Patient preference and adherence最新文献

Introduction: Pharmacists are essential healthcare professionals which play a pivotal role in public health protection by offering diverse pharmacy services. This includes not only serving individuals in Ukraine but also addressing the needs of Ukrainian citizens residing in Poland. An exemplary initiative is the creation of the website farmaceucidlaukrainy.pl, which provides organized and systematic support.

Aim: This study aims to evaluate the perceptions of Ukrainian immigrant patients from Ukraine regarding the advanced pharmaceutical consultation service provided by Polish pharmacists.

Material and methods: This study included 250 respondents from Ukraine. The study was conducted in 2022 using an anonymous survey. The survey was distributed after pharmaceutical consultations in one of the cities near the Polish-Ukrainian border. As part of the project, Ukrainian patients who had run out of medicines due to war brought their medications to pharmacy counselling points organized by Polish pharmacists, and the pharmacists helped them find equivalents ias well as help treated minor ailments in Poland.

Results: Practically all respondents strongly agree with all the statements posed in the survey, the percentage of such responses was close to 95%, with the lowest percentage observed for the statement "If possible, I would like this kind of service to be offered in any Polish pharmacy", which was 90.40%.

Conclusion: Ukrainian patients highly appreciated the pharmaceutical consultation services provided by Polish pharmacists. The information given by pharmacists was clear and practical, and the services were deemed highly supportive. Expanding such initiatives to other assistance points could enhance the support network for displaced individuals.

Background: Effective self-management in the early stage of chronic kidney disease (CKD) is key to delaying disease progression. However, no studies have confirmed that the combined support of internal individual factors and external family environmental factors may play an important role in the self-management of patients with early CKD.

Purpose: This current study aims to explore the effect of family function on the self-management of patients with early CKD and examine the mediating roles of self-perceived burden and ego depletion.

Patients and methods: Three hundred and sixty patients with stage 1-3 CKD participated in the cross-sectional survey and completed structured questionnaires, including the family APGAR index, self-perceived burden scale, self-regulatory fatigue scale and chronic kidney disease self-management instrument. Mplus 8.3 was used to establish a structural equation model.

Results: Family function had a positive predictive effect on self-management (β = 0.231, P < 0.001). Self-perceived burden and ego depletion were not only single mediating variables between family function and self-management but also played a chain-mediating role. The total indirect effect was 0.304 (95% CI: 0.234 to 0.388, P < 0.001), accounting for 56.82% of the total effect (β = 0.535, 95% CI: 0.420 to 0.651, P < 0.001).

Conclusion: This study highlights the importance of self-management for patients and their families and provides new important theoretical guidance for multiple interventions of improving family function, reducing self-perceived burden and ego depletion to improve self-management, which is of great value in delaying the progression of renal disease.

Background: Chronic disease has become an increasing burden in Indonesia, increasing the importance of treatment adherence to control the disease prognosis. Therefore, we aim to determine the prevalence and characteristics of nonadherence in Indonesian chronic disease population.

Methods: We identified 11,408 adult subjects with chronic diseases from the fifth Indonesian Family Life Survey. We defined treatment nonadherence as the outcome variable and characteristics related to the World Health Organization Multidimensional Adherence Model as exposure variables. We used descriptive and multivariable analyses to analyze factors related to treatment nonadherence.

Results: We identified that 57% (95% CI 56.1-57.9) of chronic disease patients were nonadherent to their treatment. Treatment nonadherence was notable in subjects with liver disease (61.8%), tuberculosis (59.8%), digestive diseases (57.9%), other lung diseases (56.8%), psychiatric diseases (51.6%), asthma (51.2%), and hypertension (50%). Treatment nonadherence was associated with socioeconomic-related factors of being aged 15-65 years, living in rural areas, having history of formal education, and having a household size of 2-6 people. Furthermore, in patient- and condition-related factors, positive perceptions of their health condition, missing 0-7 days of their regular activity in the last month, being ex- and non-smokers, having no depression symptoms, and having only one chronic disease were associated with treatment nonadherence.

