Healthcare最新文献

{"title":"How Different Medical Practices Are Associated with Types of Patient Complaints in Russian Clinics.","authors":"Irina Evgenievna Kalabikhina, Anton Vasilyevich Kolotusha, Vadim Sergeevich Moshkin","doi":"10.3390/healthcare14081027","DOIUrl":"10.3390/healthcare14081027","url":null,"abstract":"<p><p><b>Background/Objectives:</b> Patient-Reported Experience Measures (PREMs) help us understand how patients perceive healthcare quality. Yet most studies look at complaints in isolation, without tying them to the structural features of medical practice. This study asks whether the nature of clinical work-shaped by diagnostic pathways, interaction patterns, and professional focus-predicts what patients complain about. <b>Methods:</b> We analyzed 18,492 negative reviews from infodoctor.ru, collected between 2012 and 2023 across 16 Russian cities with populations over one million. We used a mix of methods: machine learning (logistic regression) to classify complaints as medical (M-type) or organizational (O-type), statistical tests (chi-square, proportion analysis), and expert validation by nine independent specialists. We also built a novel multidimensional classification of medical practices based on three criteria: diagnostic pathway length, frequency and duration of patient interaction, and whether the work is mainly technical or communicative. <b>Results:</b> Technical specialties received far more medical complaints than communicative ones (39.8% vs. 29.3%, <i>p</i> < 0.001), while communicative specialties received more organizational complaints (45.7% vs. 35.0%, <i>p</i> < 0.001). Specialties that manage chronic conditions over the long term had the highest share of organizational complaints (41.6%). At the city level, the share of communicative specialists correlated negatively with complaints per capita (r = -0.541, <i>p</i> = 0.0306). We found no meaningful gender differences in complaint patterns. <b>Conclusions:</b> The type of medical practice systematically shapes what patients complain about. Technical specialties draw criticism on clinical quality; communicative specialties draw criticism on how care is organized. Long-term care faces challenges rooted more in administrative friction than in clinical competence. These findings show that PREMs, when analyzed through a practice-based lens, can support targeted quality improvement-moving from simply tracking complaints to acting on them in specialty-specific ways.</p>","PeriodicalId":12977,"journal":{"name":"Healthcare","volume":"14 8","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13116909/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147814465","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of Arterial Hypertension with Thoracic Spondylophyte Formation: A Secondary Analysis of Cross-Sectional MRI Data from the SHIP Cohort.","authors":"Kim Lisa Westphal, Fiona Mankertz, Lukas Rasche, Robin Bülow, Mark Oliver Wielpütz, Marie-Luise Kromrey, Carolin Malsch","doi":"10.3390/healthcare14081024","DOIUrl":"10.3390/healthcare14081024","url":null,"abstract":"<p><p><b>Objective:</b> Back pain is a multifactorial condition commonly associated with degenerative spinal changes. Spondylophytes are frequent outgrowths of the vertebral bodies that may be influenced by arterial hypertension via a possible increased pulsation of the aorta and its effects on bone remodeling. If it can be demonstrated that an increased pulse pressure in the aorta due to hypertension promotes the growth of spondylophytes and thereby increases the likelihood of back pain, future studies may investigate how the effectiveness of blood pressure management can be improved in order to reduce the prevalence of degenerative changes in the spine and, consequently, prevent back pain. This study investigated the association between arterial hypertension and thoracic spondylophyte formation using whole-body MRI data from the population-based Study of Health in Pomerania (SHIP). <b>Materials and Methods:</b> Spondylophyte presence and area were assessed for their association with hypertension status in 859 SHIP-START-3 participants who underwent whole-body MRI. Right-sided spondylophytes at T8-T11 were measured on axial T2-weighted sequences. Hypertension was defined by self-report or antihypertensive medication use; a sensitivity analysis was conducted using the 2024 European Society of Cardiology definition (systolic blood pressure ≥ 140 mmHg). Multivariate regression models adjusted for age, sex, obesity, and smoking were used to assess associations. Machine learning algorithms were applied for validation. <b>Results:</b> Spondylophytes were present in 87.7% of participants. Hypertension was significantly associated with spondylophyte presence (OR = 2.07, 95% CI: 1.15-3.81) but not consistently associated with spondylophyte size. Spondylophyte size increased from T8 to T11, and was associated with age, male sex, and obesity. Sensitivity analyses widely confirmed robustness of the analysis. <b>Conclusions:</b> This population-based MRI study investigates the still insufficiently studied relationship between arterial hypertension and the formation of thoracic spondylophytes. The findings are consistent with the hypothesis that hypertension may be associated with spinal bone remodelling, though causal inference remains limited by the cross-sectional study design. Further longitudinal studies are needed to clarify causality and clinical relevance for spinal degeneration and back pain.