Description of Patient Opinion About Covid-19 Vaccine at Al Mulk Hospital, Sukabumi City Year 2021

COVID-19 has been declared a world pandemic by WHO (WHO, 2020). Nationally, through the Decree of the Head of the National Disaster Management Agency Number 9A of 2020 which was updated through Decree number 13 A of 2020, the Status of Certain Disaster Emergency Conditions for Disease Outbreak due to Corona Virus in Indonesia has been determined as well as Presidential Decree Number 11 of 2020 concerning the Determination of Public Health Emergencies for COVID-19, then updated by Presidential Decree No. 12/2020 concerning the Designation of Non-Natural Disaster for the Spread of COVID-19 as a National Disaster. Vaccination for COVID-19 is an important part of efforts to deal with the COVID-19 pandemic that is comprehensive and integrated covering aspects of prevention by implementing health protocols: maintaining distance, washing hands with soap and wearing masks (3M), COVID-19 vaccination, and 3T (Tes, Search, Follow Up). Therefore, the authors wish to see the conditions or opinions of the public about this Covid 19 vaccination, the research was carried out simply by using a sample of people who visited Al Mulk Hospital. People who come to the hospital are made as respondents about the vaccination problem. The results of the level of public opinion about COVID-19 at Al Mulk Regional Hospital were known by using a questionnaire that obtained good public opinion results. Most of the respondents are aware of the government's vaccine program and there are still many respondents who are still doubtful that vaccines will be targeted for education about vaccines.

A Survey of Patients’ Opinions and Preferences on the Use of E-Prescriptions in Poland

E-prescription is already used in many countries, improving the standard of patient care. Officially, from 8 January 2020 e-prescribing has been obligated in Poland. Physicians’ and pharmacists’ opinions on e-prescribing have been widely researched and reported in the literature. In contrast, patients’ perception has, to date, received little attention. For this reason, the aim of this study was to find the features and functionalities of e-prescribing that are desired by the public and influence the positive evaluation of this tool, according to patient opinion. In order to obtain data, a questionnaire was completed by 456 randomly selected adults. The obtained results indicated that only eight people (1.8%) did not know what e-prescription is. Of the remaining 448 individuals, 72.1% prefer e-prescription because it is more convenient for them. Most patients (62.1%) also recognize that e-prescribing makes it easier to purchase medications on behalf of another patient. Based on the study, it can be concluded that e-prescription is well evaluated by Polish patients. A large percentage of respondents were positive about obtaining prescriptions for continued treatment, without a personal doctor visit. Therefore, it is reasonable to maintain the possibility of such contact with a physician. The most popular, and preferred, method of receiving e-prescriptions is via SMS. However, it is necessary to offer different options for obtaining prescriptions, to meet the needs of different populations.

Speech Outcome and Self-Reported Communicative Ability in Young Adults Born With Unilateral Cleft Lip and Palate: Comparing Long-Term Results After 2 Different Surgical Methods for Palatal Repair

Objective: To compare speech outcome and self-reported speech and communicative ability (SOK) in young adults treated with one-stage (OS) or two-stage (TS) palatal repair. Furthermore, to compare with normative data on individuals without cleft lip and palate and to study the relationship between patients’ and experts’ judgments. Design: A cross-sectional group comparison study with long-term follow-up. Participants: Patients born with unilateral cleft lip and palate treated at 2 cleft centers; 17 with OS at 14 months and 25 with TS, soft palate repair at 7 months and hard palate repair at 6.2 years. Pharyngeal flap surgery was performed in 53% (OS) and 24% (TS) of patients. Main Outcome Measure(s): Speech characteristics were blindly assessed by speech and language pathologist from audio recordings, SOK at 19 years of age. Results: No group differences were found. Although the occurrence of nasality symptoms was low in both groups, only 60% (OS)/65% (TS) were assessed with competent velopharyngeal function (VPC). Articulation proficiency (percentage of consonants correct [PCC]) was 91%/97%, the /s/-sound specifically 87%/91%. Good intelligibility was found in 91%/87%. Patient opinion was in agreement with norms and significantly associated with intelligibility ( rs = 0.436, P < .01), PCC ( rs = −0.534, P < .01), and correct /s/ ( rs = −0.354, P < .05). Conclusions: No differences in speech outcome were related to operation method. The low prevalence of VPC was not clearly reflected in nasality symptoms. Patient opinion was related to articulation and intelligibility. A higher burden of care in terms of pharyngeal flap surgery was seen after the OS technique.

The diagnostic certainty levels of junior clinicians: A retrospective cohort study

Background: Clinical decision-making is influenced by many factors, including clinicians’ perceptions of the certainty around what is the best course of action to pursue. Objective: To characterise the documentation of working diagnoses and the associated level of real-time certainty expressed by clinicians and to gauge patient opinion about the importance of research into clinician decision certainty. Method: This was a single-centre retrospective cohort study of non-consultant grade clinicians and their assessments of patients admitted from the emergency department between 01 March 2019 and 31 March 2019. De-identified electronic health record proformas were extracted that included the type of diagnosis documented and the certainty adjective used. Patient opinion was canvassed from a focus group. Results: During the study period, 850 clerking proformas were analysed; 420 presented a single diagnosis, while 430 presented multiple diagnoses. Of the 420 single diagnoses, 67 (16%) were documented as either a symptom or physical sign and 16 (4%) were laboratory-result-defined diagnoses. No uncertainty was expressed in 309 (74%) of the diagnoses. Of 430 multiple diagnoses, uncertainty was expressed in 346 (80%) compared to 84 (20%) in which no uncertainty was expressed. The patient focus group were unanimous in their support of this research. Conclusion: The documentation of working diagnoses is highly variable among non-consultant grade clinicians. In nearly three quarters of assessments with single diagnoses, no element of uncertainty was implied or quantified. More uncertainty was expressed in multiple diagnoses than single diagnoses. Implications: Increased standardisation of documentation will help future studies to better analyse and quantify diagnostic certainty in both single and multiple working diagnoses. This could lead to subsequent examination of their association with important process or clinical outcome measures.

