Patient preference and adherence最新文献

Background: Ethical and professional pharmacy practice is fundamental to supporting patient safety and trust. Despite advances in Good Pharmacy Practice (GPP), evidence from developing systems indicates gaps in ethical performance. This study aimed to assess the ethical dimensions of community pharmacists' practice in Jordan from the public's perspective, focusing on counseling quality, privacy, autonomy, and fairness.

Methods: A cross-sectional survey was conducted among 710 community pharmacy clients across Jordan using a validated questionnaire measured five ethical domains and an attitude scale. Composite scores for patient satisfaction, ethical conduct, and pharmacist attitude were calculated. Descriptive statistics and logistic regression were used to identify demographic predictors.

Results: Participants were predominantly female (57.9%) and from central Jordan (69.6%). Mean domain scores were: history-taking (51.3 ± 34.3), counseling (60.3 ± 29.6), privacy (67.8 ± 26.1), autonomy (60.2 ± 36.6), and justice (86.5 ± 24.0). Counseling was strongest for medication use and timing but weakest for safety aspects-adverse effects (41.4%), storage (40.1%), and drug interactions (31.7%). Justice and professionalism received the highest perception scores, while privacy and autonomy received moderate ratings. Gender (female) and south region predicted higher satisfaction and ethical perception (p < 0.05).

Conclusion: Community pharmacists in Jordan were perceived as demonstrating strong fairness and professionalism, but gaps remain in safety-oriented counseling and privacy assurance. These findings highlight areas where communication practices, privacy infrastructure, and ethics-oriented training may warrant further attention. Strengthening these areas could contribute to supporting patient trust and the ethical quality of community pharmacy services.

Objective: This study aimed to evaluate treatment preferences for anticancer drugs among patients with non-small cell lung cancer (NSCLC), in order to provide evidence not only for clinical prescribing decisions but also for broader applications such as health insurance reimbursement and policy-making.

Methods: A Best-Worst Scaling object-case (BWS-1) questionnaire was administered to NSCLC patients. Thirteen choice sets, each containing four attributes, were generated using Balanced Incomplete Block Design. Respondents were asked to identify the most and least important attribute within each set. The attributes include overall survival (OS), disease control rate, progression-free survival (PFS), dyspnea, pain, objective response, hemoptysis, fever, nausea and vomiting, monthly out-of-pocket expenditure, cough, mode of administration, fatigue. Relative attribute importance and preference heterogeneity were estimated using counting analysis and a conditional logit model (CLM).

Results: A total of 102 NSCLC patients were enrolled. High concordance was observed between counting analysis and conditional logit results. In the CLM, OS (β=3.537, P<0.01), disease control rate (β=2.025, P<0.01), and PFS (β=1.574, P<0.01) showed the strongest positive preferences. Fatigue (β=-1.158, P<0.01) and mode of administration (β=-0.600, P<0.01) were associated with lower relative importance. Cough showed a negative coefficient but was not statistically significant (β=-0.185, P=0.11).

Conclusion: This study is the first to explore the NSCLC patient medication preference using a BWS-1. The findings suggest OS, disease control rate, and PFS are prioritized by patients when choosing treatment regimens.

Purpose: This study aimed to investigate the knowledge, attitudes, and practices (KAP) toward insomnia among patients.

Patients and methods: A cross-sectional survey was conducted from May 20, 2023, to March 25, 2024, in the Neurology Outpatient Department at the Affiliated Hospital of Chengdu University of Traditional Chinese Medicine. Data were collected through the distribution of questionnaires.

Results: A total of 568 valid questionnaires were analyzed. Of these respondents, 368 (64.79%) were female. Notably, 156 (27.46%) exhibited symptoms of anxiety, and 103 (18.13%) were found to be experiencing depressive symptoms. The mean knowledge, attitude, and practice scores were 5.50±2.20 (possible range: 0-9), 24.53±3.21 (possible range: 8-40), and 28.55±4.28 (possible range: 8-40), respectively. The results of pathway analysis showed that knowledge was directly associated with both attitude (β=0.240, P=0.010) and practice (β=-0.128, P=0.013), and attitude was associated with practice (β=0.179, P=0.010). Furthermore, an indirect association was observed between knowledge and practice through attitude (β=0.043, P=0.010).

Conclusion: The study found patients' insomnia knowledge and attitudes are poor, yet their practices are proactive. Since knowledge and attitudes were associated with practice, clinical programs should consider implementing educational interventions to improve understanding and foster positive attitudes toward insomnia management.

Purpose: This study assessed participants' experience with their clinical trial and explored perceived health improvements to support quality improvement initiatives.

Patients and methods: A cross-sectional survey was conducted among participants of a randomized, double-blind clinical trial on magnesium supplementation in type 2 diabetes. All participants were invited to complete a 25-item survey after providing informed consent. The survey covered general information, core trial experience (Five-Point-Likert-Scale), symptom improvement, overall satisfaction, and open-ended questions. The tool was bilingually developed, culturally adapted, and psychometrically tested for consistency and validity. Both quantitative and qualitative thematic analysis were performed.

