Patient preference and adherence最新文献

{"title":"Efficacy of the LEARNS-Based Health Education Program on Motor Recovery, Self-Efficacy, and Rehabilitation Adherence in Ischemic Stroke Patients.","authors":"Tingting Ji, Fang Wang, Yinyue Zhou, Min Liu, Yueqin Wang, Xun Zhuang","doi":"10.2147/PPA.S622280","DOIUrl":"10.2147/PPA.S622280","url":null,"abstract":"<p><strong>Background: </strong>Motor recovery in stroke survivors often declines post-discharge. This study evaluated the efficacy of a LEARNS-based health education program on functional recovery and behavioral adherence.</p><p><strong>Methods: </strong>In this single-center, parallel-group randomized controlled trial, 128 ischemic stroke patients were assigned to either a LEARNS-based intervention (n=64; mean age: 72.9 years; 40.6% male) or a control group (n=64; mean age: 72.5 years; 42.2% male). Primary outcome was the Fugl-Meyer Assessment (FMA) score measured across a 3-month follow-up period at baseline (T0), discharge (T1), 1-month (T2), and 3-month (T3) follow-ups. Linear Mixed-Effects Models were used for statistical analysis.</p><p><strong>Results: </strong>A total of 117 participants completed the 3-month follow-up (overall attrition rate: 8.6%, 11/128). Baseline mean FMA scores were comparable between groups (32.1 in intervention vs 31.8 in control). A significant Group by Time interaction was found for FMA scores (β = 3.81, <i>p</i> < 0.001). At T3, the intervention group achieved significantly higher motor recovery compared to the control group (mean FMA score: 54.2 vs 43.0; Difference = 11.21, <i>p</i> < 0.001). The intervention group also showed significant improvement in self-efficacy at T1 and sustained higher rehabilitation adherence through T3, whereas the control group demonstrated a significant decrease in adherence post-discharge.</p><p><strong>Conclusion: </strong>The LEARNS model effectively improves post-discharge motor recovery and sustains self-efficacy and long-term adherence in ischemic stroke patients.</p>","PeriodicalId":19972,"journal":{"name":"Patient preference and adherence","volume":"20 ","pages":"622280"},"PeriodicalIF":2.6,"publicationDate":"2026-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13532886/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148875688","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adapting Beyond the Machine: A Roy Adaptation Model-Guided KTH Nursing Pathway and Real-World Outcomes in Maintenance Hemodialysis: A Propensity Score-Matched Cohort Study.","authors":"Zhenglingxue Wang, Kang Wang, Qingqing Jia, Yiwen Wang","doi":"10.2147/PPA.S631569","DOIUrl":"10.2147/PPA.S631569","url":null,"abstract":"<p><strong>Background: </strong>Maintenance hemodialysis (HD) carries a heavy psychosocial and self-management burden that routine nursing addresses incompletely. Whether a pathway coupling the Knowledge-Treatment-Health (KTH) structure to the four adaptive modes of the Roy Adaptation Model (KTH-RAM) improves outcomes is unknown.</p><p><strong>Methods: </strong>We analysed records of 322 adults on maintenance HD at a single centre between October 2021 and October 2025; 161 received routine nursing and 161 the KTH-RAM pathway (non-randomised). Fifteen baseline covariates (demographics, comorbidity, vascular access, laboratory values, dialysis adequacy, baseline symptom severity) were extracted. Patient-reported outcomes were assessed at four weeks, objective indicators at twelve weeks. Associations were estimated by propensity-score matching, inverse-probability weighting and multivariable regression, with E-value sensitivity analysis.</p><p><strong>Results: </strong>Matching yielded 122 balanced pairs (all standardized mean differences <0.10). The KTH-RAM pathway was associated with lower anxiety (Cohen's d -0.41) and depression (-0.33) and higher resilience (0.37), perceived social support (0.42), executive self-care (0.28), partnership (0.47) and emotional management (0.26); hope and problem-solving were directional but not robust. Higher dialysis compliance was more frequent with KTH-RAM across all estimators, although the difference did not reach statistical significance (adjusted OR 1.86, 95% CI 0.97-3.56; IPTW 1.79); nursing satisfaction showed the same pattern; complications were fewer (6.2% vs 13.7%). Objective indicators (albumin, phosphorus, Kt/V) favoured KTH-RAM modestly; vascular-access events and hospitalization differences were non-significant.</p><p><strong>Conclusion: </strong>In this propensity-matched cohort, the KTH-RAM nursing pathway was associated with modestly better psychological, self-management and objective dialysis outcomes. For nephrology nursing, the pathway offers a structured, theory-based template that links mode-specific adaptive assessment to concrete behaviour-change actions and may help frontline teams prioritise psychological and self-management support within routine dialysis care. Given the non-randomised design and contact-time imbalance, these hypothesis-generating associations require confirmation in a prospective, attention-matched randomised trial.