Oral presentation by final year PhD researcher, Maryam Alkandari, at the PhD Pharmacy Conference, April 2019, Henley Business School, University of Reading.

Maryam Alkandari
Professor Kath Ryan and Dr Amelia Hollywood
Reading School of Pharmacy, University of Reading, UK

Background: Peripheral neuropathy is a neurological disease characterized by pain, numbness, tingling, swelling, or muscle weakness due to nerve damage. It can be caused by multiple factors such as trauma, infections and metabolic problems such as diabetes. In Kuwait 54% of the diabetic population, have peripheral neuropathy. Understanding the patient journey by mapping their management plan is essential to identify areas for
improvement.

Method: In this exploratory, qualitative study conducted in Kuwait, 25 subjects with peripheral neuropathy took part in a one-on-one semi-structured interviews lasting 45-60 minutes. Interviews were transcribed, translated and coded using NVivo 12. Four individual patient journeys were mapped out in detail, then compared and condensed into a single process map. The remaining 21 interviews were then reviewed to ensure the final map represented all patient journeys. The map was then compared to existing international standards.

Results: Participants reported similar care pathways for their peripheral neuropathy and faced various difficulties; psychological (not receiving satisfactory care), medical issues (shortage of specialists) and administrative problems (long waiting referral periods). The process map identified that the current Kuwait system has similar pharmacological treatment guidelines to the UK. Major improvable gaps in care were apparent, however, including inadequate follow-up, waiting time, loss of medical documents, non-compliance with treatment protocols, variability in access to newer medicines, lack of patient awareness of the disease and its treatment, and poor communication between healthcare providers.

Discussion: Mapping the current patient journey identified areas for improvement. When compared to UK standards, the map indicated the need for an integrated approach within the Kuwait medical team, the use of technology for electronic medical recording and report transmission, along with education for patients.

Conclusion: Analysis of this pioneer patient journey map provided a strong strategic direction for the Kuwaiti healthcare system to address the patient experience in peripheral neuropathy.