Background The inflammatory arthritides (IA) are a heterogeneous group of diseases which cause significant morbidity and mortality. Optimising patient engagement to provide patient-centred care are important in improving outcomes in IA. Although individual aspects of patient preferences and satisfaction relating to health services have been previously examined, few studies have directly investigated people with IAs perceived needs of health service needs.
Objectives The aim of this review was to systematically identify the existing literature relating to patient perceived health service needs related to IA, including use of allied health (AH) and complementary and alternative medicines (CAM).
Methods A systematic literature review of MEDLINE, EMBASE, CINAHL and PsycINFO was conducted (1990 – May 2015). Using a comprehensive search strategy, studies examining patient perceived needs relating to health service needs relating to inflammatory arthritis was performed. Data regarding study design and methodology were extracted. Needs were identified and collated to show the current knowledge of this issue.
Results The search strategy returned 1778 papers of which 24 articles were identified as relevant (figure 1): 14 used qualitative methods, 9 used quantitative methods and 1 used mixed methods. 16 studies included only patients with rheumatoid arthritis (RA). The quality of the included literature was variable.
The main areas of need, identified in at least 2 studies, related to
1) Communication needs: consumers wanted clear, empathic communication and to be involved with decision making. Positive relationships with health care providers with an holistic approach were prized.
2) Characteristics of ongoing care: adequate consultation length with continuity and timely care were valued.
3) Factors influencing care seeking behaviour: an individual's attitude towards health care, and disease activity and severity affected care seeking behaviour. Financial factors and family expectations, influence and beliefs were also seen to impact on the perception of need.
4) AH and CAM were perceived as useful by many. CAM was seen as an adjunct to conventional therapy, especially where pain control was inadequate. The reporting of CAM use to their doctors was variable, with several factors related for under-reporting.
Conclusions Within the existing literature that has infrequently targeted patient perceived health services needs, this review identified factors that patients with IA perceive to be important in their management. It also identified gaps in this area of knowledge, such as patient preferences for alternative methods of health care delivery, information from non-European and North American countries and information about patients with IA other than RA. Increasing knowledge regarding patient perceived needs in this area has the potential to inform novel methods of health care provision which could improve patient satisfaction whilst optimising outcomes for both the patient and health care system.
Acknowledgement This work was supported by Arthritis and Osteoporosis Victoria. A. Wluka is the recipient of an NHMRC Career Development Fellowship (Clinical Level 2)
Disclosure of Interest None declared