Introduction: OnabotulinumtoxinA (OBT-A) is one of the most studied prophylactic treatments for chronic migraine. Large clinical trials, and now real-world studies, continue to provide evidence to support the use of OBT-A as an effective treatment to manage chronic migraine. The objective of this study was to explore patient experience and perception of prophylactic treatment with OBT-A for chronic migraine. Methods: Data were collected using semistructured interviews using open-ended questions to uncover rich descriptive data on patient experiences. Interviews were transcribed and analysed using NVivo data analysis software to code and identify themes across the dataset. Three patient groups were included in the analysis: (1) patients who were receiving continued OBT-A treatment; (2) patients who discontinued OBT-A treatment; (3) patients who were recommended for OBT-A treatment but did not proceed.Results: For patients who received at least one OBT-A treatment, four main themes emerged, which described patients' expectations, experiences, and feelings towards their treatment decisions. Two main themes emerged that were common to patients, who had discontinued their treatment and those, who were recommended for OBT-A treatment but did not proceed, which were identified as potential barriers to initiate or continue prophylactic treatment with OBT-A. Conclusion: Understanding patients' perspective is an important part of clinical practice and may impact on decision-making. Qualitative data can provide a more holistic view of patient care and treatment insights that may not be evaluated during a clinical trial. This study revealed potential barriers to treatment that can inform future policy and practice.
Purpose The purpose of this paper is to examine the opportunity for supply chain processes and infrastructure to reduce the risk of medical error and create traceability of adverse events in community care settings. Patient safety has become an important area of focus over the past few decades, with medical error now accounting for the third most common cause of death in Canada and the USA. The majority of patient safety studies to date have focused specifically on safety in hospital settings; however, deaths and harm experienced by patients in the community (home care, long-term care, complex care and rehabilitation settings) are not well understood. Design/methodology/approach This paper discusses the evidence that adverse events occur at similar, if not more, frequent rates in community care settings. Findings The authors propose that above and beyond current efforts to increase awareness and promote a "safety culture" in health-care settings, system infrastructure should be designed in a way that enables clinicians to provide the safest care possible. There is currently no line of sight across the health-care continuum. The authors suggest that improving system infrastructure would reduce the occurrence of adverse events. Originality/value Such visibility across the continuum of care holds the potential to transform health-care in Canada from a fragmented system, where information is inadequately captured and transferred from provider to provider, to a system that provides complete, accurate and up-to-date information regarding patient care, procedures, medications and outcomes so as to provide the best and safest care possible. System visibility achieves quality and safe care, which is transparent and accountable and achieves value for patients.
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