V Foltan

Consumer satisfaction with pharmaceutical care in Slovak community pharmacies / Spokojnosť klientov lekární s lekárenskou starostlivosťou na Slovensku

Abstract The aim of this pilot study was to evaluate consumer satisfaction with pharmaceutical care provided in community pharmacies at the region level. Expectations and opinions of consumers were also confronted with the assumptions of pharmacists. Up to 82.0% of consumers confirmed their satisfaction with the care given to them by the pharmacist. A key factor of consumer satisfaction has been the professional (78.7%) and human approach (83.5%) of the pharmacist. A total of 73.6% of consumers in the survey accepted the pharmacist as an expert in medicines. The pharmacist´s self-evaluation was more negative. Monitoring and evaluation of consumer satisfactory with pharmaceutical care is not only essential for improvement of the quality of the healthcare system and for the implementation of pharmaceutical care focussed on the patient, but it may influence the economic and financial outcomes of entities providing pharmaceutical care in community pharmacies. Slovak abstract Cieľom tejto pilotnej štúdie bolo zhodnotiť spokojnosť zákazníkov s lekárenskou starostlivosťou poskytovanou vo verejných lekárňach na lokálnej úrovni. Očakávania a názory zákazníkov boli zároveň porovnané s predpokladmi lekárnikov. Až 82,0% zákazníkov potvrdilo svoju spokojnosť so starostlivosťou, ktorú im poskytuje lekárnik. Ako kľúčový faktor spokojnosti zákazníkov sa ukázal profesionálny (78,7%) a ľudský prístup (83,5%) lekárnika. 73,6% zákazníkov v našom prieskume akceptovalo lekárnika ako odborníka na lieky. Sebahodnotenie lekárnikov bolo negatívnejšie. Monitoring a hodnotenie spokojnosti zákazníkov s lekárenskou starostlivosťou je nevyhnutné nielen pre zlepšenie kvality systému zdravotnej starostlivosti a pre implementáciu lekárenskej starostlivosti orientovanej na pacienta, ale môže ovplyvniť ekonomické a finančné výsledky subjektov poskytujúcich lekárenskú starostlivosť vo verejných lekárňach.

The Assessment of Patient Satisfaction and Attendance of Community Pharmacies in Slovakia

Abstract Aim: Patient-oriented pharmaceutical care in pharmacies could improve patient satisfaction and influence patient’s choice of a community pharmacy. The aim of the work was to assess patient satisfaction and attendance in community pharmacies in Slovakia. Methods: A self-administered, anonymous questionnaire was distributed to patients visiting 33 community pharmacies in a total of 23 Slovak cities during October-December 2013. The questionnaire contained 29 items and three dimensions were supposed (managing therapy, interpersonal relationship, general satisfaction). A 5-point Likert-type scale (1 = very satisfied, 2 = satisfied, 3 = neither satisfied nor dissatisfied, 4 = dissatisfied, 5 = very dissatisfied) was used for assessing patient satisfaction. The results are presented in percentages and by the level of satisfaction within the range: high satisfaction (score 1.00-2.50), moderate satisfaction (score 2.51-3.50) and low satisfaction (score 3.51-5.00). Reasons for attendance in the community pharmacy and factors influencing pharmacy choice were evaluated either. Results: A total 2 844 respondents were included into the survey. Patient satisfaction with pharmaceutical care achieved high satisfaction level: interpersonal relationship (1.85 ± 0.598; 86.7% highly satisfied respondents) and general satisfaction (2.02 ± 0.643; 71.3% highly satisfied respondents). Managing therapy scored lower (2.24 ± 0.704; 65.4% highly satisfied respondents). The most frequently reported reasons for attending community pharmacy were to obtain prescription (70.4%) and over-the-counter medications (70.4%). The patient choice of a particular pharmacy was influenced by its location (74.1%). Conclusion: This study presents the first nationwide patientreported outcomes about patient satisfaction and attendance in community pharmacies in Slovakia. Future development and advancement of pharmacy practice leading to higher patient satisfaction requires modification of community pharmacists’ professional behaviour in Slovakia namely in managing therapy of patients.