</p>","PeriodicalId":19972,"journal":{"name":"Patient preference and adherence","volume":"20 ","pages":"631569"},"PeriodicalIF":2.6,"publicationDate":"2026-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13528663/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148866192","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Developing Dietary Self-Management Personas for mHealth Tools Among Patients with Kidney Failure Undergoing Hemodialysis: A Multi-Method Study.","authors":"Zhishan Wu, Yuefeng Ding, Beiqian Tong, Sijie Gao, Jiayi Huang","doi":"10.2147/PPA.S636336","DOIUrl":"10.2147/PPA.S636336","url":null,"abstract":"<p><strong>Background: </strong>Dietary management remains a widespread challenge among patients with kidney failure undergoing hemodialysis. Although mobile health (mHealth) is considered a promising approach for providing self-management support, most existing tools lack the specificity to effectively address patients' diverse behavioral patterns.</p><p><strong>Objective: </strong>To develop user personas for dietary self-management among Chinese patients on hemodialysis and explore the needs of these personas regarding mHealth tools.</p><p><strong>Methods: </strong>A sequential multi-method design was employed. In-depth qualitative interviews were conducted with 28 patients on hemodialysis recruited from a university-affiliated hospital between March and July 2025 to explore their dietary self-management experiences. Transcripts were analyzed using Colaizzi's method, and dietary self-management personas were derived through manual thematic synthesis and iterative consensus among researchers. These personas were then presented with descriptive labels. In a subsequent quantitative phase, a cross-sectional survey was administered to a separate cohort of 167 patients on hemodialysis between October 2025 and February 2026. Participants were asked to self-identify with up to two personas that best reflected their current dietary behaviors, in order to assess the coverage and distribution of the developed personas.</p><p><strong>Results: </strong>Qualitative analysis identified six distinct personas: (A) Proactive; (B) Occupation-Driven Maladaptive; (C) Family Care-Prioritizing Maladaptive; (D) Knowledge-Deficient; (E) Instant Gratification-Driven; and (F) Poor Execution Ability. Quantitative results showed that all participants identified with at least one of the six personas, with no patients reporting behaviors outside this classification. Persona A was the most prevalent (35.93%), and 19.76% of participants identified two personas.</p><p><strong>Conclusion: </strong>The six personas reflect significant diversity in dietary self-management among patients undergoing hemodialysis and provide a preliminary, comprehensive typology that can inform the design of stratified, user-centered mHealth interventions. Future studies are needed to validate the feasibility and effectiveness of these personas.</p>","PeriodicalId":19972,"journal":{"name":"Patient preference and adherence","volume":"20 ","pages":"636336"},"PeriodicalIF":2.6,"publicationDate":"2026-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13526652/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148866221","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient-Reported Perceptions of Surgical Informed Consent Communication in Elective General Surgery: A Cross-Sectional Study in a Chinese Tertiary Hospital.","authors":"Yanzhen Ouyang, Linjuan Lan, Yanan Yue, Xinyi Lei, Mingtao Huang","doi":"10.2147/PPA.S622018","DOIUrl":"10.2147/PPA.S622018","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Informed consent supports voluntary surgical decision-making, yet patients' routine perceptions of consent communication remain insufficiently described. In China, where family involvement and time-pressured care are common, understanding how patients retrospectively perceive written and oral consent communication is important.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We conducted a cross-sectional survey of 627 consecutive adult patients undergoing elective general surgery in a tertiary general hospital in Fuzhou, Fujian Province, China. Participants were interviewed face-to-face on postoperative days 2-7 using a structured questionnaire adapted from a validated instrument. Items were categorical (dichotomous, ordinal, or single/multiple-response). The survey assessed postoperative reports of written consent form handling, perceived understanding, oral explanation content, and the influence of information on decision-making. Multivariable logistic regression examined factors associated with self-reported careful reading, perceived full understanding of the written form, and reported discussion of surgical alternatives and non-treatment consequences, adjusting for sociodemographic and consent-process variables.