Journal of evaluation in clinical practice最新文献

{"title":"Patient Portal Helpline Outreach and Telehealth Visit Completion: A Randomized Controlled Quality Improvement Project.","authors":"Kevin Chen, Sarah Rose Cass, Michele Rains, Marc Michaels, Benjamin Oppong-Dwamena, Emmanuel Amezquita, Dustin Hunsinger, Hannah B Jackson","doi":"10.1111/jep.70420","DOIUrl":"https://doi.org/10.1111/jep.70420","url":null,"abstract":"<p><strong>Introduction: </strong>Patients scheduled for telehealth visits often struggle with completing these visits by the preferred means (video visit via the patient portal). This may lead to missed appointments, completion by audio-only (at lower reimbursement) and/or widening of the 'digital divide'.</p><p><strong>Methods: </strong>We conducted a randomized controlled quality improvement project to test whether utilizing a centralized patient portal helpline to provide proactive education (vs. usual appointment support) could improve attendance of telehealth visits, completion of telehealth visits by video, and enrolment in the patient portal within 14 days before the scheduled appointment. The target population was patients at four adult primary care clinics within a large, urban municipal health system with telehealth appointments scheduled to occur between 5 August and 31 December 2024 and no active patient portal account within 14 days of their appointment. We collected outcome data on appointment completion and patient portal enrolment from the electronic health record and used chi-squared tests to compare outcomes between intervention and control groups.</p><p><strong>Results: </strong>We had 164 patients in the control group and 164 patients in the intervention group. There were no significant differences in visit completion between control (n = 115/164, 70.1%) and intervention (n = 121/164, 73.8%) groups (p = 0.46). Among patients who completed visits, the intervention group (n = 34/121, 28.1%) had a higher proportion of completions by video (vs. audio-only) compared with the control group (n = 18/115, 15.7%). There were no significant differences in patient portal activation within 14 days prior to and including the visit date between control (n = 50/164, 30.5%) and intervention (n = 48/164, 29.3%) groups (p = 0.81).</p><p><strong>Discussion: </strong>Health systems looking to improve telehealth video usage can consider utilizing a centralized helpline for proactive outreach and instruction to patients without activated patient portals prior to scheduled telehealth appointments, but alternate approaches are needed to improve telehealth visit attendance and patient portal enrolment.</p>","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"32 2","pages":"e70420"},"PeriodicalIF":2.1,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147520635","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Considering Preference-Based Patient Participation-Scientific and Clinical Outcome Measures With the Patient Preferences for Patient Participation Tool.","authors":"Ann Catrine Eldh, Marcus Bendtsen","doi":"10.1111/jep.70423","DOIUrl":"10.1111/jep.70423","url":null,"abstract":"<p><strong>Rationale: </strong>Integrated and person-centred care is defined by several elements, one of them being the terms for patient involvement with respect to their needs and resources. We call this 'patient participation', emphasising the sharing component of mutual information and knowledge exchange and the shared actions of the patient and their healthcare professionals in making plans and decisions, framing goals, and providing for self-care. Comprehensively addressing all aspects, including both patients' preferences for and experiences of participation, deserve support how to investigate and represent preference-based patient participation.</p><p><strong>Objective: </strong>To offer theoretical and analytical guidance for the Patient Preferences for Patient Participation tool (the 4Ps), with procedures suitable for research and clinical evaluation.</p><p><strong>Method: </strong>The paper illustrates the planning and execution of analyses to illuminate preference-based patient participation (or partial such participation, or lack thereof). Also, we discuss why, when, and how to address preferences for patient participation along with preference-based measures. Two sets of reports are presented for research and clinical purposes.</p><p><strong>Results: </strong>By means of three cases across different healthcare contexts, we illustrate what these findings represent, and how to differentiate between insufficient, fair, and sufficient terms for preference-based patient participation. Furthermore, the more detailed scale for such patient participation is considered in relation to the outcome measures of interventions in research and clinical improvement.</p><p><strong>Conclusion: </strong>The 4Ps is a means for evaluating preference-based patient participation, though the matching of ordinal measures for preferences and experiences requires a careful and well-informed approach to planning and executing data collection and statistical analyses. As an outcome measure of interventions to facilitate more person-centred healthcare, researchers and clinicians should recognise theoretical and conceptual conditions. This enhances a recognition of patients' voice and choice; patients and staff can agree on how best to make use of resources and needs, improving health and healthcare engagement.