Patient preference and adherence最新文献

Purpose: The main treatment options offered to patients to choose from when restoring a single missing tooth include tooth-supported three-unit fixed partial dentures (FPDs) and implant-supported single crowns (ISCs). However, due to the heterogeneity of current studies, it is difficult to objectively compare these two treatment strategies. In this study, a discrete choice experiment (DCE) was used to quantify the preferences of individuals undergoing restoration treatment for single tooth loss.

Patients and methods: The DCE questionnaire was disseminated in a "snowball" fashion, with data collected from participants aged 18-60. Five important attributes of treatment were selected: (1) treatment procedure, (2) treatment time, (3) cost, (4) five-year survival rate, and (5) five-year complication rate. A conditional logit model was employed to ascertain the direction of participants' preferences for specific attribute levels and to derive their willingness to pay (WTP) through the principle of marginal utility.

Results: 287 participants completed the questionnaire. The results of the questionnaire revealed that the five-year complication rate (42.42%) was the most important attribute, followed by cost (20.43%), five-year survival rate (14.23%), treatment time (13.44%), and treatment procedure (9.49%). Participants were willing to pay RMB$11076.2 (USD$1,772.2) to obtain a 10% extra reduction in the five-year complication rate, and RMB$7434.6 (USD$1,189.5) for a non-invasive treatment.

Conclusion: In the ranking of the relative importance of key factors affecting single missing tooth restoration, complication rates are most highly valued, suggesting that reducing the complication rate is a key issue to be addressed in prosthodontics. In addition, deriving the ranking of patients' concerns about key factors can help to improve doctor-patient communication and provide a reference for treatment technology development and medical decision-making.

Purpose: In China, secondary and tertiary hospital-based dialysis facilities had been the most prominent provider of hemodialysis treatment. Developing community hemodialysis centers was the key to constructing hierarchical hemodialysis system. Thus, the aim of this study was to explore end-stage kidney disease (ESKD) patients' preferences for hemodialysis services and attract patients with stable condition to choose community hemodialysis services.

Patients and methods: The study used a labelled discrete choice experiment with ESKD patients in Wuhan, Hubei Province in China. Patients were asked to make a choice between hospital-based hemodialysis facilities and community hemodialysis centers with different attribute levels. Mixed logit model was used to measure their preferences and heterogeneity for hemodialysis services. The marginal utility was measured to predict the change of patients' choice probability of community hemodialysis centers.

Results: A total of 420 ESKD patients consented to complete the questionnaires and 408 were included in the analysis after excluding responses that did not pass the consistency test. All attributes were significantly influencing respondents' choice of hemodialysis service. Patients were more inclined to hemodialysis services with smooth and effective referral, regular doctors, 20 minutes of travel time, and home-based offline follow-up. Gender, age, income, hemodialysis year, and hemodialysis times weekly were found to influence the preferences. When the community hemodialysis service attributes gradually meet the patients' preferences, as many as 58.39% of patients will choose community hemodialysis centers.

Conclusion: A better understanding of ESKD patients' preferences for hemodialysis service is a crucial step for the future policy implementations. Although patients tended to choose hospital-based hemodialysis facilities, patients' preferences for hemodialysis institutions would reverse with the change of service attribute. Establishing a smooth and effective referral is the most important attribute to improve patients' acceptance of community hemodialysis centers. Strengthening the integration of service can facilitate hierarchical hemodialysis service system.

Background: Many patients with type 2 diabetes mellitus (T2DM) face barriers to maintain a healthy lifestyle. This study investigated the perceived barriers to healthy eating and physical activity and compared them by demographic and diabetes-related characteristics among patients with T2DM.

Methods: A cross-sectional study was conducted among 534 patients with T2DM attending primary healthcare centers in Hail City from January to June 2023. Data analyzed at a significance level of <0.05.

Results: Barriers to healthy eating and physical activity were perceived by 34.9% and 28% of patients, re-spectively. Personal and environmental barriers to healthy eating were perceived more frequently than social barriers (43.0% and 26.9%, respectively). Personal and environmental barriers to physical activity were perceived by 28.0% of patients, followed by social barriers (27.9%). The most frequently perceived barrier to healthy eating was a lack of motivation (61.6%), followed by insufficient information about healthy diets (32.2%). Regarding physical activity, a lack of motivation was the most frequently perceived personal barrier (32.0%), while a lack of a supportive work environment was the most frequently perceived social barrier (33.7%). Patients who were aged between 30 and 40 years, were highly educated, were diagnosed with DM within less than five years, and used insulin injections as a strategy to manage DM reported significantly higher levels of perceived barriers to healthy eating compared to their counterparts. In contrast, patients who were female, married, had poor financial status, and used insulin injections reported significantly higher levels of perceived barriers to physical activity compared to their counterparts.

Conclusion: Over one-third of patients with T2DM seeking medical care in Hail City perceive barriers to healthy eating, mainly a lack of motivation, insufficient diet information. Educational programs that consider the unique characteristics of patients should be developed.

Purpose: COPD treatment relies mostly on drug administration via inhaler. Adherence to therapy is highly dependent on inhaler features and patient training. With the aim of identifying patients' unmet needs and expectations about inhalers, data from a recent human factors study involving COPD patients have been analyzed. The specific use of the NEXThaler, a multidose dry powder inhaler that is activated by the patient's inhalation, and its potential impact on adherence was explored.

Methods: Adult patients with moderate to severe COPD were interviewed across 8 European countries using 90-minute semi-structured interviews to assess symptoms, services, challenges, patient expectations, and feedback on current inhalers. Patients participated in a simulation of NEXThaler use and watched a training video; they were asked to rate the device's key features regarding treatment experience, confidence, and quality of life and provide suggestions for improvement.

