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Crubezy M, Corbin S, Hyvert S, Michel P, Haesebaert J. Studying both patient and staff experience to investigate their perceptions and to target key interactions to improve: a scoping review. BMJ Open 2022; 12:e061155. [PMID: 36216415 PMCID: PMC9557797 DOI: 10.1136/bmjopen-2022-061155] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVE The improvement of patient experience (PE) is related to the experience of staff caring for them. Yet there is little evidence as to which interactions matter the most for both patients and staff, or how they are perceived by them. We aimed to summarise the interactions and the perceptions between patients and staff from studies by using both patient and staff experience data in healthcare institutions. DESIGN Scoping review. METHODS We conducted a scoping review, including studies dealing with PE and staff experience. Two authors independently reviewed each title/abstract and the selected full-text articles. A list of variables (objective, study design, data sources, tools used, results, interactions, perceptions and actions) was charted and summarised using a narrative approach including both qualitative and quantitative data. Studies were grouped according to their objective and the key interactions summarised according to this stratification. The perceptions of patients and staff were identified in the results of selected studies and were classified into four categories: commonalities and disagreements of perceptions, patients' perceptions not perceived by professionals and professional's perceptions not perceived by patients. RESULTS A total of 42 studies were included. The stratification of studies by type of objective resulted in six groups that allowed to classify the key interactions (n=154) identified in the results of the selected studies. A total of 128 perceptions related to interaction between patient and staff were reported with the following distribution: commonalities (n=35), disagreements (n=18), patients' perceptions not perceived by professionals (n=47) and professional's perceptions not perceived by patients (n=28). We separated positive and negative perceptions, which resulted in seven scenarios, each with actions that can be carried out for one or both populations to overcome barriers. CONCLUSION The study of both patient and staff experience allowed the identification of actions that can be taken to change the perceptions of patients and staff.
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Affiliation(s)
- Marion Crubezy
- Research on Healthcare Performance (RESHAPE), INSERM U1290, Université Claude Bernard Lyon 1 - Domaine de Rockefeller, Lyon, France
- Département des Études et de la Recherche, Institut d'études KPAM, Paris, France
| | - Sara Corbin
- Research on Healthcare Performance (RESHAPE), INSERM U1290, Université Claude Bernard Lyon 1 - Domaine de Rockefeller, Lyon, France
| | - Sophie Hyvert
- Pôle Santé Publique, Service Recherche et Epidémiologie Cliniques, Hospices Civils de Lyon, Lyon, France
| | - Philippe Michel
- Research on Healthcare Performance (RESHAPE), INSERM U1290, Université Claude Bernard Lyon 1 - Domaine de Rockefeller, Lyon, France
- Direction Qualité Usagers et Santé Populationnelle, Hospices Civils de Lyon, Lyon, France
| | - Julie Haesebaert
- Research on Healthcare Performance (RESHAPE), INSERM U1290, Université Claude Bernard Lyon 1 - Domaine de Rockefeller, Lyon, France
- Pôle Santé Publique, Service Recherche et Epidémiologie Cliniques, Hospices Civils de Lyon, Lyon, France
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Lau G, Ho J, Lin S, Yeoh K, Wan T, Hodgkinson M. Patient and clinician perspectives of an integrated electronic medication prescribing and dispensing system: A qualitative study at a multisite Australian hospital network. Health Inf Manag 2017; 48:12-23. [PMID: 28745564 DOI: 10.1177/1833358317720601] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND: While clinician attitudes towards electronic prescribing (e-prescribing) systems have been widely studied, little is known about the perspectives of patients, despite being the primary beneficiaries of these systems. OBJECTIVE: The objective of this study is to explore and compare patient and clinician attitudes towards an integrated e-prescribing and dispensing system, in order to guide improvements in system implementation, service delivery and enhancements to system functionality. METHOD: A cross-sectional survey was developed and administered to patients and multidisciplinary clinicians at a multisite Australian metropolitan teaching hospital network in all areas where e-prescribing was fully implemented. Participants' views on perceived impact and valued features of the e-prescribing system were elucidated. RESULTS: Overall, 783 participants (400 patients and 383 clinicians) completed the survey. Although 98% of clinicians were aware of the transition to e-prescriptions, only 36% of patients were aware prior to the study. Over 80% of patients and clinicians perceived improvements in prescribing and dispensing safety and clinician workflow; 90% of patients were comfortable with information privacy associated with e-prescriptions; and 86% of patients preferred e-prescriptions to handwritten prescriptions. Although over 80% of patients valued features that improved access to information and medication safety, clinicians were more discerning about valued system features. CONCLUSION: The majority of patients and clinicians reported a positive impact of e-prescribing on safety and efficiency. Both groups valued safe and effective use of medicines, although differences existed in the importance placed on key system features. A greater focus on patient engagement and communication is needed to optimise the delivery of patient-centred care.
