Patient preference and adherence最新文献

Objective: To develop a medication literacy intervention program for glaucoma and test its effects on medication literacy, medication self-efficacy and medication adherence.

Methods: The intervention was constructed according to the Information-Motivation-Behavioral skills Model and the Health Belief Model. Preliminary protocols were revised through expert group meetings and pre-experiments to form a formal intervention plan. Subsequently, 66 patients with glaucoma were enrolled and randomly assigned to the control and intervention groups. The control group was received with routine follow-up and education for glaucoma patients, while the intervention group was given an 8-weeks medication literacy intervention for glaucoma patients. Before the implementation of the intervention and at the end of the 8th week of the intervention, the Chinese Version of the Medication Literacy Scale, the Short Version of the Glaucoma Medication Self-Efficacy Questionnaire and the Chinese version of the Morisky Medication Adherence Scale-8 were used to evaluate the medication literacy level, medication self-efficacy and medication adherence of glaucoma patients in the intervention group and the control group.

Results: We developed an 8-weeks multi-component medication literacy intervention for glaucoma. Before the start of the intervention, there were no statistically significant differences in the scores of medication literacy, medication self-efficacy and medication adherence between the control group and the intervention group. After the intervention, the medication literacy, medication self-efficacy, and medication adherence of the intervention patients were significantly better than those of the control group (P<0.05).

Conclusion: The 8-weeks multi-component intervention for glaucoma patients can improve their medication literacy, medication self-efficacy, and medication adherence.

Introduction: The adoption of automated drug dispensing systems (ADDS) in hospital pharmacies is a global trend, driven by its potential to reduce dispensing errors, minimize prescription filling time, and ultimately, improve patient care services. However, a significant research gap exists in the field, as a comprehensive assessment of patient satisfaction with ADDS is currently lacking. This study, with its comprehensive approach, aims to fill this gap by comparing patient satisfaction between hospital pharmacies implementing ADDS and traditional drug dispensing systems (TDDS).

Patients and methods: The cross-sectional study was conducted in hospitals adopting ADDS and TDDS. All the outpatients aged 18 or above who visited the pharmacy were included, and severely ill patients were excluded from the study. A 17-item, 5-point Likert scale questionnaire assessed the participant's satisfaction. The questionnaire has four domains: pharmacy administration, dispensing practice, patient education, and dispensing system.

Results: The demographics of the study participants were normally distributed between ADDS and TDDS according to chi-square analysis. The mean participant satisfaction was significantly (P<0.05) higher in ADDS than in TDDS regarding all the items of dispensing practice and dispensing system domains. Three items related to the pharmacy administration domain showed significant participant satisfaction with ADDS. However, the participants' satisfaction showed no significant difference (p=0.176) between ADDS and TDDS in terms of the cleanliness of the pharmacy. Also, the participant's satisfaction between ADDS and TDDS was not statistically significant regarding the pharmacist's explanation of the side effects (p=0.850) and provision of all necessary information to the patient (p=0.061) in the patient education domain.

Conclusion: Patient satisfaction was higher in the ADDS participants than in TDDS regarding pharmacy administration, patient education, dispensing practice, and systems. However, pharmacists in ADDS need to be motivated to transfer the advantages of ADDS to patient care, including comprehensive patient education, particularly on side effects.

Background and purpose: Periodontitis is the leading cause of tooth loss in adults worldwide. The functional loss, nutritional deficiencies, and psychological barriers it causes, as well as its impact on overall health and quality of life, are all significant. The prevalence of periodontal disease is high in China. Our study aimed to determine the intricate relationship between periodontal disease status, dental anxiety, self-rated oral health (SROH), self-efficacy for oral care, perceived social support, socioeconomic status (SES), and the oral health-related quality of life (OHRQoL) among periodontitis patients.

Methods: This cross-sectional study used purposive sampling to identify 247 patients with periodontitis who entered the First Affiliated Hospital of Bengbu Medical University between October 2022 and October 2023. 247 participants underwent a periodontal clinical examination combined with imaging, adhering to the "2018 world new classification of periodontal and peri⁃implant diseases and conditions". Participants also completed a detailed questionnaire in paper format, which included OHRQoL, sociodemographic details, dental anxiety, SROH, self-efficacy in oral care, perceived social support, and subjective SES.

Results: Dental anxiety, self-efficacy for oral care, and SROH all had a direct and significant effect on OHRQoL. OHRQoL was indirectly related to SROH mediated by dental anxiety and subjective SES, perceived social support and self-efficacy for oral care, respectively. SROH was directly related to subjective SES, and at the same time, they had a direct effect on dental anxiety. Furthermore, patient's age, gender, annual household income, and education level were significantly associated with the degree of periodontal disease.

Conclusion: OHRQoL and periodontal status was influenced by socio-demographics characteristics, dental anxiety, SROH, self-efficacy for oral care, perceived social support, subjective SES in periodontitis patients. These insights underscore the importance of adopting a holistic approach in the management and treatment of periodontal diseases.