P197 Evaluating the patient experience of the Barts Health MySpA app for axial spondyloarthritis and psoriatic arthritis

Background/Aims In 2018, MySpA App was developed and launched by the Rheumatology team at Whipps Cross Hospital to empower patients with axial spondyloarthritis (axSpA) and psoriatic arthritis (PsA) in self-management of their condition. MySpA is an internationally available, free educational App providing instant access to evidence based medical information about axSpA and PsA. It includes a library of exercise videos created by specialist physiotherapists in axSpA, enabling patients and clinicians to build exercise programmes tailored to individual patient needs. Validated outcome measures can be completed by patients throughout the year, with the option of sharing those results with their rheumatology clinicians. Our objective was to evaluate patient opinion and usefulness of MySpA among our patients. Methods Two years since MySpA was launched at BSR, an online questionnaire was sent to 198 patients with axSpA and PsA from Whipps Cross Rheumatology Service. The questions enquired about awareness of MySpA for download and use amongst patients with managing their condition. Results Overall response was 36% (n = 72). 61% (n = 44) of the patients responded had downloaded MySpA with 64%(n = 28) of those patients using the app throughout the year. The majority that had not downloaded, were not aware the app existed (70%). All features within the app were used, with the axSpA and PsA Information section and exercise library most popular with comments “I use my exercise plan daily” and “great app.” 53% of patients used the app as an educational resource and 46% used the exercise library tailored to their own needs. The most common reason for not using the app was forgetting (29%). The majority (91%) would recommend MySpA to other patients with axSpA and PsA, with 63% reported MySpA supported them managing their condition. Conclusion MySpA is well received by patients with axSpA and PsA at Whipps Cross Hospital as a resource where they find specialist support, information and exercise guidance to empower management. It provides a useful virtual tool to assist patients take control of their arthritis and track and monitor their condition and has been particularly useful in this regard during the Covid pandemic. Patients used the facility to complete and share their assessment results and journal logs virtually with their healthcare team. However, continual awareness of MySpA amongst patients and clinicians is required to enable the opportunity to utilise instant specialist support and direction that may help patients manage their condition. The usefulness of the virtual monitoring feature of the app amongst clinicians should be explored in future research. Disclosure R. Adshead: None. S. Donnelly: None. M. Shaikh: None.

Evaluation and validation of a patient completed psoriatic arthritis flare questionnaire

Objective Evaluation of a psoriatic arthritis (PsA), multidimensional, patient completed disease flare questionnaire (FLARE). Methods The FLARE questionnaire was administered to 139 patients in a prospective observational study. The ‘gold standard’ of flare was based on patient opinion. Test-retest was evaluated by intra-class correlation coefficient (ICC). Disease activity was measured by the PASDAS, GRACE, CPDAI and DAPSA. Results The most common symptoms of a PsA flare were musculoskeletal, followed by fatigue, frustration, loss of function and an increase in cutaneous symptoms. The test-retest ICC for the FLARE questionnaire was 0.87 (95% CI 0.72 – 0.94). The optimum cut-off to identify a flare of disease was 4/10 (sensitivity 0.82, specificity 0.76; area under curve 0.85). For those patients scoring 4 or above, the mean score for the composite measures was as follows (score for those not reporting a flare in brackets): PASDAS, 5.3 ± 1.3 (3.1 ± 1.6); GRACE, 4.5 ± 1.2 (2.2 ± 1.4); CPDAI, 8.9 ± 2.5 (4.7 ± 3.1); DAPSA, 38.2 ± 20.3 (16.8 ± 14.9). In a new flare the increase in composite measure score was calculated as follows; 1 for PASDAS and GRACE, 2 for CPDAI, 7 for DAPSA. Moderate agreement was found between the definition of flare using the cut-off of 4, indicated by subjects in a separate question. Conclusion A PsA flare displays escalation of symptoms and signs across multiple domains; the FLARE questionnaire has external validity both in terms of composite disease activity and overall patient opinion of the state of their condition.

Comparison of Corresponding Scores From the Cleft Hearing Appearance and Speech Questionnaire (CHASQ) and CLEFT-Q in Swedish Patients With Cleft Lip and/or Palate

Objective: The primary aim of this study was to compare corresponding scores between 2 existing cleft-specific patient-reported outcome measures (PROMs)—Cleft Hearing Appearance and Speech Questionnaire (CHASQ) and CLEFT-Q. The second aim of the study was to investigate patient opinion on the 2 PROMs. Design: Cross-sectional questionnaire study. Setting: Participants were recruited from a University Hospital. They answered CHASQ and CLEFT-Q either in the hospital or at home. Participants: Thirty-three participants with cleft lip and/or palate, aged 10 to 19 years. Main Outcome Measure: CHASQ and CLEFT-Q. Results: The CHASQ scores and the corresponding CLEFT-Q scores on appearance correlated significantly. Corresponding scores regarding speech did not correlate significantly. A majority, 15 (58%) participants, answered that they liked CLEFT-Q more than CHASQ, 18 participants (69%) thought CHASQ was easier to complete, and 19 (76%) thought CLEFT-Q would better inform health care professionals. Conclusion: Both instruments showed strengths and limitations. Clinicians will have to consider each instrument’s respective qualities when choosing to implement either PROM.