Session Type: ACR Poster Session A
Session Time: 9:00AM-11:00AM
Background/Purpose: The University of Alberta Division of Rheumatology has launched a new multidisciplinary clinic, the On-TRACC Program (On Treating Rheumatoid Arthritis – Providing Access to Care), which provides aggressive treat to target (T2T) disease modification and co-morbidity management in a shared-care model of rheumatologists and advanced care practitioners (ACP). Primary Objective: To evaluate patient satisfaction in patients enrolled in the On-TRACC program compared to those treated in general rheumatology clinics through a patient satisfaction survey.
Methods: We performed an observational cross-sectional survey study using a modified version of the Leeds Satisfaction Questionnaire (LSQ), a validated and reliable tool developed for inflammatory arthritis (IA) outpatient clinics, to compare satisfaction between the two patient groups: On-TRAAC and the traditional model of care (TMC). The six groups included in the questionnaire’s subscales, and thus assessed with this survey included: (1) provision of information, (2) empathy with the patient, (3) attitude towards the patient, (4) access to and continuity with the caregiver, (5) technical competence and (6) overall satisfaction. A sub-group analysis of patient satisfaction between the first and second visit in the On-TRACC group was also performed. Markers of disease activity including DAS 28-CRP, HAQ (Health Assessment Questionnaire) and CRP were assessed over time in the On-TRACC group.
Results: A total of 75 patients completed the survey (27 patients in the On-TRAAC group and 48 in the TMC). The average age of the participants was 53 years and included 24 males and 51 females. The overall satisfaction score was 4.36 in the TMC group and 4.48 in the On-TRAAC group (higher values represents higher satisfaction). Ten patients in the On-TRAAC group performed the survey at least twice and showed an overall trend towards improved satisfaction on subsequent visits with an initial overall satisfaction score of 4.48 and follow up score of 4.55. No statistically significant differences were noted between groups, or within the On-TRACC group. Within the On-TRACC group, markers of disease activity including DAS 28 CRP, HAQ and CRP all showed improvement between baseline and follow-up visits.
Conclusion: While patients in both treatment groups were very satisfied with their care, patients in the On-TRACC group were at least as satisfied with their care as those in the TMC, and there was a trend towards improved satisfaction with the multi-disciplinary care model. This has important implications as it lends support to the use of this alternate model of care in the provision of services to those with IA, which has potential benefits from both a clinical and health economics perspective. Larger patient numbers with longer follow-up are needed to provide meaningful comparisons between these different models of care. Table 1. Baseline characteristics and overall satisfaction
|Characteristic||On Tracc Group (n=27)||TMC (n=48)|
|Mean age (Range) ± SD||50.6 years (22-85) ± 16.63||54.4 years (18-87) ± 16.39|
|Gender||6 Male (22%) 21 Female (78%)||18 Male (37.5%) 30 Female (62.5)|
|Duration of Inflammatory Arthritis||< 1 year = 8 (30%) 1-5 years = 6 (22%) > 5 years = 13 (48%)||< 1 year = 6 (12.5%) 1-5 years = 22 (46%) > 5 years = 20 (41.5%)|
|Ethnic Origin||22 Caucasian (81%) 2 Asian (7.5%) 2 First nations (7.5%) 1 Mixed ethnicity (4%)||Unknown|
|Smoking Status||2 Current smokers (7%) 8 Ex-smokers (30%) 17 Never smokers (63%)||Unknown|
|Baseline CRP||5 patients < 1 (19%) 20 patients > 1 (74%)||Unknown|
|Baseline DAS 28 CRP||10 patients < 2.6 (37%) 15 patients > 2.6 (56%)||Unknown|
To cite this abstract in AMA style:Roberts J, Keeling SO, Katz SJ. Evaluation of Patient Satisfaction with the on-Tracc Program; Benefits of a Joint Approach [abstract]. Arthritis Rheumatol. 2016; 68 (suppl 10). https://acrabstracts.org/abstract/evaluation-of-patient-satisfaction-with-the-on-tracc-program-benefits-of-a-joint-approach/. Accessed March 25, 2019.
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