Conclusion: Treatment nonadherence for chronic diseases in Indonesia was found to be prevalent. Further consideration of characteristics associated with treatment nonadherence should be given to ensure optimal control of chronic diseases.

Purpose: The purpose of this study was to explore the lean management strategies used by an outpatient hospital pharmacy in China to reduce internal errors in prescription dispense and to describe their impact on patient satisfaction.

Methods: The type and number of internal errors in prescription dispense from January 1, 2022, to December 31, 2022, were collected. The causes of these errors were analyzed based on a series of lean management concepts and methods, and Lean Management was implemented from January 1, 2023, to December 31, 2023, in this outpatient hospital pharmacy. The number of internal errors, the proportion of dispense errors and the change of patient satisfaction before and after Lean Management were compared.

Results: Before the implementation of Lean Management, 2978 cases of internal errors were reported. It includes 1286cases (43.18%) of delivering wrong numbers, 612cases (20.55%) of medication in close proximity, 434cases (14.57%) of forget to dispense medication, 221cases (7.42%) of sound-alike medication, 203 cases (6.82%) of multiple sizes of a medication, 125 cases (4.20%) of look-alike medication, and 97 cases (3.26%) of others. The proportion of dispense errors was 3.46‰. After the implementation of Lean Management, the total number of internal errors in prescription dispense decreased to 219 cases, the proportion of internal errors in prescription dispense decreased to 0.27‰, which has a significant difference, and the satisfaction of patients increased from 52.94% to 72.97%.

Conclusion: The implementation of Lean Management can be an efficient approach to reduce the internal errors in prescription dispense.

Background: Demodex mites are common ectoparasites in humans and can cause various skin disorders known as demodicosis, ranging from nonspecific facial dermatitis to conditions resembling eczema, seborrheic dermatitis, folliculitis, and acne. Overgrowth of these mites can lead to pityriasis folliculorum, perioral dermatitis, blepharitis, and rosacea, significantly impacting skin health. This study aims to investigate the knowledge, attitude, awareness, and practice regarding Demodex mites in the Thai population and analyze the influencing factors associated with these aspects.

Methods: This study is a cross-sectional, analytical, observational study. All participants completed a questionnaire that covered sociodemographic characteristics, knowledge, attitude, awareness, practice regarding Demodex mites, and sources of health information. The survey was distributed via Google Forms, social media platforms, and paper questionnaires.

Results: Among 540 participants, the average age was 38.65 years, with 52% males. Mean scores for knowledge, attitude, awareness, and practice were 4.56 ± 2.56 out of 10, 17.37 ± 3.88 out of 25, 13.52 ± 3.59 out of 25, and 18.57 ± 3.73 out of 25, respectively. Only 23.33% had adequate knowledge, 50.56% had positive attitudes, and 10.93% had sufficient awareness. However, 66.11% exhibited active practices. Factors associated with active practice included being female (AOR = 1.95, p = 0.003), adequate knowledge (AOR = 1.63, p = 0.042), positive attitudes (AOR = 1.83, p = 0.002), and sufficient awareness (AOR = 4.12, p = 0.001).

Conclusion: The study clearly showed that the knowledge of Demodex mites among Thai people is limited. Although their attitudes toward these mites are fairy positive, their awareness remains alarmingly low. Nevertheless, they do engage in practices related to personal hygiene. Therefore, it is essential to improve this situation through effective educational campaigns to significantly enhance the management of skin diseases caused by Demodex mites.

Purpose: A healthy diet plays an important role for chronic kidney disease (CKD) treatment, but adherence to nutritional recommendations is frequently low. The aim of the present study was to describe barriers and facilitators to adherence to a healthy diet in people with CKD.

