Patient preference and adherence最新文献

{"title":"Improving Medication Adherence in Heart Failure Through Pharmacist-Led Patient Education: Protocol for a Mechanism-Based Study of Information, Motivation, and Behavioral Skills.","authors":"Tung-Chun Russell Chien, Shao-En Weng, Wan-Tseng Hsu","doi":"10.2147/PPA.S527419","DOIUrl":"10.2147/PPA.S527419","url":null,"abstract":"<p><strong>Background: </strong>Heart failure (HF) remains a major global health challenge. Guideline-directed medical therapy can effectively reduce mortality and hospitalizations; however, persistent medication nonadherence hinders its real-world impact. Although recent guidelines emphasize the pivotal role of pharmacists in supporting medication adherence, the mechanisms through which pharmacist-led patient education influences medication adherence remain underexplored. Identifying these mechanisms could inform the development of evidence-based strategies to optimize medication adherence and ultimately improve long-term outcomes in HF management.</p><p><strong>Objective: </strong>This study aims to establish an Information-Motivation-Behavioral Skills (IMB) model to elucidate the mechanisms influencing medication adherence among patients with HF and to compare pre- and postintervention models for identifying significant pathways affected by pharmacist-led patient education.</p><p><strong>Methods: </strong>In this longitudinal pretest-posttest study, all IMB constructs-information, personal motivation, social motivation, behavioral skills, and behavior-will be assessed using validated patient-reported outcome measures (PROMs) at baseline and three and six months postintervention; additionally, verbal inquiries will be conducted to evaluate the information construct and prescription refill data will be incorporated to supplement the behavior construct. Multigroup structural equation modeling will examine relationships among these constructs and their impact on medication adherence. Latent class growth modeling will also be employed to identify distinct adherence trajectory subgroups after six-month follow-up.</p><p><strong>Expected outcomes: </strong>The recruitment phase commenced in early May 2025. By evaluating structural changes in IMB pathways pre- and postintervention using PROMs, followed by identifying short-term and sustained responders, the study is expected to facilitate the precise targeting of pharmacist-led interventions to maximize clinical impact. This approach emphasizes the importance of tailoring healthcare delivery to individual medication adherence profiles. It aims to ensure that pharmacist-led patient education achieves its fullest potential in populations expected to benefit the most, particularly patients with HF-a perspective that, to our knowledge, has not been previously explored.</p>","PeriodicalId":19972,"journal":{"name":"Patient preference and adherence","volume":"19 ","pages":"1855-1868"},"PeriodicalIF":2.0,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12209603/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144541844","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":"Impact of Adherence to Golimumab on Disease Flares in Rheumatoid Arthritis: Results from a Canadian Observational Study.","authors":"Louis Bessette, Pauline Boulos, Regan Arendse, Proton Rahman, Sam Aseer, Thanu Ruban, Meagan Rachich, Francois Nantel, Adriana Calce, Odalis Asin-Milan, Derek Haaland","doi":"10.2147/PPA.S516794","DOIUrl":"10.2147/PPA.S516794","url":null,"abstract":"<p><strong>Objective: </strong>To assess the association between adherence to golimumab treatment and the incidence of disease flares in patients with rheumatoid arthritis (RA) in routine clinical practice.</p><p><strong>Methods: </strong>A 12-month (M) prospective observational study conducted across 27 Canadian centers, involving patients with RA receiving golimumab as part of routine clinical care. Treatment adherence was assessed with the Compliance Questionnaire in Rheumatology (CQR); non-adherence was defined as a weighted baseline score predictive of ≤80% compliance. Secondary definitions involved the CQR score at M6 and M12. Disease flaring was assessed with the RA-Flare Questionnaire (RA-FQ); flare was defined as a positive response to question 7 (\"Are you having a flare?\"). The association between adherence and disease flares was analyzed by comparing RA-FQ scores and the proportion of patients reporting flares between the high and low adherence groups. The association between adherence and glucocorticoid use or adverse event (AE) incidence was similarly assessed.