</p>","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"32 2","pages":"e70423"},"PeriodicalIF":2.1,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13021268/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147520622","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":"Transparency and Methodological Quality of Clinical Practice Guidelines in Palliative Care. Scoping Review","authors":"Julio Cesar Torres-Cuellar,&nbsp;Daniel Alejandro Pérez-Muñoz,&nbsp;Ivan D. Florez,&nbsp;Sam H. Ahmedzai,&nbsp;Esther de Vries,&nbsp;Jose A. Calvache","doi":"10.1111/jep.70392","DOIUrl":"10.1111/jep.70392","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Background&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Palliative care (PC) and End-of-Life Care (EOLC) focus on improving the quality of life of patients with life-threatening illnesses by addressing physical, psychosocial, and spiritual needs. Clinical practice guidelines (CPGs) are essential for standardising care and supporting evidence-based clinical decision-making to improve patient outcomes but despite their importance, the methodological quality, transparency, and overall trustworthiness of CPGs require systematic evaluation. Given the limited assessment of CPGs in these areas, this study aimed to assess the methodological quality and transparency of CPGs in PC and EOLC for adult patients using the AGREE-II tool. Additionally, we evaluated the completeness of reporting using the RIGHT checklist.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Methods&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;We conducted a scoping review to map the existing clinical CPGs in PC and EOLC. A comprehensive search of MEDLINE, EMBASE, and multiple international guideline repositories was performed to identify relevant CPGs endorsed by professional organisations. Two reviewers independently screened, extracted data, and assessed the methodological quality and transparency using the AGREE II tool and the completeness of reporting using the RIGHT checklist. Discrepancies were resolved by consensus or a third reviewer. Descriptive analyses and inter-rater agreement were calculated.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Results&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;A total of 6430 citations were identified and screened, resulting in the final inclusion of 23 CPGs. Over half (52.2%) focused exclusively on PC and were developed by governmental institutions. Based on AGREE-II assessment, 60.9% were classified as ‘Recommended’, 30.4% as ‘Recommended with modifications’. The highest-scoring domains were Scope and Purpose (89%) and Clarity of Presentation (83%), while Applicability scored lowest (25%). Among the CPGs, ‘IETS 2016 (Institute for Technological Assessment in Health, Colombia)’ had the highest overall quality score (mean 96%), while ‘CHPCA 2013 (Canadian Hospice Palliative Care Association, Canada)’ had the lowest (mean 22%). Interrater agreement was good to excellent across most AGREE II domains, with the highest agreement for editorial independence (ICC = 0.87; 95% CI: 0.71–0.94) and the lowest for stakeholder involvement (ICC = 0.61; 95% CI: 0.29–0.81).&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusion&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Several CPGs in PC and EOLC demonstrated significant gaps in applicability and transparency. To enhance their relevance and impact in clinical practice, improveme","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"32 2","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12950261/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147326344","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":"Moral Foundations and Patient-Centered Care in a Brazilian Maternity Ward: A Survey Study","authors":"Isabella de Melo Rodrigues Franco,&nbsp;Aline Albuquerque,&nbsp;Cristina Ortiz Sobrinho Valete","doi":"10.1111/jep.70384","DOIUrl":"10.1111/jep.70384","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>To investigate the relation between moral foundations and patient-centered care in health professionals who work in the delivery room and in the rooming-in.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>Single-center quantitative survey study.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This survey was conducted in a Brazilian maternity ward. The Moral Foundations Questionnaire (MFQ-20) and the Care in Dialogue Competence Scale (CDCS) were administered to health professionals working in the delivery room and rooming-in areas. Analysis included descriptive statistics and Spearman correlations. Data were analyzed using Stata version 19.0.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 80 health professionals were included, and the median age was 34 years (IQR: 28.5–44). Cronbach's alpha of the MFQ-20 was 0.8480, and CDCS was 0.8499. In the MFQ-20, fairness and care were the domains with the highest median, and in the CDCS, communication and dialogue with the patient. MFQ-20 and CDCS were correlated (0.54; <i>p</i> &lt; 0.001). Purity presented the highest domain-specific correlation with CDCS (0.48; <i>p</i> &lt; 0.0001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>In this maternity ward, health professionals' moral foundations are correlated with patient-centered care. Although fairness and care were the MFQ-20 domains with the highest medians, purity was the domain most strongly correlated to CDCS.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Impact</h3>\u0000 \u0000 <p>Clinical practice requires health professionals to use moral dimensions that are part of their individual essence, and this can correlate with patient-centered care, a dimension of quality care.