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Of 627 participants, 94.6% reported receiving a written consent form. Among recipients, self-reported careful reading (89.4%) and perceived full understanding (91.3%) were high, although 15.6% received the form only shortly before surgery and family involvement in signing was frequent. Most respondents also received oral explanations, commonly perceived as complete and understandable. Retrospectively, oral discussions focused on diagnosis (89.0%) and planned procedures (83.3%), whereas alternatives (27.7%) and non-treatment consequences (36.2%) were discussed less frequently. In multivariable models, explanation of the form at delivery was strongly associated with careful reading (adjusted odds ratio [aOR] 30.69, 95% CI 6.67-141.31, p&lt;0.001) and perceived full understanding (aOR 41.55, 95% CI 4.77-361.55, p=0.001); college-level education was associated with reported discussion of alternatives (aOR 3.88, 95% CI 1.91-7.86, p&lt;0.001) and non-treatment consequences (aOR 3.60, 95% CI 1.87-6.92, p&lt;0.001), whereas receiving the form closer to surgery and from a non-surgeon were associated with lower odds of these disclosures. Several estimates had wide confidence intervals and should be interpreted cautiously.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Most postoperative patients reported receiving written and oral consent information and perceived both as understandable. However, alternatives and non-treatment consequences were reported less frequently, indicating gaps in the discussed information scope. These findings reflect retrospective, patient-reported perceptions of the consent process among clinically stable elective surgery patients, rather than objective understanding or an audit of overal","PeriodicalId":19972,"journal":{"name":"Patient preference and adherence","volume":"20 ","pages":"622018"},"PeriodicalIF":2.6,"publicationDate":"2026-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13526329/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148866279","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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 Warm Needle Acupuncture Based on Traditional Chinese Medicine on Psychological Well-Being and Quality of Life in Osteoporotic Patients: A Retrospective Cohort Study.","authors":"Yunhui Qiu, Xugui Li, Zhen Zeng, Yanping Meng, Xiao Pan, Zhengyang Wang, Zheng Lü, Weidan Xiao","doi":"10.2147/PPA.S623349","DOIUrl":"10.2147/PPA.S623349","url":null,"abstract":"<p><strong>Objective: </strong>Osteoporosis is associated with psychological distress and diminished quality of life, yet conventional treatments primarily target bone metabolism. The effects of warm needle acupuncture on psychological well-being and quality of life in patients with osteoporosis remain underexplored.</p><p><strong>Methods: </strong>This retrospective cohort study included 120 patients with osteoporosis (warm needle acupuncture group, n = 63; control group, n = 57). Groups were formed according to the treatment regimen received in routine clinical practice, without randomization. The control group received conventional anti-osteoporosis therapy (calcium and vitamin D supplementation, anti-osteoporosis medications as clinically indicated, and lifestyle guidance); the warm needle acupuncture group received the same conventional therapy plus warm needle acupuncture (three sessions per week for 8 weeks). Outcomes included the Self-Rating Depression Scale (SDS), Self-Rating Anxiety Scale (SAS), 36-Item Short Form Health Survey (SF-36), Visual Analog Scale (VAS), and lumbar bone mineral density (BMD). Post-treatment scores differed significantly between groups in five of eight SF-36 domains (PF, RP, BP, SF, and MH; all P < 0.05, all remaining significant after false discovery rate correction), and improvements in change scores were significantly greater in the warm needle acupuncture group across all eight domains (all adjusted P < 0.05). In an exploratory multiple regression analysis, warm needle acupuncture was the only covariate independently associated with mental component summary improvement (B = 7.53, 95% CI: 5.73-9.33, P < 0.001).</p><p><strong>Results: </strong>The warm needle acupuncture group showed significantly greater improvements in SDS, SAS, and VAS scores (all <i>P</i> < 0.001). BMD remained unchanged in both groups over the short 8-week observation period. Depression reduction was more strongly correlated with quality-of-life improvement <i>(rs</i> = -0.415, <i>P</i> < 0.001) than anxiety reduction <i>(rs</i> = -0.225, <i>P</i> = 0.014).</p><p><strong>Conclusion: </strong>In this retrospective, non-randomized cohort study, warm needle acupuncture combined with conventional therapy was associated with greater short-term improvements in psychological symptoms, pain, and multiple quality of life domains in patients with osteoporosis; these findings represent associations rather than confirmed causal effects. Depression improvement showed a stronger association with quality-of-life gains than anxiety improvement. Prospective trials are needed to confirm these associations.