Improving Patient Quality of Life By Verifying And Enhancing Quality of Orthopaedic And Prosthetic Medical Devices.

Extended psychometric analysis was done using the factor analysis (Horn ́s Parallel Analysis, Exploratory Factor Analysis) and Rasch analysis (RA, Rating Scale model) (Scale diagnostic, Validity, Reliability, Dimensionality and Local independence, Differential item functioning (DIF)). Results: Horn ́s Parallel Analysis revealed one factor (loading factor > 0.40). RA showed a correct functioning of the rating categories of the scale. As for the item fit, only one item ‘It is easy to put on my device’ slightly underfitted the model (Outfit MSQ = 0.720, Infit MSQ = 0.650) and item ‘durability’ overfitted the model (Outfit MSQ = 1.378, Infit MSQ = 1.291). The study showed a few similar allocations of items along the logit scale, weight and fit was easy to endorse, whereas the look and comfort of the orthosis were difficult to agree with. No local dependency was detected. The targeting of item difficulty to the patient ability was good. Omega reliability value of CSD-Sk was 0.9 (polychoric Cronbach’s alpha level 0.9). No DIF was detected. ConClusions: Despite some limitations in terms of fit, psychometric properties of CSD-Sk are in line with previous analyses on the English, Swedish and Italian version of the tool.

PATIENT SATISFACTION WITH ORTHOPEDIC AND PROSTHETIC MEDICAL DEVICES

Collecting information about patient satisfaction with orthopedic and prosthetic medical devices in terms of utility, tolerance, and compliance is essential for verifying and improving the quality of these devices. In addition, such information is useful for improving the patients’ quality of life, and the quality management systems of health care providers. This study assessed patient satisfaction with these devices from a sample of patients with orthopedic, neurologic, and rheumatic diseases at the Specialized Hospital for Orthopedic Prosthetics and at the premises of the Dispenser of O rthopedic and Prosthetic M edical Devices, both in Bratislava in the Slovak Republic. The assessment involved a translated and validated questionnaire about patient satisfaction with orthopedic and prosthetic medical devices to evaluate key factors of weight, fit, appearance, comfort, pain free, free of abrasiveness, ease of application, and durability of each device. The study samples consisted of patients with lower limb problems (42.5%), spine problems (26.9%), and a combination of leg and spine issues (25.9%). Orthopedic disease occurred in 73.6% of these patients, a combination of orthopedic and neurologic disease in 13.5%, and neurologic disease in 7.3%. Orthopedic insoles (36.3%), hip belts (17.6%), and the corset on the spine (5.2%) were the most used devices. Overall, the medical devices rated highly, with a high proportion of patients voting “strongly satisfied” in five of the eight key factors (range 51.8 to 63.2%), followed by a moderately lower proportion for durability (43.5%), comfort (37.3%), and appearance (31.1%). The comfort in wearing the device received the greatest patient dissatisfaction (22.8% of patients), followed by appearance (12.4%), and then fit (7.3%).

