Skip to main content
Top
Published in: Orphanet Journal of Rare Diseases 1/2024

Open Access 01-12-2024 | Research

Factors affecting overall care experience for people living with rare conditions in the UK: exploratory analysis of a quantitative patient experience survey

Authors: Jennifer Jones, Marie Cruddas, Amy Simpson, Nick Meade, Daphnee Pushparajah, Michelle Peter, Amy Hunter

Published in: Orphanet Journal of Rare Diseases | Issue 1/2024

Login to get access

Abstract

Background

Although individually rare, collectively, rare conditions are common and affect a large number of people and are often chronic, life threatening and affect multiple body systems; the majority of them have no effective treatment. The literature has identified many specific challenges for those living with rare conditions, however, we do not know which of these in combination are most likely to impact how someone rates their overall experience of care. The aim of this study is to do further exploratory analysis of the Genetic Alliance UK 2020 Rare Experience survey data to identify which variables are most strongly associated with respondents’ overall care experience.

Results

There were strong associations between most of the selected survey variables and the overall rated experience of care variable. In the multiple linear regression only nine variables remained in the best fit model: ‘Trust and confidence in hospital staff involved in ongoing care’; ‘Satisfaction with information provided by healthcare professionals—following diagnosis’; ‘The professionals providing care work as a team’; ‘Feel care is coordinated effectively’; ‘The timing and frequency of appointments are convenient for the patient/carer/family’; ‘Whether or not there is a specific healthcare professional to ask questions of about the rare/undiagnosed condition’; ‘Experience of searching for a diagnosis’; ‘Knowledge of whether there is a specialist centre for the condition’; and ‘Number of different clinics attend for the condition’.

Conclusions

Our findings indicate the challenges that play the largest part in explaining the varied experiences with rare disease healthcare in the UK for our survey respondents. These challenges should be further investigated with a broader sample of people affected by rare conditions, ideally through the implementation of a comprehensive national rare condition patient registry. Our findings highlight an important potential gap in the Framework, ‘trust and confidence in healthcare professionals’; further research is required to fully understand the foundations of trust and confidence.
Appendix
Available only for authorised users
Footnotes
1
SWAN UK is a Genetic Alliance UK support group for families with children with ‘Syndromes Without A Name’.
 