</p>","PeriodicalId":12977,"journal":{"name":"Healthcare","volume":"14 8","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13115812/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147814324","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association Between Chin-Tuck-Generated Force and Sarcopenia in Community-Dwelling Older Adults: A Cross-Sectional Study.","authors":"Naoto Kamide, Takeshi Murakami, Takuya Sawada, Masataka Ando, Miki Sakamoto","doi":"10.3390/healthcare14081018","DOIUrl":"10.3390/healthcare14081018","url":null,"abstract":"<p><p><b>Background</b>: Although swallowing-related muscle function has been implicated in sarcopenia, the association between swallowing-related cervical muscle function and sarcopenia has not been thoroughly examined. The aim of this study was to investigate this association in community-dwelling older adults. <b>Methods</b>: This cross-sectional study included 390 community-dwelling adults aged ≥65 years. Sarcopenia was defined as the concurrent presence of low handgrip strength and low appendicular skeletal muscle mass. The force generated during the chin-tuck maneuver (chin-tuck force) was measured using a dynamometer to indicate swallowing-related cervical muscle function. Tongue pressure and oral diadochokinesis were measured as indicators of swallowing-related muscle function. Potential confounders included body mass index, comorbidities, number of medications, functional capacity, timed up-and-go test and trail-making test times. <b>Results</b>: In logistic regression analyses adjusted for age and sex, chin-tuck force was found to have a statistically significant association with sarcopenia; greater force correlated inversely with sarcopenia (odds ratio = 0.59, <i>p</i> < 0.001). Receiver operating characteristic curve analysis demonstrated acceptable discriminative ability of chin-tuck force for identifying sarcopenia (area under the curve (AUC) = 0.82, 95% confidence interval (CI): 0.72-0.90), which was significantly higher than that for tongue pressure (AUC = 0.62, 95% CI: 0.50-0.74; <i>p</i> < 0.01). <b>Conclusions</b>: Among swallowing-related muscle functions, reduced chin-tuck force may be associated with sarcopenia in older adults. Future studies should investigate targeted assessments and interventions focused on improving swallowing-related cervical muscle function as a potential strategy for sarcopenia prevention.</p>","PeriodicalId":12977,"journal":{"name":"Healthcare","volume":"14 8","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13116830/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147814394","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unlikely Storyteller: Leveraging Narrative-Based Communication in LLM-Generated Medical Advice.","authors":"Fan Wang, Ningshen Wang, Weiming Xu, Peng Zhang","doi":"10.3390/healthcare14081015","DOIUrl":"10.3390/healthcare14081015","url":null,"abstract":"<p><strong>Background/objectives: </strong>Time-constrained consultations in high-volume settings can crowd out patient-centered communication, while AI-generated advice may face algorithm aversion when it lacks a humanistic dimension. This study examined whether a brief narrative-based prompt could improve coded patient-facing communication features in an LLM relative to both clinicians and an unprompted model on authentic patient queries.</p><p><strong>Methods: </strong>We conducted a three-condition comparative evaluation using a stratified sample of 1000 de-identified MedDialog-CN consultations (2016-2020). For each consultation, the same patient query was used to generate (i) a zero-shot GPT-o3-mini response and (ii) a narrative-prompted GPT-o3-mini response; the original physician reply served as the human baseline. Responses were annotated with a pre-specified schema operationalizing four communication dimensions-Storytelling, Empathy, Personalization, and Clarity-with expert adjudication. Frequency-based indicators were summarized as mean events per consultation, and binary indicators as proportions; secondary checks captured unwarranted certainty and risk-relevant language.</p><p><strong>Results: </strong>Narrative prompting shifted coded patient-facing communication from sparse and selectively deployed (clinicians and zero-shot AI) to more routine and standardized. Across the reported communication measures, the prompted model showed the most favorable overall pattern, with higher narrative-device use, empathic support, contextual tailoring, and terminology explanation, alongside more frequent consideration of patient preferences and markedly higher rates of emotion-symptom linkage and the presence of a patient-centered narrative framework.</p><p><strong>Conclusions: </strong>Narrative prompting may offer a lightweight and potentially scalable strategy for improving patient-facing communication in Chinese asynchronous, text-based online consultations. An important next step is calibration: humanistic cues should be delivered selectively and safely so that responses remain credible, locally feasible, and cognitively manageable.</p>","PeriodicalId":12977,"journal":{"name":"Healthcare","volume":"14 8","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13116779/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147814496","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of Psychological Interventions for Mental Health in Police Officers: A Systematic Review and Meta-Analysis.","authors":"Ga-In Lee, Jin-Hyuck Park","doi":"10.3390/healthcare14081025","DOIUrl":"10.3390/healthcare14081025","url":null,"abstract":"<p><strong>Background/objectives: </strong>Police officers are exposed to chronic occupational stress and traumatic events, placing them at increased risk for mental health problems. Previous meta-analyses have been limited by heterogeneous samples and methodological variability. This study evaluated the effectiveness of psychological interventions on mental health and posttraumatic stress disorder (PTSD) symptoms among police officers using randomized controlled trials (RCTs).