Purpose: People with noncommunicable diseases (NCDs) have a high risk of contracting flu and suffering from its associated complications; however, in many countries flu vaccine uptake in this group is sub-optimal. This survey assessed the knowledge, attitudes, and gaps toward vaccination in general and flu in particular among adults with NCDs in Europe.

Patients and methods: The survey was conducted in France, Italy, Spain, Germany, Poland, Belgium, Portugal, and the Czech Republic. A structured web-based questionnaire was administered to the subjects.

Results: In total, 1106 subjects were enrolled, with 61% aged between 41 and 60 years. The main reasons for getting vaccinated were disease prevention and healthcare practitioner recommendations. Protection against infection and the risks of not receiving a vaccination was the most common vaccine information received, followed by information about possible side effects, duration of protection, and need for a booster dose. In the unvaccinated group, there was a lack of belief in the need for a flu vaccine, with a lack of recommendation from treating practitioners, and the experience of mild severity of flu being the main barriers against the vaccine. The physician remained the most preferred and tapped resource for information followed by dedicated websites. Understanding of flu vaccine benefits was particularly widespread among vaccinated patients, yet >50% wanted to know more about them. There was less clarity of the benefits of flu vaccine among unvaccinated patients; however, approximately 50% of them wanted to know more about it. Between January 2021 and December 2022, about 30% and 36% of the vaccinated and unvaccinated individuals, respectively, reported having suffered from flu.

Conclusion: Healthcare practitioners are the key influencers for people to get vaccinated. The dissemination of information about the importance of flu vaccines needs to be increased, and clear and explanatory messaging based on country-specific characteristics is important.

Purpose: This study aims to map the clinical pathway for psoriasis and atopic dermatitis (AD) in a tertiary hospital to better understand patient needs and experiences, thereby suggesting improvements in patient-centered care.

Methods: A mixed-method approach was utilised involving a literature review, a questionnaire for healthcare professionals (HCPs), and two focus groups (one with HCPs and the other with patients with psoriasis or AD). Ethical approvals were obtained, and informed consent was acquired from all participants.

Results: Patients and HCPs identified significant delays in the pre-diagnosis phase, extending up to five years for psoriasis and three years for AD, adversely affecting the timely initiation of effective treatment. In addition, there were reported difficulties in obtaining appointments during flares, a lack of dermatologic emergencies, a need to increase human resources and physical space, and a need for telematic consultations for urgent cases. Discrepancies between HCPs' perceptions and patients' experiences highlighted unmet needs, particularly in primary care settings and emergency departments. Several strengths were also identified, including satisfactory experience in dermatology, the hospital's high level of specialisation in the management of complex patients, optimal communication between services, consideration of patient preferences, and proper advice on hospital pharmacy care and administration support of treatment and adherence monitoring.

Conclusion: The findings underscore the necessity for interventions to reduce wait times and improve treatment immediacy and effectiveness post-diagnosis. The insights from this study can direct enhancements in patient management and satisfaction for individuals with psoriasis and AD.

Atopic dermatitis (AD) is a common chronic inflammatory cutaneous disease. Upadacitinib, a selective JAK-1 inhibitor, has been approved as a systemic medication for moderate-to-severe AD in patients aged ≥12 years. Although previous studies have examined the safety profile of upadacitinib, this is the first report to describe a potential association between amenorrhea and upadacitinib or other JAK inhibitors. Herein, we report a rare adverse event of amenorrhea in an adolescent female patient who was treated with upadacitinib for AD. This case report expands the range of adverse events potentially associated with upadacitinib therapy.

Purpose: Asthma and chronic obstructive pulmonary disease (COPD) are associated with substantial morbidity and mortality. This analysis assessed patient, caregiver, and healthcare provider (HCP) opinions regarding asthma and COPD diagnosis and treatment, including inhaler device preferences.

Patients and methods: Insights were from: (1) face-to-face/telephone patient/HCP communications with GSK Global Medical Teams; (2) social media listening; (3) a self-completed online patient/caregiver survey. Data were anonymized and informed consent was provided. Qualitative outputs were extracted, analyzed inductively, and coded per key themes, such as treatment preferences (including perceptions of single inhaler triple therapy [SITT] versus multiple inhaler triple therapy [MITT]) and long-term treatment goals. Data could be assigned to ≥1 theme.

Results: Overall, 2966 patient and HCP insights (patients, 1150; HCPs, 1816), 988 social media posts, and 44 survey responses (patients, 33; caregivers, 11) were included. Within this analysis, some patients delayed seeking medical advice due to lack of disease understanding and used alternative information sources to better understand treatment options (eg, social media). Patients preferred SITT over MITT in terms of convenience, ease of use, and perceived efficacy; some believed that MITT provided greater coverage due to frequent dosing. HCPs recognized the tendency of patient preferences to drive treatment decisions, and highlighted a reluctance to change therapy among some patients, particularly those well controlled in current therapy. Patients preferred therapies with a shorter onset of action. Patients tended to measure treatment success by symptom improvement and quality of life, whereas HCPs measured treatment success through clinical tests. HCPs reported a lack of patient awareness of the mortality risk associated with COPD.

