Background Patients with rheumatoid arthritis (RA) may select subcutaneous, oral or intravenous routes of administration for biologic therapy. Patients who select intravenous biologic treatment often have infusions at multispecialty centers within hospitals in which patients with rheumatic diseases are cared for in a unit shared with oncology patients.

Objectives In order to assess cross-cultural patient attitudes about infusion therapy in a shared unit, surveys were performed in two hospitals in Japan and the United States.

Methods Patients with RA or rheumatic disease who underwent infusions in a multispecialty infusion center, in Japan (Hosp-J) and in the United States (Hosp-A) completed a satisfaction survey. In the United States, physicians and nurses were also asked to predict their patient's attitudes about treatment in the shared unit.¹ The following seven-question Likert scale survey was administered: (1) I am content having infusions in a cancer infusion center or room; (2) I am not bothered by the cancer-focused environment; (3) I understand that my disease is not a form of cancer; (4) I do not mind entering the Cancer Institute; (5) I have no preference about a non-cancer infusion center or room; (6) I am not worried about my privacy; and (7) I do not mind if the infusion unit is moved in the future if more space is needed for cancer patients. The survey scoring ranged from 5 (strongly agree) to 1 (strongly disagree). In addition, comments regarding the shared infusion unit were gathered from the survey respondents.

Results There were 107 RA subjects in Hosp-J and 52 subjects with various rheumatic and autoimmune diseases in the Hosp-A. In Hosp-A, 18 physicians and 13 nurses also completed the survey. Average scores on the patient survey were as follows: Hosp-J results ranged from 4.39 to 5.0 of 5.0; Hosp-A, the results ranged from 4.02 to 4.76 for all questions indicating very positive attitude by patients towards the shared infusion unit in both Hosp-J and Hosp-A. There were statistical differences between hospitals for Questions 3, 4, 6, and 7 (p=0.0001, 0.02, 0.01, and 0.0009 respectively) with American patients having a lower score. When comparing patients with physicians and nurses at Hosp-A, patients scored significantly higher on all questions. Patients commented that the shared unit gave them better perspective on their own disease as compared to oncology patients and they expressed concern for the cancer patients. On the survey, in contrast to patient responses, Hosp-A physicians and nurses reported lower perceived patient satisfaction on all seven items. Hence, patients had greater satisfaction than had been realized by the physicians and the nurses.

Conclusions Rheumatology patients in both countries expressed little reluctance to undergo infusions in a unit shared with oncology patients. Although scores were all high, there were some subtle statistical differences with American patients scoring lower than Japanese patients. Assessment of patient attitudes should be a key driver in future planning for infusion space allocation.

References

1. Patient Prefer Adherence. 2014; 8: 755–761

Disclosure of Interest None declared