</p><p><strong>Methods: </strong>A systematic search of PubMed, Embase, Web of Science, PsycINFO, and MEDLINE was conducted for studies published between January 2000 and September 2025. The search strategy utilized key terms including \"police officers,\" \"psychological interventions,\" \"mental health,\" and \"randomized controlled trials\". Only RCTs involving police officers were included. Psychological interventions were compared with waitlist, usual-care, or active control conditions. General mental health outcomes (depression, anxiety, and stress) were analyzed as the primary outcome, and PTSD symptoms as a secondary outcome. Effect sizes were calculated as Hedges's g using random-effects models. Subgroup, meta-regression, sensitivity, and publication bias analyses were conducted when appropriate.</p><p><strong>Results: </strong>Ten RCTs comprising 637 police officers met the inclusion criteria. Psychological interventions demonstrated moderate improvements in overall mental health (Hedges's g = 0.516, 95% CI = 0.296-0.735, <i>p</i> < 0.001), albeit with substantial heterogeneity. Comparable effects were observed across waitlist and usual-care/active control comparisons. For PTSD symptoms, significant improvements were found only in comparisons with waitlist controls, whereas the overall pooled effect was not statistically significant. Meta-regression showed no dose-response relationship between total intervention hours and treatment effects. Sensitivity analyses confirmed result robustness. The certainty of evidence was rated as moderate for general mental health and low for PTSD symptoms, primarily due to substantial inconsistency and imprecision.</p><p><strong>Conclusions: </strong>These findings suggest that structured psychological programs show potential to confer added benefits for general mental health beyond routine wellness activities, although the certainty of the evidence is moderate to low. In contrast, the evidence for PTSD symptoms remains inconclusive, with effects failing to reach robust statistical significance. This underscores that preliminary individual-level intervention may be insufficient for trauma-specific symptoms, necessitating further research into specialized, trauma-focused approaches and the role of organizational determinants in enhancing intervention efficacy.</p>","PeriodicalId":12977,"journal":{"name":"Healthcare","volume":"14 8","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13115800/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147814373","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bibliometric Analysis of 30 Years of Scientific Publications Related to Low-Flow Anesthesia.","authors":"İsmet Çopur, Hüseyin Özçınar, Turan Evran","doi":"10.3390/healthcare14081020","DOIUrl":"10.3390/healthcare14081020","url":null,"abstract":"<p><p><b>Background:</b> This study aims to conduct an analysis of the literature on low-flow anesthesia published over the past 30 years, identifying the most productive countries, institutions, authors, and journals; uncovering the intellectual structure of the field through the most influential publications, authors, and journals; and visualizing thematic clusters and evolving research trends based on keyword analyses. <b>Methods:</b> This retrospective bibliometric study analyzed scientific publications on low-flow anesthesia indexed in the Science Citation Index Expanded (SCIE) of the Web of Science Core Collection (WoSCC) between 1993 and 2024. Articles were classified by countries, institutions, journals, and researchers, and the number of studies and citations were determined. Co-citation analysis and keyword co-occurrence analysis were performed to map thematic clusters and intellectual structures. <b>Results:</b> A total of 260 articles met the inclusion criteria. The United States led with 39 publications, followed by Turkey (33) and Japan (27). The most productive institution was Northwestern University (USA), and the most published journal was <i>Anesthesia & Analgesia</i>. The most prolific authors were André M. De Wolf and Jan F. A. Hendrickx, while co-citation analysis identified Edmund I. Eger II and Hiromichi Bito as the most influential authors based on centrality metrics. MDS and trend topic analyses revealed prominent keywords including \"closed loop\", \"remifentanil\", \"sevoflurane\", \"bispectral index\", \"EEG analysis\", \"pharmacokinetics\", \"absorbent\", \"performance\", and \"FGF\" (fresh gas flow). <b>Conclusions:</b> The United States leads the field of low-flow anesthesia in both publication count and citations. Trending terms such as \"closed loop,\" \"performance,\" \"remifentanil,\" \"sevoflurane,\" \"bispectral index,\" \"EEG analysis,\" \"FGF,\" and \"absorbent\" reflect the current research directions in this field.