(1213) Perceptions of Obesity-related Metabolic Syndrome Management Utilization in Relation to Patient Experience and Health-related Quality of Life

Objectives: Obesity remains a significant public health hazard and a risk factor for metabolic syndrome (MetS) development. Some of the identified challenges with obesity-related MetS (OrM) management include non-treatment of existing MetS and poor rate of management effectiveness, leading to poor health-related quality of life (HRQoL). One critical factor for these inadequacies is poor utilization of management services, which could be attributed to poor prior experience with pharmacy services and patients’ perceptions of management resources utilization (PMU). These attributes may influence patients’ decision-making regarding OrM management utilization and impact patients’ health outcomes. Therefore, understanding patients’ experience with pharmacy service could be critical to improving PMU effectively and promoting quality health outcomes. The study’s objective was to explore the influence of patients’ experience with pharmacy services and PMU on OrM patients’ HRQoL.

Methods: The study sample included obese patients with at least two MetS comorbidities who were at least 45 years old and living in any of the southern states of the United States. A total of 706 patients’ data on perceptions of healthcare, medication and pharmacy services utilization, prior experience with pharmacy services, and HRQoL were collected using validated tools such as the National Consumer Survey on Medication Experience and Pharmacist roles (NCSME&PR), EuroQoL-5D, and the Consultation and Relational Empathy (CARE) through Qualtrics via an electronic survey link. A conceptual framework was built between PMU, patients’ experience with pharmacy service, and HRQoL. Meanwhile, the Chi-square test and ordinal regression were used to predict and investigate the association between the framework’s constructs. Also, Process macro mediation analysis through Haye’s model 4 was used to explore the direct and indirect influence of patients’ PMU and experience on patients’ HRQoL.

Results: The patients had an average of three comorbidities, a median age of 58 years, and an average BMI of 36.7 kg/m2. About 68.6% were between 45 and 64 years old, while the majority (71.1%) were female. About 72% and 32.6% were classified into good experience and PMU categories, respectively. The median HRQoL score was 11, with 40.8% of patients having good HRQoL. A proportion of 38.4% of patients with good experience belonged to the good PMU category as compared to 17.3% of patients with poor experience. Also, 47% and 42.9% of patients with good PMU and good experience had good HRQoL compared to 35.3% of OrM patients with poor PMU or experience. The ordinal regression indicated that patients with good prior experience had about 200% higher odds and 0.4 probability of being in a higher PMU category than those with poor experience. Also, OrM patients with good PMU had 58% (OR=1.58, P = 0.008, 95% CI = 0.12, 0.8) higher odds and 0.47 probability of being in a higher HRQoL category than those with poor PMU. Meanwhile, patients in the good experience category had 30% higher odds (OR = 1.30, P=0.17, 95% CI -0.12, 0.64) and 0.43 probability of being in a higher HRQoL category than those with poor experience. Although the direct effect model revealed no significant relationship between HRQoL and prior experience, the indirect effect model through bootstrap analysis indicated a statistically significant relationship (BootCI = -0.072, -0.022) between prior experience and HRQoL through the patients’ PMU. This result suggested that PMU had a full and significant mediating influence on the relationship between patients’ prior experience with pharmacy services and HRQoL.

Conclusions: OrM patients with good experience and PMU were more likely to have good HRQoL. Prior experience with pharmacy service influenced patients’ PMU and indirectly impacted patients’ HRQoL. Therefore, pharmacists must consider patients’ experience and management utilization perceptions while using patient-centered care practice to promote OrM patients’ health outcomes.