</p>","PeriodicalId":19972,"journal":{"name":"Patient preference and adherence","volume":"20 ","pages":"623349"},"PeriodicalIF":2.6,"publicationDate":"2026-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13526338/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148866297","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Oral Health Behavior Management in Patients with Periodontitis: A COM-B-Guided Qualitative Study.","authors":"Jianuo Bao, Yuan Li, Lei Zhang, Shuying Li, Fanli Meng, Yingxue Huang, Rui Liu","doi":"10.2147/PPA.S631205","DOIUrl":"10.2147/PPA.S631205","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to explore barriers and support needs related to oral health behaviors among patients with periodontitis guided by the Capability-Opportunity-Motivation-Behavior (COM-B) model in a Chinese clinical context.</p><p><strong>Patients and methods: </strong>Semi-structured qualitative interviews were conducted with 17 patients diagnosed with stage II-IV periodontitis who attended the Department of Stomatology at a tertiary hospital in Chengde, China, between December 2025 and January 2026. Participants were recruited using purposive sampling. Interviews were conducted in person, and data were analyzed using qualitative content analysis guided by the COM-B model. Themes and sub-themes were identified through an iterative and collaborative coding process conducted by two trained researchers.</p><p><strong>Results: </strong>Three main themes and eleven sub-themes were identified, reflecting barriers and support needs related to oral health behaviors. Within the capability domain, barriers included insufficient disease knowledge and information literacy, inadequate skills in using oral hygiene tools, and physical limitations. Within the opportunity domain, barriers included constraints related to objective resources and life circumstances and unsupportive social norms, while participants expressed support needs for professional and social support. Within the motivation domain, barriers included negative behavioral experiences, concerns about social judgment, and lack of self-efficacy, whereas perceived benefits and disease awareness and the desire to preserve oral health supported sustained oral health behaviors.</p><p><strong>Conclusion: </strong>Patients with periodontitis experience interconnected barriers and support needs across capability, opportunity, and motivation domains. These qualitative findings provide evidence to inform the development of tailored oral health behavior interventions.</p>","PeriodicalId":19972,"journal":{"name":"Patient preference and adherence","volume":"20 ","pages":"631205"},"PeriodicalIF":2.6,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13525797/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148857208","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Experiences and Perceptions of Patients Participating in Prehabilitation and Early Rehabilitation for Hip and Knee Arthroplasty: A Systematic Review and Narrative Synthesis of Qualitative Evidence.","authors":"Manca Opara Zupančič, Žiga Kozinc, Stefan Löfler, Karl Miedler, Nejc Šarabon","doi":"10.2147/PPA.S627109","DOIUrl":"10.2147/PPA.S627109","url":null,"abstract":"<p><strong>Objective: </strong>To synthesize qualitative evidence on patients' experiences and perceptions of prehabilitation and early rehabilitation in the context of hip and knee arthroplasty.</p><p><strong>Methods: </strong>A systematic review was conducted across PubMed, Scopus, and Web of Science, with the databases searched from inception to March 2026. Eligible studies included individuals referred for or undergoing total hip or knee arthroplasty and reporting qualitative data on experiences with prehabilitation or early rehabilitation. Titles, abstracts, and full texts were screened by one reviewer and independently checked by a second reviewer, while data extraction was performed independently by two reviewers. Methodological quality was assessed using the Critical Appraisal Skills Programme qualitative checklist. Findings were synthesized using a primarily descriptive narrative approach with thematic organization into facilitators and barriers; a formal qualitative meta-synthesis was not conducted. The review protocol was not registered.</p><p><strong>Results: </strong>Twelve studies were included: 11 focused on prehabilitation and two on early postoperative rehabilitation. The included studies involved patients undergoing total hip arthroplasty, total knee arthroplasty, or both procedures. Patient experiences were grouped into five thematic domains: symptoms and physical condition, understanding and information, behavior, psychological well-being, and intervention delivery. Reported facilitators included improved symptoms and physical function, greater understanding and preparedness for surgery, better pain coping, improved psychological well-being, and positive experiences with different delivery formats. Reported barriers included increased pain, information overload, language barriers, limited individualization, restricted interaction, and varying delivery preferences. The evidence base was heterogeneous in terms of intervention content, delivery mode, patient populations, and depth of qualitative reporting.