Patients and methods: Cross-sectional study; 80 predialysis (n=20), hemodialysis (n=20), peritoneal dialysis (n=20) and transplant (n=20) patients matched by age and sex, were included. Nutritional evaluation included subjective global assessment, anthropometry, quality of food consumption (Mini-ECCA v.2), self-perception about diet and willingness to change. Barriers and facilitators were evaluated with a qualitative approach (semi-structured interviews). Concepts were converted into "in vivo" and "theoretical" codes, then, grouped into categories. A second analysis was performed with the ATLAS.ti software.

Results: Frequency of malnutrition was 50% in people receiving dialysis. Quality of food consumption was healthier on people with CKD stages 3b-5 (40%) and people with kidney transplant (65%) compared to peritoneal dialysis (25%) and hemodialysis (0%). The main themes influencing adherence to a healthy diet were: need for nutritional guidance, economy, dietary restrictions, willingness to change, relationship with consequences in disease control and health status, aversion for healthy foods, bad and good self-perception, family support, feelings and emotions, environment, eating habits and CKD itself. Lack of time, work, economy, food preferences and cravings were the main barriers in people with CKD stage 3b-5 and transplant, while low willingness to eat healthy foods and dietary restrictions were the main barriers in people receiving dialysis.

Conclusion: Personal, environmental, health professional-related, CKD related as well as feelings and emotions aspects that people with CKD face in a daily basis, act as barriers or facilitators when trying to follow a healthy diet. Individualizing nutritional treatment taking into account people with CKD perspectives and situations is of utmost importance to improve adherence to nutritional treatment.

Objective: Population aging and epidemiological transition have prompted requests for integrating health and social care. The goal of meeting complex care needs necessitates the understanding of preferred patterns among older adults. The study aimed to elicit the preferred care patterns and the influencing factors of integrated health and social care among community-dwelling older adults in multiple regions of China.

Methods: From a national survey, 1184 community-dwelling older adults in three cities across China were included in the study. Individual characteristics and preferred care patterns were measured. Five preferred care patterns were classified, including Home-based health and social care, Community-based health and social care, Home-based health care but community-based social care, Community-based health care but home-based social care, and Institution-based health and social care. Multivariate logistic regression and random forest model were applied to obtain reliable results.

Results: Overall, approximately half of the participants (47.7%) in the survey preferred Home-based health and social care and more than a quarter of participants (25.6%) preferred Community-based health and social care, followed by Institution-based health and social care (14.4%). A relatively small fraction of participants reported preferences for Home-based health care but community-based social care (8.0%) and Community-based health care but home-based social care (4.2%). Gender, age, education, living arrangement, resident city, income per month, access to medication, and self-care capability were significantly associated with older adults' preferences (p<0.05 each). Education, living arrangement, age, resident city, and income per month were the most relevant predictors, followed by gender, number of chronic diseases, self-care capability, and access to medication.

Conclusion: To effectively meet care needs, efforts should focus on home- and community-based care. Since the preferred care patterns were characterized by obvious variability, policymakers and service providers should carefully consider the differences in making tailored strategies.

Purpose: Gout is a common, chronic inflammatory joint disease, and men are more likely to suffer from gout. Improving patient self-management behaviors is a priority in gout healthcare. Psychological capital is associated with self-management behaviors in chronic diseases and can be improved through a number of interventions. However, this topic has not been well studied in gout patients. The aim of this study was to determine the level of psychological capital among male gout patients in Southwest China and to compare differences in self-management behaviors among patients with different levels of psychological capital.

Patients and methods: This was a cross-sectional study. A total of 242 male gout patients were recruited from West China Hospital of Sichuan University, and demographic characteristics, clinical characteristics, psychological capital, and behavioral variables related to patient self-management were collected. K-Means cluster analysis was used to characterize psychological capital.