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Tamblyn R, Girard N, Dixon WG, Haas J, Bates DW, Sheppard T, Eguale T, Buckeridge D, Abrahamowicz M, Forster A. Pharmacosurveillance without borders: electronic health records in different countries can be used to address important methodological issues in estimating the risk of adverse events. J Clin Epidemiol 2016; 77:101-111. [PMID: 27212138 DOI: 10.1016/j.jclinepi.2016.03.033] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2015] [Revised: 02/19/2016] [Accepted: 03/11/2016] [Indexed: 12/22/2022]
Abstract
OBJECTIVES Evaluate methodological advantages and limitations of an international pharmacosurveillance system based on electronic health records (EHRs). STUDY DESIGN AND SETTINGS Type 2 diabetes was used as an exemplar. Cohorts of newly treated diabetics were followed in each country (Quebec, Canada; Massachusetts, United States; Manchester, UK) from 2009 to 2012 using local EHR systems. Cox proportional hazards models were used to assess the risk of cardiovascular events. RESULTS A total of 44,913 newly treated diabetics were identified; 82.6% (United States) to 93.1% (Canada) were started on biguanides; 13% of patients failed to fill initial prescriptions. An increased risk of cardiovascular events with sulfonylureas was observed when dispensing [hazard ratio (HR): 2.83] vs. EHR prescribing (HR: 2.47) data were used. The addition of clinical data produced a threefold to 10-fold increase in comorbidity for obesity and renal disease, but had no impact on the risk of different hypoglycemic therapies. The risk of cardiovascular events with sulfonylureas was higher in the United States [HR: 3.4; 95% confidence interval (CI): 2.1, 5.5] compared to England (HR: 1.3; 95% CI: 1.1, 1.6). CONCLUSION An international surveillance system based on EHRs may provide more timely information about drug safety and new opportunities to estimate potential sources of bias and health system effects on drug-related outcomes.
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Affiliation(s)
- Robyn Tamblyn
- Department of Epidemiology, Biostatistics and Occupational Health, Purvis Hall, McGill University, 1020 Pine Avenue West, Montreal, Quebec H3A 1A2, Canada; Department of Medicine, McGill University Health Center, 1001 Decarie Boulevard, Montreal, Quebec H4A 3J1, Canada; Clinical and Health Informatics Research Group, McGill University, 1140 Pine Avenue, Montreal, Quebec H3A 1A3, Canada.
| | - Nadyne Girard
- Clinical and Health Informatics Research Group, McGill University, 1140 Pine Avenue, Montreal, Quebec H3A 1A3, Canada
| | - William G Dixon
- Arthritis Research UK Centre for Epidemiology, Centre for Musculoskeletal Research, Institute of Inflammation and Repair, Manchester Academic Health Science Centre, The University of Manchester, 2nd Floor, Stopford Building, Oxford Road, Manchester M13 9PT, UK
| | - Jennifer Haas
- Brigham and Women's Hospital, 75 Francis Street, Boston, MA 02115, USA
| | - David W Bates
- Brigham and Women's Hospital, 75 Francis Street, Boston, MA 02115, USA
| | - Thérèse Sheppard
- Arthritis Research UK Centre for Epidemiology, Centre for Musculoskeletal Research, Institute of Inflammation and Repair, Manchester Academic Health Science Centre, The University of Manchester, 2nd Floor, Stopford Building, Oxford Road, Manchester M13 9PT, UK
| | - Tewodros Eguale
- Department of Epidemiology, Biostatistics and Occupational Health, Purvis Hall, McGill University, 1020 Pine Avenue West, Montreal, Quebec H3A 1A2, Canada
| | - David Buckeridge
- Department of Epidemiology, Biostatistics and Occupational Health, Purvis Hall, McGill University, 1020 Pine Avenue West, Montreal, Quebec H3A 1A2, Canada
| | - Michal Abrahamowicz
- Department of Epidemiology, Biostatistics and Occupational Health, Purvis Hall, McGill University, 1020 Pine Avenue West, Montreal, Quebec H3A 1A2, Canada
| | - Alan Forster
- The Ottawa Hospital, 501 Smyth Road, Ottawa, Ontario K1H 8L6, Canada
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Freccero C, Sundquist K, Sundquist J, Ji J. Primary adherence to antidepressant prescriptions in primary health care: a population-based study in Sweden. Scand J Prim Health Care 2016; 34:83-8. [PMID: 26828942 PMCID: PMC4911028 DOI: 10.3109/02813432.2015.1132884] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Medical adherence is important in the treatment of depression. Primary medical adherence, i.e. patients collecting their newly prescribed medications from pharmacies, is very different depending on the drug prescribed OBJECTIVE To assess the rate of primary medical adherence in patients prescribed antidepressants and to identify characteristics that make patients less likely to pick up prescriptions. METHODS An observational study was performed using primary health care data from Sweden on patients who were prescribed antidepressants. Univariate and multivariate logistic regression was used to determine differences in pick-up rate according to patient characteristics. MAIN OUTCOME Pick-up rate, defined as collection of a prescription within 30 days. RESULTS A total of 11 624 patients received an antidepressant prescription during the study period, and the overall pick-up rate was 85.1%. The pick-up rate differed according to country of birth: individuals born in the Middle East and other countries outside Europe had lower primary medical adherence than Swedes, with adjusted odds ratios (ORs) of 0.58 and 0.67, respectively. Patients at ages 64-79 years had a higher pick-up rate compared with those aged 25-44 years (OR 1.71). Divorced patients had a lower rate compared with married patients (OR 0.80). CONCLUSION Immigrants from the Middle East and other countries outside Europe and younger and divorced patients had lower primary medical adherence, which calls for clinical attention and preventive measures. KEY POINTS Primary medical adherence is important in the treatment of depression. Are patient characteristics associated with primary medical adherence? The overall primary medical adherence rate was 85%. The rate differed by country of birth, age at diagnosis of depression, and marital status. Clinical attention is needed in patients who do not pick up their antidepressants.
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Affiliation(s)
- Carl Freccero
- Center for Primary Health Care Research, Lund University/Region Skåne, Sweden
| | | | | | - Jianguang Ji
- Center for Primary Health Care Research, Lund University/Region Skåne, Sweden
- CONTACT Jianguang Ji Center for Primary Health Care Research, Lund University/Region Skåne. Clinical Research Centre (CRC), building 28, floor 11, Jan Waldenströms gata 35, Skåne University Hospital, SE-205 02 Malmö, Sweden
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