</p><p><strong>Conclusion: </strong>Prehabilitation and early rehabilitation were generally perceived positively, but several barriers were identified. The findings highlight the importance of symptom monitoring, individualized exercise prescription, clear tailored education, and flexible delivery formats. However, the findings should be interpreted cautiously because the synthesis was primarily descriptive, the included studies were heterogeneous, and the evidence was substantially stronger for prehabilitation than for early rehabilitation.</p>","PeriodicalId":19972,"journal":{"name":"Patient preference and adherence","volume":"20 ","pages":"627109"},"PeriodicalIF":2.6,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13526168/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148866321","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Variation in Attribute Prioritization and Design of Discrete Choice Experiments Across Pharmaceuticals and Medical Devices Patient Preference: A Systematic Review.","authors":"Dong-Heui Jang, Sun-Kyeong Park, Hye-In Jung, Ga-Hee Choi, Ha-Jun Song, Hyeonjin Cho, Sangeun Lee, Mi-Hai Park, Leslie Wilson, Eui-Kyung Lee","doi":"10.2147/PPA.S576996","DOIUrl":"10.2147/PPA.S576996","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;As patient-centered care gains global prominence, understanding patient preferences (PP) has become essential for informing clinical, regulatory, and policy decisions. Discrete choice experiments (DCEs) offer a robust approach for quantifying PP for treatment decisions. As PP information is increasingly used in regulatory and reimbursement decisions, the comparability of evidence across DCE studies becomes important. However, how DCEs are designed and reported for PP-including which attributes are included and which are identified as most prioritized-varies across disease areas and intervention types in ways that remain insufficiently understood.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We systematically reviewed DCE studies measuring PP, identified through comprehensive searches of PubMed, EMBASE, and the Cochrane Library. Searches were updated on February 10, 2026, covering records from database inception through that date. Study selection, data extraction, and synthesis followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. This systematic review was prospectively registered in the PROSPERO database (CRD420251043402). Eligible studies were those in which the authors identified a single most prioritized attribute in any reporting format. Extracted attributes were grouped into five categories (effectiveness, side effects, cost, convenience, and other). The primary review-level outcomes were which attributes were included and which attribute was identified as most prioritized. We characterized variation along four dimensions: attribute inclusion and prioritization, analytic and survey methods, clinical context, and study-level factors (intervention type, region, and funding). All contextual comparisons were exploratory, using chi-square tests.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 534 studies were included, increasing at 17.1% per year (95% CI, 15.1-19.2%; published 2004-2025). Most focused on pharmaceuticals (87.5%; medical devices, 8.1%) and were conducted in North America (34.8%) or Europe (34.5%), using online surveys (75.8%), random-parameters/mixed logit models (36.7%), and industry funding (63.3%). The most frequently included attributes were side effects (86.9%), effectiveness (84.1%), and convenience (81.5%), followed by cost (33.5%); cost inclusion was higher in Asia-based (68.5%) and publicly funded (45.1%) studies (both &lt;i&gt;P&lt;/i&gt; &lt; 0.001). Effectiveness was the most prioritized attribute (50.6%), especially in oncology (73.0%), whereas convenience was often prioritized in endocrine and metabolic diseases (25.0%); the most prioritized attribute differed significantly across intervention types, regions, and disease categories (all &lt;i&gt;P&lt;/i&gt; &lt; 0.05).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;These findings demonstrated substantial variation in study characteristics and attribute prioritization depending on clinical context, region, and funding. They highlight the need for m","PeriodicalId":19972,"journal":{"name":"Patient preference and adherence","volume":"20 ","pages":"576996"},"PeriodicalIF":2.6,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13525815/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148857224","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Medication Adherence, Clinical Outcomes, and Health-Related Quality of Life Among Pediatric Patients with β-Thalassemia Major Receiving Iron Chelation Therapy: A Multicenter Study from Punjab, Pakistan.","authors":"Anfas Muneeb, Sana Inam, Ijaz Ali, Abdullah Ali Alshehri, Maham Siddiq, Salamat Ali","doi":"10.2147/PPA.S615467","DOIUrl":"10.2147/PPA.S615467","url":null,"abstract":"<p><strong>Background: </strong>Thalassemia is a chronic blood disorder requiring lifelong blood transfusions and iron chelation therapy (ICT) to reduce iron overload.