Literature
2.
go back to reference Nguengang Wakap S, Lambert DM, Olry A, Rodwell C, Gueydan C, Lanneau V, et al. Estimating cumulative point prevalence of rare diseases: analysis of the Orphanet database. Eur J Hum Genet. 2020;28(2):165–73.CrossRefPubMed Nguengang Wakap S, Lambert DM, Olry A, Rodwell C, Gueydan C, Lanneau V, et al. Estimating cumulative point prevalence of rare diseases: analysis of the Orphanet database. Eur J Hum Genet. 2020;28(2):165–73.CrossRefPubMed
4.
go back to reference Dharssi S, Wong-Rieger D, Harold M, Terry S. Review of 11 national policies for rare diseases in the context of key patient needs. Orphanet J Rare Dis. 2017;12. Dharssi S, Wong-Rieger D, Harold M, Terry S. Review of 11 national policies for rare diseases in the context of key patient needs. Orphanet J Rare Dis. 2017;12.
5.
go back to reference Forman J, Taruscio D, Llera VA, Barrera LA, Cote TR, Edfjall C, et al. The need for worldwide policy and action plans for rare diseases. Acta Paediatr. 2012;101(8):805–7.CrossRefPubMedPubMedCentral Forman J, Taruscio D, Llera VA, Barrera LA, Cote TR, Edfjall C, et al. The need for worldwide policy and action plans for rare diseases. Acta Paediatr. 2012;101(8):805–7.CrossRefPubMedPubMedCentral
6.
go back to reference Department of Health and Social Care. The UK Rare Diseases Framework. 2021. Department of Health and Social Care. The UK Rare Diseases Framework. 2021.
7.
go back to reference Department of Health. The UK Strategy for Rare Diseases. 2013. Department of Health. The UK Strategy for Rare Diseases. 2013.
14.
go back to reference Genetic Alliance UK. Rare Experience 2020 The lived experiences of people affected by genetic, rare and undiagnosed conditions. Genetic Alliance UK; 2020. Genetic Alliance UK. Rare Experience 2020 The lived experiences of people affected by genetic, rare and undiagnosed conditions. Genetic Alliance UK; 2020.
15.
go back to reference Alexion UK. Reforming Rare Diseases. Alexion UK; 2020. Alexion UK. Reforming Rare Diseases. Alexion UK; 2020.
16.
go back to reference Courbier S, Berjonneau E. Juggling care and daily life: the balancing act of the rare disease community. Paris, France: EURORDIS; 2017. Courbier S, Berjonneau E. Juggling care and daily life: the balancing act of the rare disease community. Paris, France: EURORDIS; 2017.
17.
go back to reference Molster C, Urwin D, Di Pietro L, Fookes M, Petrie D, van der Laan S, et al. Survey of healthcare experiences of Australian adults living with rare diseases. Orphanet J Rare Dis. 2016;11:12.CrossRef Molster C, Urwin D, Di Pietro L, Fookes M, Petrie D, van der Laan S, et al. Survey of healthcare experiences of Australian adults living with rare diseases. Orphanet J Rare Dis. 2016;11:12.CrossRef
18.
go back to reference Kole A, Faurisson F. Rare Diseases Social Epidemiology: Analysis of Inequalities. Rare Diseases Epidemiology. Advances in Experimental Medicine and Biology. 686. Berlin: Springer-Verlag Berlin; 2010. p. 223–50. Kole A, Faurisson F. Rare Diseases Social Epidemiology: Analysis of Inequalities. Rare Diseases Epidemiology. Advances in Experimental Medicine and Biology. 686. Berlin: Springer-Verlag Berlin; 2010. p. 223–50.
19.
go back to reference EURORDIS. Improve our experience of health care! Key findings from a survey on patients' and carers' experience of medical care for their rare diseases. EURORDIS - Rare Diseases Europe; 2021. EURORDIS. Improve our experience of health care! Key findings from a survey on patients' and carers' experience of medical care for their rare diseases. EURORDIS - Rare Diseases Europe; 2021.
20.
go back to reference von der Lippe C, Diesen PS, Feragen KB. Living with a rare disorder: a systematic review of the qualitative literature. Mol Genet Genomic Med. 2017;5(6):758–73.CrossRefPubMedPubMedCentral von der Lippe C, Diesen PS, Feragen KB. Living with a rare disorder: a systematic review of the qualitative literature. Mol Genet Genomic Med. 2017;5(6):758–73.CrossRefPubMedPubMedCentral
21.
