AB1207 ASSESSMENT OF RHEUMATIC DISEASES PATIENTS EXPERIENCE WITH THEIR HEALTHCARE USING IEXPAC. FACTORS ASSOCIATED AND AREAS OF IMPROVEMENT:
Authors: Javier de Toro-Santos, L María, García Vivar, Lucía Pantoja, Cristina Lerín Lozano, Silvia García-Díaz, Yvonne Mestre, Sabela Fernández, Luis Cea-Calvo
Journal: Annals of the Rheumatic Diseases (2019)

<h3>Background</h3> The experience of patients with healthcare has been associated to important outcomes. <h3>Objectives</h3> We describe the experience with healthcare of patients with rheumatic diseases from Spain self-reported through IEXPAC, a validated questionnaire, and the influence of demographic and health care-related factors. <h3>Methods</h3> The IEXPAC scale <i>("Instrument to Evaluate the EXperience of PAtients</i><i> with Chronic diseases"</i>, http://www.iemac.es/iexpac/) was developed and validated in Spain by health care professional and social organizations, experts in quality of healthcare and chronic patients (1). It consists of 12 items with Likert responses from "always" to "never" and yields an overall score from 0 (worst) to 10 (best experience). Three factors with sub-scores derive from the scale: Factor 1 (productive interactions, average of items 1, 2, 5 and 9, on patient-health care professionals relationship), Factor 2 (new relational model, average of items 3, 7 and 11, on the use of new technologies and contact with other patients) and Factor 3 (self-management, patients' ability to self-care, average of items 4, 6, 8 and 10). Data were obtained through an anonymous survey to patients from 25 Spanish hospitals. Bivariate comparisons and a multivariate analysis were made to explore the association between scores and demographic and health care-related characteristics. <h3>Results</h3> 625 patients received the survey, 359 (57.4%) returned it (mean age 55 years, 67% women). The percentage of patients who responded "always" or "nearly always" to the different statements is displayed in table 1. Mean overall IEXPAC score was 5.5 (SD 2.0), sub-scores were: productive interactions: 7.5 (2.5); new relational model: 1.7 (2.1); self-care: 6.5 (2.5). Overall score was higher (better experience) in men (p= 0.022), in those needing follow-up in a different region (p= 0.004), seen by a lower number of physicians (p= 0.025), seen by the same physician each time (p&lt; 0.001), treated with lower number of medicines (p= 0.039) or with subcutaneous or intravenous (SC/IV) drugs (p= 0.083). Multiple linear regression models (table 2) showed that being followed up by the same physician, being seen by lower number of specialists, and being treated with SC/IV drugs were associated to better overall experience scores. Associations were similar for the productive interactions and self-management factors. <h3>Conclusion</h3> Through IEXPAC, patients with rheumatic diseases identified areas of improvement in healthcare, especially those related with access to reliable information and services, interaction with other patients and continuity of health care after hospital discharge. Better experience was associated to being seen by lower number of specialists or being followed-up by the same physician each time, and also with treatment with SC/IV drugs, maybe in relation to the more personalized care these patients receive. <h3>Acknowledgement</h3> Funded by MSD of Spain and endorsed by 4 patients associations: ACCU, CONARTRITIS, SEISIDA, FEDE. We thank the participant patients for providing this valuable information by completing the survey. <h3>Disclosure of Interests</h3> Javier de Toro-Santos: None declared, María L. García Vivar: None declared, Lucía Pantoja: None declared, Cristina Lerín Lozano: None declared, Silvia García-Díaz: None declared, Yvonne Mestre Employee of: MSD, Sabela Fernández Employee of: MSD, Luis Cea-Calvo Employee of: MSD