</p><p><strong>Purpose: </strong>In Pakistan, limited evidence exists on how medication adherence, clinical outcomes, and health-related quality of life (HRQoL) interact simultaneously in β-thalassemia major (β-TM) children. This study therefore aimed to evaluate these variables and examine their interrelationships in pediatric β-TM patients receiving ICT.</p><p><strong>Methods: </strong>A cross-sectional observational study was conducted among 622 patients aged 5-12 years across six thalassemia centers in Punjab, Pakistan (September 2024-February 2025). For data collection, Treatment Adherence Scale (TAS) and Paediatric Quality of Life Inventory™ (PedsQL™) 4.0 Generic Core Scales were used. Clinical outcomes were assessed via hematological and iron overload parameters. Statistical analyses, including non-parametric tests, Friedman test, multiple regression analysis, and Spearman's rank correlation, with p < 0.05 considered significant.</p><p><strong>Results: </strong>The total adherence score was 6 IQR (3-8). Clinical outcomes showed significant improvement in hemoglobin levels, while serum ferritin remained elevated. Younger age, urban residency, and deferasirox monotherapy were significantly associated with higher adherence and HRQoL. The total QoL score was 67.3 IQR (50-84.4). Family history, deferoxamine use, and serum ferritin were identified as negative predictors of adherence and HRQoL, whereas urban residency, splenectomy, and higher adherence to ICT were positive predictors of HRQoL. A significant positive correlation was found between adherence and HRQoL (<i>ρ</i> = 0.420, p < 0.001), while serum ferritin was negatively correlated with adherence (<i>ρ</i> = -0.476, p < 0.001) and HRQoL (<i>ρ</i> = -0.329, p < 0.001).</p><p><strong>Conclusion: </strong>Pediatric β-TM patients reported moderate overall adherence to ICT. Clinical outcomes showed improvement in anemia and increased iron overload. HRQoL was moderately affected, especially in school functioning. Patients with low adherence had lower HRQoL and increased serum ferritin levels, reflecting suboptimal clinical outcomes.</p>","PeriodicalId":19972,"journal":{"name":"Patient preference and adherence","volume":"20 ","pages":"615467"},"PeriodicalIF":2.6,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13525769/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148857745","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Severity and Outcome of Adverse Drug Reactions Reported and Assessed by Patients and Pharmacist at Secondary Care Setting.","authors":"Sasithorn Chaowanjantuek, Warisara Jiamsathit, Thongchai Pratipanawatr, Anthony R Cox, Narumol Jarernsiripornkul","doi":"10.2147/PPA.S632224","DOIUrl":"10.2147/PPA.S632224","url":null,"abstract":"<p><strong>Purpose: </strong>The aim of the study was to describe Adverse Drug Reactions (ADRs) characteristics, compare ADR severity and outcomes as rated by patients and pharmacist, and identify factors associated with ADR severity.</p><p><strong>Methods: </strong>A cross-sectional study was conducted among patients from a secondary care hospital in northeastern Thailand who had experienced an ADR within the previous year. A self-administered questionnaire was mailed to eligible patients. Patients assessed ADR severity their most severe ADR using visual analog scale. These rating were compared with pharmacist assessment based on the Hartwig and Siegel scale. Additional data on ADR severity and outcomes were collected by a research pharmacist from both electronic and paper medical records database. Causality assessment was performed by researcher pharmacist using the Naranjo's algorithm.</p><p><strong>Results: </strong>Of 745 invited patients, 381 completed the questionnaire. The mean patient-rated ADR severity score was 6.4 ± 2.94. According to patient ratings, ADRs were classified as mild (25.5%), moderate (32.0%), and severe (42.5%), whereas pharmacist assessments classified ADRs as mild (63.2%), moderate (33.9%), and severe (2.9%). The most commonly reported ADRs, classified by systemic organ class, were skin and subcutaneous tissue disorders (30.7%). Agreement between patient and pharmacist assessments was slight for ADR severity (κ = 0.043), and fair for ADR outcomes (κ = 0.212). Positive agreement between patient and pharmacist assessments was 31.2% for severity and 85.0% for outcomes. Higher patient-reported severity was associated with greater number of comorbidities, higher levels of anxiousness and bothersomeness, acute onset of ADRs, and greater confidence in identifying ADRs.</p><p><strong>Conclusion: </strong>Patients tended to rate ADR severity higher than pharmacists, particularly when symptoms affected daily activities. Incorporating patient-reported assessments may support the timely recognition and communication of suspected ADRs while complementing, rather than replacing, professional clinical assessment.</p>","PeriodicalId":19972,"journal":{"name":"Patient preference and adherence","volume":"20 ","pages":"632224"},"PeriodicalIF":2.6,"publicationDate":"2026-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13523864/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148851084","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}