go back to reference McMullan J, Crowe AL, Bailie C, Moore K, McMullan LS, Shamandi N, et al. Improvements needed to support people living and working with a rare disease in Northern Ireland: current rare disease support perceived as inadequate. Orphanet J Rare Dis. 2020;15(1):14.CrossRef McMullan J, Crowe AL, Bailie C, Moore K, McMullan LS, Shamandi N, et al. Improvements needed to support people living and working with a rare disease in Northern Ireland: current rare disease support perceived as inadequate. Orphanet J Rare Dis. 2020;15(1):14.CrossRef
22.
go back to reference McMullan J, Crowe AL, Downes K, McAneney H, McKnight AJ. Carer reported experiences: Supporting someone with a rare disease. Health Soc Care Community. 2022;30(3):1097–108.CrossRefPubMed McMullan J, Crowe AL, Downes K, McAneney H, McKnight AJ. Carer reported experiences: Supporting someone with a rare disease. Health Soc Care Community. 2022;30(3):1097–108.CrossRefPubMed
23.
go back to reference Kole A, Faurisson F. The voice of 12,000 patients: experiences and expectations of rare disease patients on diagnosis and care in Europe. EURORDIS; 2009. Kole A, Faurisson F. The voice of 12,000 patients: experiences and expectations of rare disease patients on diagnosis and care in Europe. EURORDIS; 2009.
25.
go back to reference Gomez-Cano M, Lyratzopoulos G, Abel GA. Patient experience drivers of overall satisfaction with care in cancer patients: evidence from responders to the english cancer patient experience survey. J Patient Exp. 2020;7(5):758–65.CrossRefPubMed Gomez-Cano M, Lyratzopoulos G, Abel GA. Patient experience drivers of overall satisfaction with care in cancer patients: evidence from responders to the english cancer patient experience survey. J Patient Exp. 2020;7(5):758–65.CrossRefPubMed
26.
go back to reference Limb L, Nutt S, Sen A. Experience of rare diseases: an insight from patients and families. London: Rare Disease UK; 2010. Limb L, Nutt S, Sen A. Experience of rare diseases: an insight from patients and families. London: Rare Disease UK; 2010.
27.
go back to reference Muir E. The Rare Reality—an insight into the patient and family experience of rare disease. London: Rare Disease UK; 2016. Muir E. The Rare Reality—an insight into the patient and family experience of rare disease. London: Rare Disease UK; 2016.
31.
go back to reference Norman G. Likert scales, levels of measurement and the “laws” of statistics. Adv Health Sci Educ. 2010;15(5):625–32.CrossRef Norman G. Likert scales, levels of measurement and the “laws” of statistics. Adv Health Sci Educ. 2010;15(5):625–32.CrossRef
33.
go back to reference de Vries E, Fransen L, van den Aker M, Meijboom BR. Preventing gatekeeping delays in the diagnosis of rare diseases. Br J Gen Pract. 2018;68(668):145–6.CrossRefPubMedPubMedCentral de Vries E, Fransen L, van den Aker M, Meijboom BR. Preventing gatekeeping delays in the diagnosis of rare diseases. Br J Gen Pract. 2018;68(668):145–6.CrossRefPubMedPubMedCentral
34.
go back to reference Yan X, He SJ, Dong D. Determining how far an adult rare disease patient needs to travel for a definitive diagnosis: a cross-sectional examination of the 2018 National Rare Disease Survey in China. Int J Environ Res Public Health. 2020;17(5):18.CrossRef Yan X, He SJ, Dong D. Determining how far an adult rare disease patient needs to travel for a definitive diagnosis: a cross-sectional examination of the 2018 National Rare Disease Survey in China. Int J Environ Res Public Health. 2020;17(5):18.CrossRef
35.
go back to reference Huyard C. What, if anything, is specific about having a rare disorder? Patients’ judgements on being ill and being rare. Health Expect. 2009;12(4):361–70.CrossRefPubMedPubMedCentral Huyard C. What, if anything, is specific about having a rare disorder? Patients’ judgements on being ill and being rare. Health Expect. 2009;12(4):361–70.CrossRefPubMedPubMedCentral
36.
