Background Patient experience is acknowledged as a principal aspect of quality healthcare delivery, and it has implications with regard to outcomes. Objectives Our objective was to evaluate the healthcare experience of patients with chronic diseases to identify patient-perceived healthcare gaps and to assess the influence of demographic and healthcare-related variables on patient experiences. Methods A cross-sectional survey was delivered to adult patients with chronic diseases: diabetes mellitus (DM), human immunodeficiency virus (HIV) infection, inflammatory bowel disease (IBD) or rheumatic diseases. Patient experiences were assessed with the Instrument for Evaluation of the Experience of Chronic Patients (IEXPAC) questionnaire, with possible scores ranging from 0 (worst) to 10 (best experience). Results Of the 2474 patients handed the survey, 1618 returned it (response rate 65.4%). Patients identified gaps in healthcare related mainly to access to reliable information and services, interaction with other patients and continuity of healthcare after hospital discharge. The mean ± standard deviation (SD) IEXPAC score was 6.0 ± 1.9 and was higher for patients with HIV (6.6 ± 1.7) than for those with rheumatic disease (5.5 ± 2.0), IBD (5.9 ± 2.0) or DM (5.9 ± 1.9) ( p < 0.001). In multivariate models, better overall IEXPAC experience was associated with follow-up by the same physician, follow-up by a nurse, receiving healthcare support from others and treatment with subcutaneous or intravenous drugs. The multivariate model that confirmed patients with HIV or DM had better experience than did those with rheumatic diseases. Conclusions Through IEXPAC, patients identified aspects for healthcare quality improvements and circumstances associated with better experience, which may permit greater redirection of healthcare toward patient-centered goals while facilitating improvements in social care and long-term healthcare quality. Electronic supplementary material The online version of this article (10.1007/s40271-018-0345-1) contains supplementary material, which is available to authorized users.

Aim To assess the experience with health care among patients with type 2 diabetes (T2DM) and to evaluate patients’ demographic variables and healthcare‐related characteristics which may affect their experience. Methods A cross‐sectional survey was delivered to T2DM adults. Patient experiences were assessed with the ‘Instrument for Evaluation of the Experience of Chronic Patients’ (IEXPAC) questionnaire, a validated 12‐item survey, which describes patient experience within the last 6 months (items 1–11) and hospitalization in the last 3 years (item 12), with possible scores ranging from 0 (worst) to 10 (best experience). Results A total of 451 T2DM patients responded to the survey (response rate 72.3%; mean age 69.5 ± 10.1 years, 67.8% men). The mean overall IEXPAC score was 5.92 ± 1.80. Mean scores were higher for productive interactions (7.92 ± 2.15) and self‐management (7.08 ± 2.27) than for new relational model (1.72 ± 2.01). Only 32.8% of patients who had been hospitalized in the past 3 years reported having received a follow‐up call or visit after discharge. Multivariate analyses identified that regular follow‐up by the same physician and follow‐up by a nurse were associated with a better patient experience. Continuity of healthcare score was higher only in those patients requiring help from others. Conclusions The areas of T2DM care which may need to be addressed to ensure better patient experience are use of the Internet, new technologies and social resources for patient information and interaction with healthcare professionals, closer follow‐up after hospitalization, and a comprehensive multidisciplinary approach with regular follow‐up by the same physician and a nurse.

Aim:The aim of this study was to analyze the patterns of insulin consumption between 2014 and 2018 in Cádiz. Methods: This study was a cross-sectional retrospective study. All people that used any insulin were included in the study. The Cadiz Diabetes Database includes data on yearly anti-diabetic prescriptions and hemoglobin A1c (HbA1c) levels. Results:The prevalence of insulin-users was 2.15%. More prevalent in women and increased with age (0.18% in the 0-15-year-old group to 8.53% in the > 75-year-old group); insulin' users represent 28.8% of the total population with diabetes mellitus treatments. Seventy percent of insulin-treated patients (ITP) were over 60 years old. Long-acting insulin was consumed by 79% of users, representing 55% of the total insulin types consumed. Glargine was the most consumed (4,654,000 defined daily dose and valuing > 7.000.000€ in 2018). In > 75-year-old group, 50% were treated with long-acting and fast-acting insulin combinations. Annual HbA1c was determined for two out of three ITP and 37% of these had Hb1Ac < 7% (53 mmol/mol). Conclusions: The Cadiz population presents a high consumption of insulin. Insulin prescription patterns have changed during the study. Long-acting insulins, especially Glargine (alone or in combination), are the most widely used types of insulin. In the group of elderly patients, the patterns found are not in line with the current recommendations. ITP in Cadiz has a poor glycemic (median HbA1c 7.84%) control and a low amount of Hb1Ac determinations.