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> <b>Patient or</b> Public C<b>ontribution</b></h3>\u0000 \u0000 <p>These results contribute to a better understanding of the relations between moral foundations and patient-centered care in neonatology. By highlighting moral motivations strongly associated with patient-centered care, we can strengthen it.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"32 2","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12950277/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147326286","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":"Knowledge and Attitudes Regarding Pharmacogenetics of Pharmacists in the Netherlands: A National Online Survey Study","authors":"Emma Y. De Brabander,&nbsp;Nicole K. Leibold,&nbsp;Therese van Amelsvoort,&nbsp;Roos van Westrhenen,&nbsp;The PSY-PGx Consortium","doi":"10.1111/jep.70395","DOIUrl":"10.1111/jep.70395","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Rationale, Aims and Objectives</h3>\u0000 \u0000 <p>Pharmacogenetics is considered a promising method to improve pharmacotherapy, yet its implementation in clinical practice is hampered, limiting its potential benefits to the public. Previously, its uptake has been investigated within a variety of healthcare professional groups. Commonly cited barriers by prescribing physicians are lack of knowledge and insurance coverage. An important occupational group who may support physicians due to their expert knowledge are pharmacists. However, they have been understudied in research on pharmacogenetics implementation thus far. Therefore, we investigated the experience and attitudes of pharmacists regarding pharmacogenetics using an online questionnaire.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>Using Qualtrics software, an online survey was distributed nationally from April 1st to December 1st 2024. Respondents were recruited during a national conference organized by the Dutch pharmacy residents, through email-invites, and via newsletters of national pharmacist-associations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In total, data of <i>n</i> = 281 respondents were analyzed in the study, the majority of which were working professionals (±15.8 years of experience). Although only 44.4% had ever requested a pharmacogenetic test, 88.6% of respondents had experience with test result interpretation. Cost, lack of reimbursement through insurance, and lack of availability of pharmacogenetic guidelines including clinical evidence, were found as key barriers. Importantly, respondents generally felt confident regarding their own pharmacogenetics-related knowledge and skills, while maintaining caution in situations where pharmacogenetic evidence is limited.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Successful adoption of pharmacogenetics in practice may benefit from interprofessional collaboration, expanding the pharmacogenetics evidence base, and prioritizing pharmacogenetics in updated health policy.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"32 2","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12950278/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147326364","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":"Beyond Compliance: Understanding the Role of Peer Review Through a Theory of Change.","authors":"Axel Kaehne, Julie Feather, Tom Simcock","doi":"10.1111/jep.70422","DOIUrl":"10.1111/jep.70422","url":null,"abstract":"<p><strong>Objective: </strong>Peer review is a widely used mechanism to support quality improvement in healthcare, yet its effectiveness remains uncertain. This study aims to examine how peer review visits contribute to care quality improvement in NHS England's specialised commissioned services, and to develop a theory of change that explains their mechanisms of action.</p><p><strong>Methods: </strong>A theory-based evaluation was undertaken using qualitative methods. Data were collected in two phases: (1) 17 semi-structured interviews with peer reviewers, NHS staff, commissioners, and patient representatives; and (2) two stakeholder workshops with directors of nursing and service commissioners. Thematic analysis using deductive coding was guided by the Impact Domain Framework. Findings were synthesised into a logic model and Theory of Change, visualised using Directed Acyclic Graphs (DAGs), incorporating relational dimensions of peer review.</p><p><strong>Results: </strong>Analysis of transcripts from a diverse range of stakeholders produced four core themes: the tension between compliance and learning objectives; the role of trust and relational dynamics; limited mechanisms for knowledge exchange; and a lack of follow-up impeding sustained improvement. The final Theory of Change model distinguishes between compliance-driven and learning-driven pathways, integrating relational factors such as trust and engagement as key enablers of improvement.</p><p><strong>Conclusion: </strong>Peer review visits are more effective when perceived as opportunities for learning rather than compliance monitoring. The study offers a novel Theory of Change and visual model to guide future evaluation and practice, emphasising the importance of relational dynamics and sustained follow-up. These insights should inform both implementation and policy by supporting a shift toward trust-based, developmental peer review models that strengthen organisational learning and align with the goals of a learning health system.