Patients view on consultation in outpatient clinic – from satisfaction to demand of guidance into more self-management

Background: Patients with rheumatic diseases, routinely consult the outpatient clinic 1-2 times a year to see their rheumatologist. Many of the patients also attend nurse-led consultations to receive instructions, regarding treatment in association to their intravenous treatment, or DMARD dispensing in the clinic. As clinicians we have an assumption of what the textquotedblrightgood practicetextquotedblright is in relation to the patients, but we have little insight, into the patients’ own experience and satisfaction.Objectives: To investigate the patients views on the level of information, and their experience and satisfaction with the doctor and nurse-led consultations in the outpatient clinic.Methods: The approach of the survey was both quantitative and qualitative. A questionnaire was designed with four questions on a matrix scale concerning their information level on their disease/symptoms; their treatment; if they had received written material and if so, it’s value; and their possibility to talk about subjects that matters for them during consultations. To gain a qualitative approach with focus on the patients’ experiences and comments, every question was constructed with space for comments. Comments were transcribed, indexed, analysed, and thematically divided. The inclusion of patients were all patients visiting the clinic within a specific week in January 2019.Results: The results from the four questions, are shown in the figures below, measured in percentage. In total, 283 participated (response rate 60.Four themes covered from the analysis of patients’ comments. textquotedblleftSeeking own answerstextquotedblright, textquotedblleftOwn coping textendash efforttextquotedblright, textquotedblleftConversation with doctor/nursetextquotedblright and textquotedblleftTreatment/medicationtextquotedblright. Comments revealed many descriptions and stories of patients, showered with all types of suggestions of taking control or managing the disease by them self, from their family or media. It also revealed their interest in discussing, these subjects and matters with the doctor/nurse, without being rejected. The feeling of rejection resulted in some patients trying other treatments or introducing changes in their lifestyle, without involving the doctor. The patients also called for more knowledge about physical training, and not only medical treatment.Conclusion: In general, the patients had a very positive perception towards the consultations, and the information from the outpatient clinic. Despite that, the themes indicated a pattern, that needs to be considered, so clinicians acknowledge the patients wish for guidance, besides the medical treatment. To support the patient, without leaving them with a feeling of being rejected, we need to consider how to articulate the subjects the patients are exposed to outside our clinic, so the patients feel free to inform or involve the clinic instead of being silent, in risk of counteracting the medical treatment.Acknowledgments: We are grateful to the participants who shared their experiences. We also thank an internal research group taking part of the investigation.Disclosure of Interests: Ida Lund: None declared, Annette Hansen Consultant of: AbbVie, Speakers bureau: Eli Lily, Betina Stampe: None declared, René Cordtz: None declared, Lene Dreyer: None declared