Results: The total psychological capital score of the participants was 134.5 (SD = 21.3). Cluster analysis of the four dimensions of psychological capital yielded three clusters, namely, Cluster 1 (higher level, 29.8%), Cluster 2 (moderate level, 52.3%), and Cluster 3 (poor level, 17.9%). The differences in the self-management behaviors among the three clusters, the differences were statistically significant. Post hoc analyses revealed that cluster 1 scored higher on the self-Management behaviors and its four dimensions than either cluster 2 or cluster 3 (p < 0.05).

Conclusion: The psychological capital of men with gout in Southwest China could be improved, and moderate and low levels of psychological capital are associated with suboptimal self-management behaviors. Healthcare providers may target gout patients with low or moderate levels of psychological capital as an intervention and take steps to improve their levels of psychological capital. These results may assist in decision-making for self-management behavioral interventions for gout patients.

Introduction: Digital health techniques were adopted faster during COVID-19, but the gap remains. This study analyzes how the digital gap affected pandemic patient portal uptake during and after. Patient portals improve physician connections and patient health information access, increasing health outcomes. Digital divide-lack of internet, digital literacy, and SDOH-may inhibit fair adoption. One study found that the internet and IT affected people during and after the pandemic. Learn why this patient demographic uses online patient portals so much. Like finding demographic, socioeconomic, and behavioral characteristics that affect portal usage, specifically drivers and barriers for health-conscious patients. This project developed a health promotion model and implemented initiatives to increase patient portal use and reduce health inequities.

Methods: In 2020 and 2022, we used Health Information National Trends Survey (HINTS) data. Patient portal use dominated. Our cross-sectional study assessed patient portal use and various predictors. Age, marital status, sex, mental health, education, income, urban/rural (urbanity), family size, trust, social media use, chronic condition, and health app use predict. We handled survey data collection biases with weighted analyses. Data was computed using survey weights for population representation. Logistic regression and weighted descriptive statistics utilized STATA SE 16.1.

Results: Demographic, socioeconomic, and behavioral characteristics significantly affect online patient portal use. Portal usage is positively correlated with health app use, urbanity, higher income, sex, Asian/Native American race/ethnicity, and hospital trust. In addition, our data shows low adoption rates across the digital divide. Patients who trust others utilize patient portals, and previously established characteristics affect self-motivation for health improvement.

Conclusion: Access obstacles and behavioral factors affect online patient portal adoption. Addressing the digital divide is crucial, but trust and self-motivation may improve patient portal utilization. Adopting health IT can improve patient participation and access to care, supporting equitable health outcomes.

Purpose: Oral corticosteroids (OCS) are an effective treatment for severe uncontrolled asthma or asthma exacerbations, but frequent bursts or long-term use carry serious and sometimes irreversible adverse effects, or complications such as adrenal insufficiency upon discontinuation. Our aim was to survey people with asthma on their experiences of, and attitudes towards, using OCS.

Patients and methods: This study was a national descriptive cross-sectional survey of people with asthma in Australia. An anonymous survey was hosted online with invitations to participate distributed by national consumer peak bodies. Survey free-text responses were coded to the Theoretical Domains Framework (TDF) to elicit determinants of OCS use.

Results: 1808 people with asthma participated between 3 and 16 May 2022. Most common reasons for using OCS were severe asthma symptoms (40%), doctor prescription (38%) or asthma action plan recommendations (20%). Approximately 55% of people had experienced adverse effects from OCS use. Commonly reported adverse effects were trouble sleeping (69%), weight gain (56%) and mood problems (41%). Of people who had OCS at home or an OCS script, 44% did not have an action plan that described when and how they should take them. People (33%) did not feel well informed about OCS adverse effects from their healthcare team. People had varied awareness (3-65%) of current available strategies to reduce OCS use. 'Knowledge', 'Environmental context and resources' and 'Social influences' were the most coded TDF domains influencing OCS use.

Conclusion: Adverse effects of OCS use are common. People with asthma are not adequately informed about optimal OCS use or strategies to reduce overuse. These findings can help guide the implementation of OCS stewardship initiatives.