Results: The survey demonstrated a high internal consistency (Cronbach's alpha=0.93), and a strong construct validity characterized by a predominant unidimensional structure (Kaiser-Meyer-Olkin value=0.897). Of 227 contacted participants, 132 completed the survey (response rate: 58.15%). Satisfaction scores were consistently positive, especially for staff professionalism, respect for time, and informed consent clarity. Most respondents (75%) were willing to join future trials, and 87.88% would recommend participation. Over half reported symptom improvements, particularly in muscle cramps, energy, and sleep quality. No significant association was found between satisfaction and symptom improvement. Satisfaction was high across all educational levels. Open-ended responses emphasized staff professionalism, clear communication, and perceived health benefits as key factors to the overall reported satisfaction.

Conclusion: Respondents reported a consistently high satisfaction level, with perceived symptom improvements and strong willingness to future participation. This internally reliable and structurally valid survey captured meaningful feedback and may serve as a valuable quality improvement initiative to enhance patient engagement and optimize trial conduct, however, within the study's limitations.

Purpose: Medication sharing has been reported in many countries, with prevalence rates of 6-42% for lending and 5-54% for borrowing. This can cause serious harm, particularly in older adults. Therefore, this study aimed to investigate older adults' perceptions and experiences of medication sharing.

Patients and methods: For this qualitative study, semi-structured interview study, data were collected in person from older adults aged 65-90 years, who were recruited using snowball sampling. The study was conducted between May and November 2020. Descriptive analysis was conducted to summarize participants' demographic characteristics. The interview responses were analyzed using content analysis with deductive and inductive methods.

Results: A total of 20 participants were included in the study. Among them, 18 participants (90%) reported medication-sharing experiences with prescription or over-the-counter medications, and 16 (80%) reported sharing medications with family or relatives. The shared medications ranged from oral tablets for chronic disease management to topical patches for acute pain. The participants primarily described the following reasons for medication sharing: lenders having unused (leftover) medications available, borrowers' financial difficulties, and lenders having drug coverage provided through their health insurance. Eleven participants (55%) identified leftover medications as one of the reasons for medication sharing, and five participants (25%) identified financial difficulties. The lenders reported that the medication-sharing behavior negatively affected their medication therapy adherence.

Conclusion: In this study's sample, most older adults (90%) reported engaging in medication sharing within close relationships, which was described as a socially situated practice with implications for medication management. Addressing this behavior may require privacy-assured, non-judgmental communication strategies that are culturally tailored. Future quantitative or mixed-methods studies are needed to better understand the behavior and inform the development of effective interventions.

Purpose: Medication non-adherence remains a major barrier to effective long-term disease management. Smart packaging technologies offer digital solutions to monitor and support adherence. This study evaluated the usability and feasibility of a smart blister pack (Cerepak^®) for monitoring medication adherence, both with and without a mobile adherence app (MEMS^® Mobile), in healthy adult participants.

Methods: In this randomized controlled trial, 36 participants were assigned to use the smart blister pack either with the mobile adherence app (intervention) or without the app (control) over eight weeks, simulating twice-daily medication intake. Usability was assessed using the System Usability Scale (SUS) and user experience surveys. Semi-structured interviews explored user satisfaction, barriers, and suggestions for improvement. Adherence was measured electronically and via pill counts.

Results: Usability scores were significantly higher in the intervention group (median SUS: 80.0) compared to the control group (67.5; p = 0.0007). Participants appreciated the packaging's visual layout and the app's reminder and tracking features. Qualitative findings highlighted improved structure, motivation, and ease of use with the app, alongside technical and packaging challenges. Electronic adherence was 91.7% in the app group and 86.2% in the non-app group. Pill count adherence was 96.4% and 88.0%, respectively. No statistically significant differences were observed. Intermittent data capture issues associated with the smart blister pack led to minor performance inconsistencies in 10.4% of packages, which were accounted for in the analysis, ensuring data integrity.

Conclusion: The smart blister pack is usable and feasible for daily medication taking and tracking, particularly when supported by a mobile app. These findings support further research into clinical populations and long-term implementation studies.

Objective: This study aimed to identify distinct in-hospital cardiac rehabilitation (CR) adherence profiles and explore their associated clinical and sociodemographic factors among patients following percutaneous coronary intervention (PCI).