Conclusion: There is discordance between patient and HCP perceptions of treatment success and goals in asthma and COPD. Improved patient education and HCP-patient communication are needed to facilitate meaningful shared decision-making, optimize care plans, and provide early treatment options.

Background: Poor medication adherence is a well-recognized problem, and behavior change techniques (BCTs) have shown promise in improving patient adherence to prescribed drug treatment. Through the utilization of medication adherence technologies (MATech), these BCT interventions could be delivered effectively in a person-centered way. MATech can be defined as systems, services or physical devices (hardware), with a digital component, used to support patients in their drug utilization. However, there is a lack of knowledge regarding their availability and to what extent they apply evidence-based BCTs.

Purpose: This study aimed to identify and describe MATech with BCT interventions available in the Swedish language.

Methods: A cross-sectional survey study was conducted in 2023. After identifying potential MATech developers by contacting umbrella organizations in the private sector, public agencies and regions, and conducting an app search, a survey was distributed to 381 potential MATech developers. Included MATech were in Swedish, used by patients, incorporated a BCT intervention, and had survey response from the developer. The survey was based on the BCT taxonomy and the framework of attributes from the COST ENABLE project, and included questions regarding BCT features. Following correspondence with 189 potential developers, 32 with products of interest responded to the survey, and 21 MATech were identified (12 standalone software and nine hardware solutions).

Results: Among the 21 MATech identified, nine were hardware and ten were specifically designed for a particular disease or medication. The majority of technologies incorporated BCTs of reminding the patient to take the medication (81%), information about the treatment (71%) and providing feedback on the monitoring of medication adherence or clinical outcomes (76%).

Conclusion: Swedish-language MATech employing BCTs are available, encompassing both hardware and software solutions. There is a need to enhance the visibility of these technologies, enabling patients to discover and utilize the support they provide.

Purpose: Clozapine is an antipsychotic which was approved in 1989 for treatment-resistant schizophrenia in the United States (US). There were few randomized trials before its approval and potentially lethal clozapine adverse drug reactions (ADRs), such as agranulocytosis and myocarditis were identified by pharmacovigilance. VigiBase, the WHO global database, is a cornerstone of international pharmacovigilance efforts for ADR identification during post-marketing surveillance. This systematic review of the literature explores additional contributions to the knowledge of clozapine ADRs from recent VigiBase studies.

Methods: Using the terms "clozapine AND VigiBase" we conducted an article search in PubMed on September 5, 2024. Of the 29 articles, 11 were excluded and 18 described in the Results section.

Results: All clozapine ADRs were described in two VigiBase studies. One on pregnancy indicated no increased risk with clozapine compared with other antipsychotics; the other reported 191,557 clozapine ADRs, including 22,956 fatal outcomes through January 15, 2023, and paid attention to the reporting style of the top 4 reporting countries (the US, the United Kingdom, Canada and Australia). Infections were described in three VigiBase studies where clozapine treatment was associated with infections, respiratory aspiration, and pneumonia. Rapid titration can lead to localized clozapine-induced inflammations including myocarditis, pericarditis or pancreatitis, or generalized inflammations such as drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome. Clozapine-induced inflammation was described in four VigiBase studies, two focused on all ages (myocarditis and DRESS) and two on youth (myocarditis and another on pericarditis and pancreatitis). Other specific ADRs were described in nine VigiBase studies (hematological malignancies, rhabdomyolysis, sialorrhea, seizures, diabetes mellitus, drug-induced parkinsonism, withdrawal symptoms, and suicidal behaviors).

Conclusion: The spectrum of respiratory aspiration - aspiration pneumonia - pneumonia and other infections are significant causes of fatal outcomes in clozapine-treated patients. Clozapine had anti-suicidal effects versus other antipsychotics across all VigiBase labels of suicidal behavior.

Objective: To conduct an in-depth exploration of the factors influencing unfulfilled needs in caregivers of patients with phenylketonuria.

Methods: A rapid qualitative analysis approach was used to conduct semi-structured interviews with 16 caregivers of patients with phenylketonuria undergoing specialized dietary interventions, along with 5 medical professionals, within a designated phenylketonuria diagnosis and treatment center in Shanxi Province. Interview data were systematically organized, analyzed, and thematically extracted.

Results: Four primary themes were extracted: self-imposed constraints (including insufficient caregiver engagement, economic limitations, and stigma); interpersonal constraints (encompassing social isolation, inadequate social support networks, and lack of doctor-patient interactions); structural limitation factors (inadequate provision of specialized professional support systems, lack of medical dietary supplements, and deficiencies in national policies); and experiential limitation factors (encompassing sensory perceptions of medical dietary supplements and insufficient continuity in psycho-emotional care).

Conclusion: The unfulfilled needs of caregivers of patients with phenylketonuria primarily manifest across four dimensions. Greater emphasis on addressing these needs is warranted, necessitating increased attention to patients with phenylketonuria and their caregivers. Specifically, the focus should be directed toward addressing their emotional requirements, along with proactive development of the medical service infrastructure. Such measures are imperative for reducing unfulfilled needs among caregivers of patients and enhancing their prognosis.