</p>","PeriodicalId":12977,"journal":{"name":"Healthcare","volume":"14 8","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13116801/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147814462","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Impact of Exercises and Physical Activity Programs on Paediatric Patients Undergoing Haemodialysis in Africa: A Scoping Review.","authors":"Makwena Midah Sibuyi, Siyanda Alex Ngema","doi":"10.3390/healthcare14081023","DOIUrl":"10.3390/healthcare14081023","url":null,"abstract":"<p><p><b>Introduction</b>: Chronic kidney disease and kidney failure are associated with a decline in physical abilities resulting in severe health-related complications. Existing systematic reviews and meta-analyses show that exercise interventions in patients on haemodialysis enhance physical functioning, cardiovascular health, muscle strength, and overall quality of life. However, the available literature mostly stem from adult cohorts outside Africa. Thus, this scoping review aims to evaluate existing literature on the impact of exercise programs on paediatric patients undergoing haemodialysis in Africa. <b>Methods</b>: A systematic search of electronic databases, including CINAHL, EBSCO, Medline, PubMed, and Scopus, was conducted following the Arksey and O'Malley methodological framework for scoping reviews and complied with the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) reporting guidelines. The inclusion criteria was applied to identify peer-reviewed articles published between 2015 and 2025, focusing on the effects, impact, and benefits of exercises and physical activity programs in paediatric patients undergoing haemodialysis aged up to 18 years. The selection process was done by two researchers pertaining to importing search results, removing duplicates, screening titles and abstracts, and analysis the reference lists of selected studies to ensure comprehensive coverage. <b>Results</b>: Two exercise-based intervention studies were eligible in the final review. In both studies, the duration of the intervention was about two months, and they included sample sizes of 60 and 50 participants. The first study, using the Paediatric Quality of Life Inventory (PedsQL-I), reported significant improvements across all dimensions in quality-of-life following muscle stretching and isometric exercises. The second study, employing the Paediatric Quality of Life Multidimensional Fatigue Scale (PedsQL-MFS) and the Depression Anxiety Stress Scale (DASS), found reductions in fatigue and psychological distress, and positive biochemical changes. A notable omission was the lack of detail regarding contraindications and precautionary measures. These are essential for informing clinical decision-making and ensuring exercises are safe. <b>Discussion</b>: The findings underscore the importance of incorporating exercise into the standard care of paediatric patients undergoing haemodialysis to facilitate better health outcomes. The fact that only two relevant studies were found highlights a narrow regional scope within Africa as both studies originated from a single country. Further research is needed to develop and implement effective exercise interventions tailored to other countries in Africa.</p>","PeriodicalId":12977,"journal":{"name":"Healthcare","volume":"14 8","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13115713/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147814359","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How Do Portuguese Care Providers Address Disability and LGBT Identity in Their Work?","authors":"Inês Soares, Ana R Pinho, Liliana Rodrigues, Catarina Maria Rêgo-Moreira, Conceição Nogueira","doi":"10.3390/healthcare14081026","DOIUrl":"10.3390/healthcare14081026","url":null,"abstract":"<p><p>Despite growing interest in the sexuality and gender identity of people with disabilities (PWD), this topic remains underexplored in both research and institutional policies, owing to prevailing views that ignore PWD sexual life. This contributes to the invisibility of individuals who identify as lesbian, gay, bisexual, and trans (LGBT) and to inadequate attention to the specific needs of LGBT people with disabilities (LGBT PWD). <b>Background/Objectives</b>: Given the lack of Portuguese studies that examine the intersection of LGBT and disability identities, this study aimed to understand professionals' attitudes and practices toward PWD regarding sexuality and LGBT belonging. <b>Methods</b>: We conducted qualitative research using semi-structured interviews with eleven professionals (two psychologists, three occupational therapists, and six personal assistants). We analyzed the data using reflexive thematic analysis. <b>Results</b>: Key findings highlight professionals' limited knowledge, prevailing cis-heteronormative attitudes, and emerging affirmative practices. <b>Conclusions</b>: Training and institutional changes are needed to make services more inclusive and responsive to the needs of LGBT PWD.