</p>","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"32 2","pages":"e70422"},"PeriodicalIF":2.1,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13021267/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147521151","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":"Parental Attitudes on Childhood Vaccinations: A Qualitative Study on Hesitancy and Motivations","authors":"Zeynep Tüzün,&nbsp;Zeynep Meva Altaş,&nbsp;Seyhan Hıdıroğlu,&nbsp;Fatma Berna Çörekci,&nbsp;Amine Avcı,&nbsp;Zeynep Asmin Kaya,&nbsp;Gizem Çavuş","doi":"10.1111/jep.70390","DOIUrl":"10.1111/jep.70390","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This study aimed to reveal the decision-making processes, hesitations, and motivations of parents who had their children vaccinated during childhood but experienced hesitation during this process.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In-depth interviews were conducted via telephone with 16 parents in Türkiye who had children aged 0–7 years and had vaccinated their children. Participants were selected with a purposive sampling method and their data were analyzed thematically in line with a phenomenological approach.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Parents' vaccination decisions were shaped by their sense of parental responsibility, the motivation to protect their child, social expectations, and their interactions with healthcare professionals. Parents who experienced vaccine hesitancy frequently reported feelings of uncertainty, loss of control, and inadequate communication. The information overload encountered in digital environments often deepened confusion and distrust. However, personal contact with healthcare professionals—especially empathetic and trust-based communication—played a critical role in transforming hesitancy into acceptance. The main motivations guiding parents' final decisions were the desire to be good parents, to cope with uncertainty, and to ensure their children's safety.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Interventions to reduce vaccine hesitancy should integrate the supportive and guiding role of healthcare professionals, focusing on communication that builds trust and meets parents' emotional as well as informational needs.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"32 2","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147326373","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Application and Effect of the Nurse-Led Pre-Hospital, Intra-Hospital, Post-Hospital Management Model in the Fine Management of Pre-Admitted Surgical Patients","authors":"Junhua Cao,&nbsp;Qiongna Zheng,&nbsp;Qingmiao Qiu,&nbsp;Hongyan Huang,&nbsp;Jinfeng Zhao,&nbsp;Lingling Chen,&nbsp;Qun Li,&nbsp;Ying Ye","doi":"10.1111/jep.70371","DOIUrl":"10.1111/jep.70371","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To enhance the management of pre-admission surgical patients within an efficiency-oriented healthcare system.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This study adopted a method combining retrospective analysis and prospective observation. A total of 400 patients aged 14–75 years who underwent surgical treatment in our hospital from April 2024 to September 2024 were selected. A combination of random sampling and stratified sampling was used to balance the number of patients from different departments, ensuring the scientific rigor and representativeness. The aim is to explore the application of the comprehensive management model led by our hospital, covering the three stages of pre-hospital, in-hospital and post-hospital, as well as to improve the quality indicators of surgical management, strengthen patient safety management internally, and enhance patient satisfaction.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The same-day surgery cancellation rate decreased from 10.71% before the intervention to 6.35% after the intervention, reflecting a reduction of 40.71%. The hospital discharge rate also saw a substantial decline from an average of 8.97% to 4.44%, a reduction of 50.50%. Meanwhile, the persuasion rate to prevent discharge increased from 8.35% to 12.20%, representing a rise of 46.11%. Additionally, the compliance rate of Enhanced Recovery After Surgery (ERAS) on postoperative day 1 improved from 92.75% to 96.13%, an increase of 3.64%. Most notably, the patient satisfaction with the hospitalization experience increased from 93.95% before the intervention to 97.69% after the intervention, a rise of 3.74%.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This model improved the safety and efficiency of pre-admission surgical management, offering practical insights for similar hospitals.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"32 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146220046","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-Term Adherence and Drug Utilisation Patterns Among New Users of Anti-Hyperlipidemic Monotherapy: Development of a Risk Prediction Model","authors":"Xuechun Li,&nbsp;Eelko Hak,&nbsp;Jens H. J. Bos,&nbsp;Catharina C. M. Schuiling-Veninga,&nbsp;Sumaira Mubarik","doi":"10.1111/jep.70380","DOIUrl":"10.1111/jep.70380","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Rationale</h3>\u0000 \u0000 <p>Real-world long-term adherence and drug patterns are essential in hyperlipidemia management. However, the evidence was unclear.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aims and Objectives</h3>\u0000 \u0000 <p>This study aimed to assess long-term adherence, drug usage patterns of anti-hyperlipidemic monotherapy, associated risk factors, and develop risk prediction models.