Spending of medical devices in Slovakia

Abstract Medical devices (MD), together with pharmacotherapy are supportive treatment of many acute and chronic diseases. MD as a part of medical technologies lead to more effective treatment, faster patient recovery and a reduced risk of complications. Many MD are reimbursed from public health insurance funds entirely; for others, particularly advanced functional types of MD, there must be patient participation on price or they can buy them according own decision (direct sale). The target of this study is to analyze the data from paid databases of National Center for Health Information (NCHI) that collects the outputs of provided healthcare. The most recent data were from 1.1.2013 to 30.9.2013. According to NCHI, apart from community pharmacies, there are 226 registered establishments that sold MD until 30.9.2013. Their specialization included dispensing MD (n=163), dispensing orthopaedic devices (n=48) and dispensing audioprosthetic devices (n=15). In the observed period, average monthly spending on MD were 10.1 million packages and 14 million €. Average monthly spending on reimbursed MD were 8.8 million packages and 12.9 million €. The groups with the largest shares were MD for incontinence and urinary retention, 7.7 million packages (86.9%) and 3.9 million € (30.7%); plasters and bandaging materials, 0.5 million packages (6.0%) and 1.3 million € (10.1%); MD for ostomies, 0.4 million packages (4.5%) and 1 million € (8.0%); and the MD for diabetics group, 0.1 million packages (1.4%) and 1.6 million € (12.8%). Direct sales of MD per month on average reached 1.3 million packages and 1.1 million €. The groups with largest shares were MD for incontinence and urinary retention, 629,660 packages (50.3%) and 291,919 € (26.2%); plasters and bandaging materials, 388,111 packages (31.0%) and 227,119 € (20.4%); and MD for diabetics, 56,014 packages (4.5%) and 81,721 € (7.3%).

New Types of Assessments of Community Pharmacy Technology Businessand Their Contribution Towards Prosperity of the Community Pharmacy

The new approach how to assess community pharmacy business by monitoring indicators of financial analysis, contributes to a positive economic development in the community pharmacy business. The better is understanding and analysis of the financial statements in the community pharmacy business, the better will be improvement in managing and controlling finances. Financial analysis enable the community pharmacy to make more informed decisions, comparisons of actual financial performance with forecast targets, performances in past years and comparisons to industry averages. The most important analysed financial statements are balance sheet and profit and loss statement. The outcomes of the financial analysis are debt, efficiency, profitability, liquidity ratios and working capital ratio. They are compared to recommended values and the suggestions are made to improve community pharmacy´s efficiency and prosperity. The result of the new approach to assessment community pharmacy technology business will contribute to positive financial development of the community pharmacy and it´s maintenance or survival at the upcoming time.

PCV57 COSTS OF ATRIAL FIBRILLATION IN SLOVAKIA FROM A PAYER PERSPECTIVE

the care pathway to ensure rapid assessment and treatment for TIA patients would avoid 128 future stroke events over three years. As a result, the costs associated with the reconfiguration of the TIA patient care pathway would be partially offset by savings in acute stroke management costs. CONCLUSIONS: Our model suggests that implementing a revised TIA care pathway in Hungary would result in a reduction of TIA-related recurrent strokes, leading to reduced costs associated with the acute management of stroke. This would partially offset the costs of establishing rapid assessment and treatment clinics for patients experiencing TIA.

PCV8 COST OF ILLNESS IN PATIENTS WITH PULMONARY EMBOLISM AFTER ELECTIVE TOTAL HIP REPLACEMENT

economic evaluations studies published to date regarding these three drugs. METHODS: The economic impact was determined comparing the annual costs with drug and adjuvant therapy. The prices established by government for these drugs in renal transplantation were considered. Leaflet’s recommendations were followed for everolimus and MMF dosages. The dosage of azathioprine was based on clinical trials. The average cyclosporine dosages were taken according to the respective treatment available in clinical trials. Cochrane, Pubmed and Medline databases were used for pharmacoeconomic studies research. RESULTS: The most cost-saving therapy was found to be azathioprine, followed by everolimus, with the incremental annual cost of US

ECONOMIC EVALUATION OF HEALTH CARE UTILIZATION IN THE SLOVAK REPUBLIC

2862.81 (R

ACCESSIBILITY AND AVAILABILITY OF PHARMACEUTICAL CARE IN COMMUNITY PHARMACIES IN THE SLOVAK REPUBLIC. AN EVIDENCE-BASED STUDY FROM 1998 TO 2014

2.27/USD 1.00) compared to azathioprine. The third is MMF, showing US