Methods: A cross-sectional survey was conducted among patients undergoing Phase I cardiac rehabilitation following percutaneous coronary intervention (PCI) who were hospitalized in the cardiology department between June and July 2025 (n=384). Data were collected using a general information questionnaire and a treatment adherence questionnaire (Since the study population consisted of inpatients undergoing PCI followed by phase I cardiac rehabilitation, the dimension of follow-up compliance was excluded). LPA, a person-centered method that identifies unobserved subgroups (profiles) based on response patterns, was prespecified to classify CR adherence profiles. Multinomial logistic regression was performed to examine factors associated with profile membership. Clinical indicators (number of diseased vessels, LVEF, LDL-C, and serum creatinine) were included as candidate predictors; after LASSO selection, LDL-C and number of diseased vessels were retained and entered the final multinomial logistic regression model as continuous variables (original values).

Results: Three distinct CR adherence profiles were identified: Low CR Adherence (125/384, 32.55%), Medium CR Adherence (169/384, 44.01%), and High CR Adherence (90/384, 23.44%). Profile membership was significantly associated with gender, living situation, family monthly income, residential distance, smartphone use/proficiency and LDL-C (P < 0.05).

Conclusion: CR adherence among post-PCI patients was overall moderate-to-low, with substantial heterogeneity across adherence patterns. The associated sociodemographic and contextual factors may help inform profile-based, tailored support to improve CR adherence after PCI. Given the cross-sectional design, these associations are non-causal and should be validated in future multicenter longitudinal and intervention studies.

Purpose: The study aimed to cross-culturally adapt and psychometrically test the Mandarin version of the Chinese Health Literacy Scale for Diabetes (M-CHLSD).

Patients and methods: A cross-sectional study was conducted in Beijing with 221 adults diagnosed with type 2 diabetes. The adaptation followed a rigorous five-step process: forward translation, synthesis, back translation, expert review (utilizing a two-round Delphi method), and cognitive interviews using the Questionnaire Appraisal System. Psychometric properties of the M-CHLSD were evaluated using reliability, content validity, and construct validity. Criterion validity was assessed by correlating the scale with glycemic measures and conducting group comparisons using the Mann-Whitney U-test.

Results: The Delphi review highlighted the need for linguistic refinement, clinical accuracy, and contextual adaptation, leading to revisions aligned with Mainland China's healthcare system. Pilot testing with 15 patients confirmed comprehensibility. Confirmatory Factor Analysis indicated a good model fit (Comparative Fit Index = 0.93, Tucker-Lewis Index = 0.91, Root Mean Square Error of Approximation = 0.064). The scale demonstrated excellent internal consistency (Cronbach's α=0.884) and test-retest reliability (Intraclass Correlation Coefficient=0.82-0.91). The M-CHLSD showed moderate correlations with fasting plasma glucose (ρ = -0.36) and 2-hour postprandial glucose (ρ = -0.39). The scale successfully distinguished between individuals with good versus poor glycemic control (Cohen's d = 0.54-0.56). A mild ceiling effect (15.1%) was observed.

Conclusion: The M-CHLSD is a robust, reliable, and clinically relevant tool for assessing health literacy in Mandarin-speakers with diabetes. Its rigorous methodology, including Delphi, cognitive interviews, and comprehensive psychometric testing, makes it superior to other adapted tools. The scale's strong clinical correlations and ability to stratify patients based on glycemic control ensure its utility in personalized education and follow-up care pathways.

Purpose: To assess the effectiveness of treatment modalities for radiation-induced trismus in improving mouth opening (MO) and oral health-related quality of life (OHRQoL), with considering of treatment timing and patient adherence.

Methods: Electronic databases (PubMed, Google Scholar, Scopus, EBSCOhost, and ScienceDirect) were searched for studies published between 2015 and 2025 using relevant Medical Subject Headings (MeSH) combined with Boolean operators, including "Treatment OR therapy AND trismus OR limited mouth opening AND radiation therapy OR radiotherapy AND head and neck neoplasm OR head and neck cancer" and "Timing OR starting time AND treatment OR exercise AND trismus OR limited mouth opening OR restricted mouth opening." After duplicate removal, titles, abstracts, and full texts were screened for eligibility.

Results: The initial search identified 472,480 articles, of which 18 met the inclusion criteria after screening titles, abstracts, and full texts. Kruskal-Wallis analysis demonstrated significantly greater improvement in mouth opening when trismus treatment was initiated during or after radiotherapy compared to before radiotherapy (p = 0.020). The greatest improvement was observed with combined laser therapy and Therabite exercises, initiated concurrently with radiotherapy for 3 months with high adherence, resulting in a mean increase of 26.95 mm in MO and an improvement in OHRQoL. The second most effective modality was threaded tapered screw appliance (TTSA) therapy combined with low-level laser therapy (LLLT) administered post-radiotherapy for 6 weeks, yielding a 15 mm improvement with high adherence.

Conclusion: The effectiveness of treatment for radiation-induced trismus is influenced by the therapeutic modality, timing of therapy initiation, and patient adherence, all of which contribute to improvements in MO and OHRQoL. Combination therapy modalities, particularly laser therapy combined with jaw movement devices, initiated during or after radiotherapy and supported by high patient adherence, optimize mouth opening and enhance OHR-QoL.