go back to reference Garrino L, Picco E, Finiguerra I, Rossi D, Simone P, Roccatello D. Living with and treating rare diseases: experiences of patients and professional health care providers. Qual Health Res. 2015;25(5):636–51.CrossRefPubMed Garrino L, Picco E, Finiguerra I, Rossi D, Simone P, Roccatello D. Living with and treating rare diseases: experiences of patients and professional health care providers. Qual Health Res. 2015;25(5):636–51.CrossRefPubMed
37.
go back to reference Spencer-Tansley R, Meade N, Ali F, Simpson A, Hunter A. Mental health care for rare disease in the UK - recommendations from a quantitative survey and multi-stakeholder workshop. BMC Health Serv Res. 2022;22:648.CrossRefPubMedPubMedCentral Spencer-Tansley R, Meade N, Ali F, Simpson A, Hunter A. Mental health care for rare disease in the UK - recommendations from a quantitative survey and multi-stakeholder workshop. BMC Health Serv Res. 2022;22:648.CrossRefPubMedPubMedCentral
38.
go back to reference Frankish N. Good diagnosis improving the experiences of diagnosis for people with rare conditions. London: Rare Disease UK; 2022. Frankish N. Good diagnosis improving the experiences of diagnosis for people with rare conditions. London: Rare Disease UK; 2022.
39.
go back to reference Chao A, Hunter A, Jones J, Ramsey A, Walton H. Barriers and facilitators to diagnosis of rare diseases: a systematic narrative review. London: University College London; 2021. Chao A, Hunter A, Jones J, Ramsey A, Walton H. Barriers and facilitators to diagnosis of rare diseases: a systematic narrative review. London: University College London; 2021.
40.
go back to reference Lewis C, Skirton H, Jones R. Living without a diagnosis: the parental experience. Genet Test Mol Biomark. 2010;14(6):807–15.CrossRef Lewis C, Skirton H, Jones R. Living without a diagnosis: the parental experience. Genet Test Mol Biomark. 2010;14(6):807–15.CrossRef
41.
go back to reference Frankish N, Clayton R, Jones J, Simpson A, Hunter A. Delivering a good diagnosis: How to equip healthcare professionals to deliver an improved experience of diagnosis for people living with a rare condition. Orphanet J Rare Dis. 2023;18(Suppl 1):118. Frankish N, Clayton R, Jones J, Simpson A, Hunter A. Delivering a good diagnosis: How to equip healthcare professionals to deliver an improved experience of diagnosis for people living with a rare condition. Orphanet J Rare Dis. 2023;18(Suppl 1):118.
42.
go back to reference Davlin AS, Clarkin CM, Kalish JM. Beckwith–Wiedemann syndrome: partnership in the diagnostic journey of a rare disorder. Pediatrics. 2018;141(3):4.CrossRef Davlin AS, Clarkin CM, Kalish JM. Beckwith–Wiedemann syndrome: partnership in the diagnostic journey of a rare disorder. Pediatrics. 2018;141(3):4.CrossRef
43.
go back to reference Simoes E, Sokolov AN, Kronenthaler A, Hiltner H, Schaeffeler N, Rall K, et al. Information ranks highest: Expectations of female adolescents with a rare genital malformation towards health care services. PLoS ONE. 2017;12(4):18.CrossRef Simoes E, Sokolov AN, Kronenthaler A, Hiltner H, Schaeffeler N, Rall K, et al. Information ranks highest: Expectations of female adolescents with a rare genital malformation towards health care services. PLoS ONE. 2017;12(4):18.CrossRef
44.
go back to reference Feragen KB, Rumsey N, Heliovaara A, Boysen BM, Johannessen EC, Havstam C, et al. Scandcleft randomised trials of primary surgery for unilateral cleft lip and Palate: 9. Parental report of social and emotional experiences related to their 5-year-old child’s cleft diagnosis. J Plast Surg Hand Surg. 2017;51(1):73–80.CrossRefPubMed Feragen KB, Rumsey N, Heliovaara A, Boysen BM, Johannessen EC, Havstam C, et al. Scandcleft randomised trials of primary surgery for unilateral cleft lip and Palate: 9. Parental report of social and emotional experiences related to their 5-year-old child’s cleft diagnosis. J Plast Surg Hand Surg. 2017;51(1):73–80.CrossRefPubMed
45.
go back to reference Walton H, Simpson A, Ramsay AIG, Hunter A, Jones J, Ng PL, et al. Development of models of care coordination for rare conditions: a qualitative study. Orphanet J Rare Dis. 2022;17(1):24. Walton H, Simpson A, Ramsay AIG, Hunter A, Jones J, Ng PL, et al. Development of models of care coordination for rare conditions: a qualitative study. Orphanet J Rare Dis. 2022;17(1):24.