Results: The 62 patients interviewed most appreciated an inhaler's ease of use, followed by the presence of an inhalation counter and a comfortable mouthpiece. Some patients were more interested in the drug itself rather than in the delivery device. Overall, the participants had positive feedback about NEXThaler, appreciating its ease of use, the low inhalation effort required to activate it, and the presence of both the inhalation click (referred to as the "click of confidence" because it gives COPD patients confidence that the dose has been released correctly) and the inhalation counter.

Conclusion: NEXThaler has been appreciated for its three differentiating features (click of confidence, low inhalation effort, and inhalation counter), which have been shown to have a positive impact on patient's lives, treatment experience, and confidence. This can potentially translate into improved medication adherence with a positive impact on the QoL of people living with COPD.

Purpose: This review aims to provide a comprehensive overview of sensor technologies employed in interventions to enhance patient adherence to inhalation therapy for chronic respiratory diseases, with a particular emphasis on human factors. Sensor-based interventions offer opportunities to improve adherence through monitoring and feedback; however, a deeper understanding of how these technologies interact with patients is essential.

Patients and methods: We conducted a systematic review by searching online databases, including PubMed, Scopus, Web of Science, Science Direct, and ACM Digital Library, spanning the timeframe from January 2014 to December 2023. Our inclusion criteria focused on studies that employed sensor-based technologies to enhance patient adherence to inhalation therapy.

Results: The initial search yielded 1563 results. After a thorough screening process, we selected 37 relevant studies. These sensor-based interventions were organized within a comprehensive HFE framework, including data collection, data processing, system feedback, and system feasibility. The data collection phase comprised person-related, task-related, and physical environment-related data. Various approaches to data processing were employed, encompassing applications for assessing intervention effectiveness, monitoring patient behaviour, and identifying disease risks, while system feedback included reminders and alerts, data visualization, and persuasive features. System feasibility was evaluated based on patient acceptance, usability, and device cost considerations.

Conclusion: Sensor-based interventions hold significant promise for improving adherence to inhalation therapy. This review highlights the necessity of an integrated "person-task-physical environment" system to advance future sensor technologies. By capturing comprehensive data on patient health, device usage patterns, and environmental conditions, this approach enables more personalized and effective adherence support. Key recommendations include standardizing data integration protocols, employing advanced algorithms for insights generation, enhancing interactive visual features for accessibility, integrating persuasive design elements to boost engagement, exploring the advantages of conversational agents, and optimizing experience to increase patient acceptance.

Background: In patients with chronic diseases, including those with chronic obstructive pulmonary disease (COPD), knowledge on the disease and its self-management is considered as relevant for improving disease control and long-term outcome. We studied to which extent components of knowledge depended on potential predictors, such as participation in educational programs and disease severity. For example, the perception of exacerbations or GOLD grade might modulate the content and reliability of COPD understanding.

Methods: Data from the German COSYCONET 2 COPD cohort was used, and 13 questions addressing knowledge and self-management were analyzed.

Results: Overall, 310 patients with the diagnosis of COPD of GOLD grades 1/2/3/4 as well as the former grade 0 were included (39.7% female, median age 66.0 years). The answers to 3 questions (knowledge of term exacerbation, pursed lip breathing technique, criteria for contacting a doctor) were improved (p < 0.05 each) when patients had had moderate-to-severe exacerbations, and to one question (breathing exercise) when having COPD grade 3/4 versus 0/1/2. The other 9 responses did not depend on disease severity, but most of the knowledge was improved when having participated in an educational COPD program. This was particularly true for knowledge that also depended on exacerbations, or if the treating physician was a pulmonary specialist. In some responses, the proportion of correct answers was significantly reduced in males compared to females. The dependence on education level, existence of a treatment plan, self-reported level of risk aversion and low depression score was weak and heterogeneous.

Conclusion: These findings suggest that part of the disease-related knowledge in patients with COPD was reinforced by the experience of exacerbations, especially knowledge regarding criteria on contacting a physician. These observations might help in focusing education on those parts of knowledge that are considered as important by patients based on their own experience.

Introduction: Surgeon attire significantly affects patients' perceptions and can improve patient-surgeon relationships, which are crucial for patient comfort, experience, satisfaction, and treatment adherence. Understanding patient preferences for surgeon attire is essential, particularly in Saudi Arabia, for establishing appropriate dress codes in healthcare institutions. This national cross-sectional study aimed to fill this gap by assessing patient preferences for surgeon attire and its impact on patients' confidence in their surgeons across various medical settings.

Methods: The study used a questionnaire with 16 questions and images of surgeons in different attire styles, focusing on trust, care, approachability, and comfort ratings. The questionnaire included options like scrubs with a white coat, formal attire, and traditional Saudi attire for male surgeons, and various options including niqab and skirts for female surgeons. The survey had four sections covering ratings, attire preferences, opinions on white coats, and demographic data.

Results: A total of 612 patients completed the questionnaires, mainly aged 35-54 (33%). Skirt and niqab and white coat attire for females received the highest ratings. Attire other than scrubs, especially jeans and heels with a white coat, had significantly lower ratings. Scrubs and white coats were the most preferred attire for male (23.7%) and female (17%) surgeons. Additionally, 71.24% of participants agreed that surgeons should wear white coats.

Conclusion: In Saudi Arabia, male surgeons are preferred in scrubs and white coats, while female surgeons are preferred in skirts with white coats and niqabs. These preferences reflect notions of formality, professionalism, and cultural influences. Jeans received the lowest ratings, possibly due to perceptions of informality. Patients favor scrubs and white coats for hygiene benefits and conveying dedication and expertise. Future research should validate these findings across diverse cultures and medical fields.

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.