Patients' satisfaction with the rheumatology day care unit

Background: Patients receiving biological therapies are regularly evaluated and monitored at rheumatology day care units (RDCU). Despite patients’ satisfaction with the delivered care and the relationship between the patient and the multidisciplinary team being acknowledged as important aspects to ensure adherence to therapy, factors associated with them have not been investigated so far. Objectives: To evaluate patients’ satisfaction with the functioning of the RDCU and to identify the factors associated with the level of satisfaction.Methods: An anonymous questionnaire was administered to all patients with rheumatoid arthritis (RA) or spondyloarthritis treated with biological drugs and followed at the RDCU at Hospital Garcia de Orta, Almada, Portugal. Satisfaction was measured using a visual analogue scale (0-100, 0 meaning completely unsatisfied, 100 meaning completely satisfied). Further information was collected on socio-demographic variables, physical conditions of the RDCU, waiting time, satisfaction with the role of medical, nursing and administrative staff (satisfaction level with their friendliness, question answering, care delivery, privacy during consultation, clarity in the information given, which was then transformed into a composite score, 0-20). Factors associated with satisfaction were studied by univariable followed by multiple linear regression to adjust for potential confounders. Results: In total, 150 patients were included in the study (mean age 50.6 ± 13.7 years, 64% female, 62% RA, mean disease duration 10.6 ± 6.1 years). The majority of patients attended the RDCU for more than three years and 57% received subcutaneous therapy. The mean level of satisfaction with the RDCU was 81.9 ± 17.9. Multivariable analysis showed that intravenous therapy (β 6.13, 95% confidence interval - CI 0.71-11.55), physician score (β 2.28, 95%CI 1.20-3.35) and increasing levels of satisfaction with the room temperature (β 5.64, 95%CI 3.06-8.21) and waiting time (β 25.53, 95%CI 8.17-42.89, for a very good vs non-acceptable waiting time) were positively associated with the level of satisfaction, while the nursing score was inversely associated. Conclusions: Patients were overall very satisfied with the functioning of the RDCU. Waiting time, satisfaction with the physician role, room temperature and intravenous therapy were the main factors positively associated with the level of satisfaction.Keywords: Patient Satisfaction; Day care; Biological Therapy; Portugal