Holmqvist LW, von Koch L (2008) Perceived needs and satisfaction with care in people with multiple sclerosis: a two-year prospective study. BMC Neurol 29:36
Wensing M, Hermsen J, Grol R, Szecsenyi J (2008) Patient evaluations of accessibility and co-ordination in general practice in Europe. Health Expect 11:384–390
Fuertes JN, Mislowack A, Bennett J, Paul L, Gilbert TC, Fontan G (2007) The physician-patient working alliance. Patient Edu Couns 66:29–36
Fuertes JN, Boylan LS, Fontanella JA (2009) Behavioral indices in medical care outcome: the working alliance, adherence, and related factors. J Gen Intern Med 24:80–85
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We thank Ms Tania Merlino for editing the English language used in this paper.
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Koudriavtseva, T., Onesti, E., Pestalozza, I.F. et al. The importance of physician–patient relationship for improvement of adherence to long-term therapy: data of survey in a cohort of multiple sclerosis patients with mild and moderate disability. Neurol Sci 33, 575–584 (2012). https://doi.org/10.1007/s10072-011-0776-0
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DOI: https://doi.org/10.1007/s10072-011-0776-0