46.
go back to reference Zajac S, Woods A, Tannenbaum S, Salas E, Holladay CL. Overcoming Challenges to Teamwork in Healthcare: A Team Effectiveness Framework and Evidence-Based Guidance. Frontiers in Communication. 2021;6. Zajac S, Woods A, Tannenbaum S, Salas E, Holladay CL. Overcoming Challenges to Teamwork in Healthcare: A Team Effectiveness Framework and Evidence-Based Guidance. Frontiers in Communication. 2021;6.
47.
go back to reference Walton H, Simpson A, Ramsay AIG, Hudson E, Hunter A, Jones J, et al. Developing a taxonomy of care coordination for people living with rare conditions: a qualitative study. Orphanet J Rare Dis. 2022;17(1):25. Walton H, Simpson A, Ramsay AIG, Hudson E, Hunter A, Jones J, et al. Developing a taxonomy of care coordination for people living with rare conditions: a qualitative study. Orphanet J Rare Dis. 2022;17(1):25.
48.
go back to reference Rare Disease UK. Rare disease care coordination: delivering value, improving services. London: Genetic Alliance UK; 2013. Rare Disease UK. Rare disease care coordination: delivering value, improving services. London: Genetic Alliance UK; 2013.
49.
go back to reference Van Groenendael S, Giacovazzi L, Davison F, Holtkemper O, Huang ZX, Wang QY, et al. High quality, patient centred and coordinated care for Alstrom syndrome: a model of care for an ultra-rare disease. Orphanet J Rare Dis. 2015;10:1–8. Van Groenendael S, Giacovazzi L, Davison F, Holtkemper O, Huang ZX, Wang QY, et al. High quality, patient centred and coordinated care for Alstrom syndrome: a model of care for an ultra-rare disease. Orphanet J Rare Dis. 2015;10:1–8.
50.
go back to reference Goodwin N, Sonola L, Thiel V, Kodner DL. Co-ordinated care for people with complex chronic conditions Key lessons and markers for success. London: The King’s Fund; 2013. Goodwin N, Sonola L, Thiel V, Kodner DL. Co-ordinated care for people with complex chronic conditions Key lessons and markers for success. London: The King’s Fund; 2013.
51.
go back to reference Simpson A, Bloom L, Fulop NJ, Hudson E, Leeson-Beevers K, Morris S, et al. How are patients with rare diseases and their carers in the UK impacted by the way care is coordinated? An exploratory qualitative interview study. Orphanet J Rare Dis. 2021;16(1):12.CrossRef Simpson A, Bloom L, Fulop NJ, Hudson E, Leeson-Beevers K, Morris S, et al. How are patients with rare diseases and their carers in the UK impacted by the way care is coordinated? An exploratory qualitative interview study. Orphanet J Rare Dis. 2021;16(1):12.CrossRef
52.
go back to reference Arditi C, Eicher M, Colomer-Lahiguera S, Bienvenu C, Anchisi S, Betticher D, et al. Patients' experiences with cancer care in Switzerland: Results of a multicentre cross-sectional survey. Eur J Cancer Care. 2022:15. Arditi C, Eicher M, Colomer-Lahiguera S, Bienvenu C, Anchisi S, Betticher D, et al. Patients' experiences with cancer care in Switzerland: Results of a multicentre cross-sectional survey. Eur J Cancer Care. 2022:15.
53.
go back to reference Barlow JH, Stapley J, Ellard DR. Living with haemophilia and von Willebrand’s: a descriptive qualitative study. Patient Educ Couns. 2007;68(3):235–42.CrossRefPubMed Barlow JH, Stapley J, Ellard DR. Living with haemophilia and von Willebrand’s: a descriptive qualitative study. Patient Educ Couns. 2007;68(3):235–42.CrossRefPubMed
54.
go back to reference Grut L, Kvam MH. Facing ignorance: people with rare disorders and their experiences with public health and welfare services. Scandinavian Journal of Disability Research, . 2013;15(1),:pp.20–32. Grut L, Kvam MH. Facing ignorance: people with rare disorders and their experiences with public health and welfare services. Scandinavian Journal of Disability Research, . 2013;15(1),:pp.20–32.
55.
go back to reference von der Lippe C, Frich JC, Harris A, Solbraekke KN. Experiences of being heterozygous for Fabry disease: a qualitative study. J Genet Couns. 2016;25(5):1085–92.CrossRefPubMed von der Lippe C, Frich JC, Harris A, Solbraekke KN. Experiences of being heterozygous for Fabry disease: a qualitative study. J Genet Couns. 2016;25(5):1085–92.CrossRefPubMed