</p>","PeriodicalId":12977,"journal":{"name":"Healthcare","volume":"14 8","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13115647/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147814413","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"More AI, Less Care-Seeking? A National Survey Experiment on the Impact of AI Intensity on Patient Care-Seeking Intention in Chinese Family Doctor Services.","authors":"Feng Jiang, Shengtian Hou, Qianqian Huang, Ruiping Zhao, Yi-Lang Tang","doi":"10.3390/healthcare14081022","DOIUrl":"10.3390/healthcare14081022","url":null,"abstract":"<p><p><b>Background:</b> Artificial intelligence (AI) is increasingly embedded in routine primary care, yet how the levels of integration might affect its acceptability is unknown, especially in relationship-based service models where patients expect visible human stewardship. Prior experimental studies often treat AI adoption as a binary condition, leaving the \"intensity gradient\" of automation and the role of model specialization under-explored. We examine whether increasing AI integration in the clinical encounter erodes patients' intention to seek care from family doctors in China, and whether labeling the AI as a medical-specific model buffers such erosion. <b>Methods:</b> We conducted a nationwide online survey experiment in China (N = 2790). Participants were randomly assigned to vignettes that varied by (i) the level of AI integration (low, medium, high) and (ii) the AI type (general-purpose vs. medical-specific large language model), with a human-only care scenario as a reference. Care-seeking intention from family doctors was assessed immediately after exposure. We estimated treatment effects using OLS regression with heteroskedasticity-robust standard errors, and examined the buffering hypothesis through an interaction term between AI integration intensity and AI type. <b>Results:</b> Care-seeking intention declined steadily as AI integration increased (<i>p</i> < 0.001), with the sharpest drop under high-intensity AI integration where clinical decisions were delegated to the AI system. Across all intensity levels, framing the system as a medical-specific AI consistently resulted in higher care-seeking intention than a general-purpose model. However, the interaction between AI intensity and the AI type was not statistically significant (<i>p</i> = 0.508). <b>Conclusions:</b> Patient acceptance of AI in primary care depends not only on whether AI is involved, but on how deeply AI is positioned in the encounter. Medical-specific AI labeling may enhance acceptance across all AI integration levels. The findings underscore the need to preserve human clinical agency in AI-embedded primary care. The results contribute to research on healthcare systems, digital health, and AI-patient interaction.</p>","PeriodicalId":12977,"journal":{"name":"Healthcare","volume":"14 8","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13116385/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147813849","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Integrating Pharmacists into CGM-Enabled Digital Diabetes Care: Advancing Personalized and Data-Driven Management.","authors":"Xiaoxiao Chen, Gyeong Eon Kim, Nam Ah Kim, Kwang Joon Kim","doi":"10.3390/healthcare14081019","DOIUrl":"10.3390/healthcare14081019","url":null,"abstract":"<p><p><b>Background/Objectives</b>: Continuous glucose monitoring (CGM) has transformed diabetes management by enabling high-resolution assessment of glucose dynamics, with well-established use in type 1 diabetes (T1D) and insulin-treated type 2 diabetes (T2D), and expanding applications across broader populations, including non-insulin-treated T2D and gestational diabetes. However, real-world implementation remains constrained by economic barriers, fragmented reimbursement, workflow challenges, and limited capacity for continuous data interpretation. This review examines key barriers to CGM implementation and synthesizes current evidence on pharmacist-integrated CGM care as an emerging model to support CGM adoption across clinical and community-based settings. <b>Methods</b>: A narrative literature review was conducted to synthesize evidence on pharmacist-integrated CGM services in diabetes care. Literature was identified through structured searches of PubMed, Embase, and the Cochrane Library, supplemented by Google Scholar and citation tracking, covering publications from January 2010 to December 2025. Studies were selected based on predefined criteria, including those reporting clinical outcomes, pharmacist involvement, or health system and implementation factors related to CGM use. Relevant survey-based and real-world studies were also considered to capture healthcare professionals' perspectives and implementation experiences. Evidence was synthesized thematically across clinical, behavioral, and health system domains. <b>Results</b>: Available evidence suggests that pharmacist-integrated CGM care is associated with improvements in glycemic management, including increased time in range, reduced glycemic variability, and more timely pharmacotherapy optimization. Pharmacist involvement may also support patient education, self-management, and engagement with digital health technologies, and facilitate ongoing data interpretation and treatment adjustment between clinical encounters. However, evidence remains heterogeneous and geographically limited, with predominantly retrospective and pilot studies and few randomized trials, constraining the robustness and external validity of the findings. Further studies are needed to confirm its clinical effectiveness, comparative effectiveness, and economic value. <b>Conclusions</b>: Pharmacist-integrated CGM represents a promising and operationally feasible approach to supporting CGM use in routine diabetes care. While current evidence indicates potential benefits in glycemic management and care delivery processes, further research and implementation efforts are required to support its effective and sustainable adoption across diverse healthcare settings.</p>","PeriodicalId":12977,"journal":{"name":"Healthcare","volume":"14 8","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13115816/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147814509","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}