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We performed a retrospective inception cohort study utilising data from the University of Groningen's IADB.nl dispensing database. The study included new users of anti-hyperlipidemic monotherapies—simvastatin, pravastatin, fluvastatin, atorvastatin, rosuvastatin, and fibrates, with approximately a follow-up to 10 years. Using logistic regression, we developed risk prediction models for adherence and drug utilisation patterns, including discontinuation, continuation, switching, and add-on therapies.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Simvastatin users demonstrated high prevalence of high adherence throughout the study (83.6%–90.2%) and had the highest continuation rate (39.2%) with minimal switching or add-on therapy use. Individuals aged 40 and older exhibited better adherence and higher continuation rates. Male patients had lower adherence but higher continuation rates. High adherence was associated with both high continuation and increased switching or add-on therapy use. Patients using diabetes medications had better adherence, higher continuation, and lower switching and add-on rates, whereas those on antiparkinson drugs had lower continuation rates. Recent initiators showed better continuation and lower switching or add-on rates.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Simvastatin users demonstrated higher adherence and continuation rates compared to other anti-hyperlipidemic monotherapy users. Factors including older age, female sex, and diabetes medications use were associated with improved adherence. Sensitivity analyses using equivalent dosing regimens yielded consistent findings. These insights into adherence and drug patterns are critical for informing personalised strategies to optimise cardiovascular disease prevention.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"32 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12917296/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146219993","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 Effect of Audiovisual Education on Breast Cancer Screening and Fear Among Illiterate Women: A Double-Blind Randomised Controlled Trial","authors":"Sabriye Ucan Yamaç,&nbsp;Nurten Terkeş","doi":"10.1111/jep.70387","DOIUrl":"10.1111/jep.70387","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Rationale&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Breast cancer persists as a significant contributor to global morbidity and mortality. Although early detection through systematic screening plays a pivotal role in improving outcomes, women with limited literacy frequently exhibit reduced participation, primarily due to insufficient awareness and heightened apprehension.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Aims&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;The purpose of this research was to evaluate whether an educational programme using audiovisual tools could improve breast cancer screening practices and decrease fear in women with low literacy levels.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Methods&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;A randomised, double-blind study was carried out involving 120 women between 40 and 69 years old. Participants were assigned by chance to one of two groups: the intervention group (&lt;i&gt;n&lt;/i&gt; = 60) or the control group (&lt;i&gt;n&lt;/i&gt; = 60). The intervention entailed a 12-week structured programme, delivered once a week, which included the use of multimedia resources and breast models to provide training in breast self-examination, clinical breast examination, and mammography techniques. Outcomes were measured pre- and post-intervention using the Champion Breast Cancer Fear Scale and the Breast Cancer Screening Behaviour Questionnaire. Data were analysed using chi-square tests, mixed-model ANOVA, independent &lt;i&gt;t&lt;/i&gt;-tests, and repeated-measures MANOVA.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Results&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Post-intervention, screening behaviours were markedly higher in the intervention versus control group— breast self-examination BSE 91.7% versus 33.3% (χ²(1) = 43.56, &lt;i&gt;p&lt;/i&gt; &lt; 0.001), clinical breast examination 95.0% vs. 6.7% (χ²(1) = 93.66, &lt;i&gt;p&lt;/i&gt; &lt; 0.001), and mammography 81.7% vs. 6.7% (χ²(1) = 68.43, &lt;i&gt;p&lt;/i&gt; &lt; 0.001). Breast cancer–related fear showed a significant time × group effect (mixed-model ANOVA), F(1,114) = 70.35, &lt;i&gt;p&lt;/i&gt; &lt; 0.001, ηp² = 0.38. Groups were equivalent at pre-test (t(118) = 0.46, &lt;i&gt;p&lt;/i&gt; = 0.647). At post-test, fear scores were substantially lower in the intervention group (M = 12.38, SD = 3.05) than control (M = 23.78, SD = 10.91), Welch's t(68.19) = −7.79, &lt;i&gt;p&lt;/i&gt; &lt; 0.001, Cohen's d = 1.42, indicating a large effect.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusion&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Audiovisual education with breast model simulations effectively enhances screening behaviours and reduces fear among low-literacy populations. Implementing such programmes in rural areas can also support midwives and healthcare providers by improving patient engagement, facilitating education, and reducing barri","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"32 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146220021","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}