56.
go back to reference Whetten K, Leserman J, Whetten R, Ostermann J, Thielman N, Swartz M, et al. Exploring lack of trust in care providers and the government as a barrier to health service use. Am J Public Health. 2006;96(4):716–21.CrossRefPubMedPubMedCentral Whetten K, Leserman J, Whetten R, Ostermann J, Thielman N, Swartz M, et al. Exploring lack of trust in care providers and the government as a barrier to health service use. Am J Public Health. 2006;96(4):716–21.CrossRefPubMedPubMedCentral
57.
go back to reference Schwei RJ, Kadunc K, Nguyen AL, Jacobs EA. Impact of sociodemographic factors and previous interactions with the health care system on institutional trust in three racial/ethnic groups. Patient Educ Couns. 2014;96(3):333–8.CrossRefPubMedPubMedCentral Schwei RJ, Kadunc K, Nguyen AL, Jacobs EA. Impact of sociodemographic factors and previous interactions with the health care system on institutional trust in three racial/ethnic groups. Patient Educ Couns. 2014;96(3):333–8.CrossRefPubMedPubMedCentral
58.
go back to reference Ferguson E, Dawe-Lane E, Khan Z, Reynolds C, Davison K, Edge D, et al. Trust and distrust: Identifying recruitment targets for ethnic minority blood donors. Transfus Med. 2022;32(4):276–87.CrossRefPubMedPubMedCentral Ferguson E, Dawe-Lane E, Khan Z, Reynolds C, Davison K, Edge D, et al. Trust and distrust: Identifying recruitment targets for ethnic minority blood donors. Transfus Med. 2022;32(4):276–87.CrossRefPubMedPubMedCentral
59.
go back to reference Karnati SA, Wee A, Shirke MM, Harky A. Racial disparities and cardiovascular disease: One size fits all approach? J Card Surg. 2020;35(12):3530–8.CrossRefPubMed Karnati SA, Wee A, Shirke MM, Harky A. Racial disparities and cardiovascular disease: One size fits all approach? J Card Surg. 2020;35(12):3530–8.CrossRefPubMed
60.
go back to reference Petersen A. The best experts: the narratives of those who have a genetic condition. Soc Sci Med. 2006;63(1):32–42.CrossRefPubMed Petersen A. The best experts: the narratives of those who have a genetic condition. Soc Sci Med. 2006;63(1):32–42.CrossRefPubMed
61.
go back to reference Dures E, Morris M, Gleeson K, Rumsey N. The psychosocial impact of epidermolysis bullosa. Qual Health Res. 2011;21(6):771–82.CrossRefPubMed Dures E, Morris M, Gleeson K, Rumsey N. The psychosocial impact of epidermolysis bullosa. Qual Health Res. 2011;21(6):771–82.CrossRefPubMed
62.
go back to reference Budych K, Helms TM, Schultz C. How do patients with rare diseases experience the medical encounter? Exploring role behavior and its impact on patient-physician interaction. Health Policy. 2012;105(2–3):154–64.CrossRefPubMed Budych K, Helms TM, Schultz C. How do patients with rare diseases experience the medical encounter? Exploring role behavior and its impact on patient-physician interaction. Health Policy. 2012;105(2–3):154–64.CrossRefPubMed
63.
go back to reference Paddison CAM, Abel GA, Roland MO, Elliott MN, Lyratzopoulos G, Campbell JL. Drivers of overall satisfaction with primary care: evidence from the English General Practice Patient Survey. Health Expect. 2015;18(5):1081–92.CrossRefPubMed Paddison CAM, Abel GA, Roland MO, Elliott MN, Lyratzopoulos G, Campbell JL. Drivers of overall satisfaction with primary care: evidence from the English General Practice Patient Survey. Health Expect. 2015;18(5):1081–92.CrossRefPubMed
Metadata
Title
Factors affecting overall care experience for people living with rare conditions in the UK: exploratory analysis of a quantitative patient experience survey
Authors
Jennifer Jones
Marie Cruddas
Amy Simpson
Nick Meade
Daphnee Pushparajah
Michelle Peter
Amy Hunter
Publication date
01-12-2024
Publisher
BioMed Central
Published in
Orphanet Journal of Rare Diseases / Issue 1/2024
Electronic ISSN: 1750-1172
DOI
https://doi.org/10.1186/s13023-024-03081-5

Other articles of this Issue 1/2024

Orphanet Journal of Rare Diseases 1/2024 Go to the issue