</p><p><strong>Results: </strong>Of 215 patients enrolled, 169 (78.6%) completed the study. No significant difference in mean RA-FQ scores was observed between low and high adherence groups at M6 (22.5 vs 23.8; p=0.56) and M12 (20.8 vs 19.9; p=0.70); disease flares were reported by 35.7% of low adherence patients, compared to 28.2% in the high adherence group (p=0.34). At M12, these rates were 30% vs 24.7%, respectively (p=0.49). Glucocorticoid use was comparable between baseline adherence groups, although a higher rate was observed in the low visit-predicted adherence group based on the M6 CQR score (30.5% vs 16.3%; p=0.04). No significant differences were observed in AE incidence.</p><p><strong>Conclusion: </strong>In this study, no significant differences in RA-FQ scores and the proportions of patients reporting disease flares or AEs were observed between patients with RA with low and high predicted adherence to golimumab. The increased glucocorticoid use in patients with low adherence merits further investigation.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov identifier, NCT03729349.</p>","PeriodicalId":19972,"journal":{"name":"Patient preference and adherence","volume":"19 ","pages":"1843-1853"},"PeriodicalIF":2.0,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12206409/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144529194","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":"Are HIV Treatment Clients Offered a Choice of Differentiated Service Delivery Models? Evidence from Malawi, South Africa, and Zambia.","authors":"Idah Mokhele, Vinolia Ntjikelane, Nancy A Scott, Jeanette L Kaiser, Allison Juntunen Morgan, Amy Huber, Nomcebo Oratile Mokgethi, Timothy Henry Tchereni, Wyness Phiri, Aniset Kamanga, Prudence Michelo Haimbe, Priscilla Lumano-Mulenga, Rose Kolola Nyirenda, Sophie J S Pascoe, Sydney Rosen","doi":"10.2147/PPA.S494679","DOIUrl":"10.2147/PPA.S494679","url":null,"abstract":"<p><strong>Purpose: </strong>Differentiated service delivery (DSD) models for antiretroviral therapy (ART) for HIV aim to increase patient-centeredness, a concept that incorporates patient choice of service delivery options. We explored choice in DSD model enrollment at 42 public sector clinics in Malawi, South Africa, and Zambia.</p><p><strong>Methods: </strong>From 09/2022-05/2023, we surveyed people receiving HIV treatment to ask if they had a choice about DSD model enrollment and healthcare providers about their practices in offering choice. We estimated risk differences for ART clients' self-reported offer of choice and report risk differences. We thematically analyzed open-ended questions and report key themes.</p><p><strong>Results: </strong>We enrolled 1049 people receiving HIV treatment (Malawi 409, South Africa 362, Zambia 278) and 404 providers (Malawi 110, South Africa 175, Zambia 119). The proportion of study participants indicating that they had been offered a choice ranged from 4% in Malawi to 17% in Zambia to 47% in South Africa. Over 90% of people receiving HIV treatment in all three countries reported that they were happy to be enrolled in their current DSD model. Participants from urban (ARD 0.94 [0.90-0.99]) and medium-volume facilities (2000-4000 ART clients, 0.91 [0.84-0.98]) were slightly less likely to be offered DSD enrollment. Participants in community-based models 1.21 [1.12-1.30] and those satisfied with their current model 1.06 [1.01-1.13] were more likely to be offered a choice. Among providers, 64% in Malawi, 80% in South Africa, and 59% in Zambia said they offered clients the choice to enroll in DSD or remain in conventional care.</p><p><strong>Conclusion: </strong>As of 2023, relatively few people receiving HIV treatment in Malawi, South Africa, and Zambia reported being offered a choice about enrolling in a DSD model, despite most providers reporting offering such a choice. The value of patient choice in improving clinical outcomes and satisfaction should be explored further.</p>","PeriodicalId":19972,"journal":{"name":"Patient preference and adherence","volume":"19 ","pages":"1825-1841"},"PeriodicalIF":2.0,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12206428/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144529192","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":"Effectiveness of Digital Health Interventions to Enhance Continuity of Care in Patients with Pulmonary Tuberculosis: A Systematic Review of Randomized Controlled Trials.","authors":"Qonita Nur Miladi, Tuti Pahria, Iqbal Pramukti","doi":"10.2147/PPA.S533210","DOIUrl":"10.2147/PPA.S533210","url":null,"abstract":"<p><strong>Background: </strong>Pulmonary tuberculosis (TB) remains a global health concern with high morbidity and mortality rates. Despite being curable with proper treatment, challenges in ensuring continuity of care persist, particularly in resource-limited settings. Digital health interventions (DHI) offer a potential solution to improve treatment adherence and continuity of care among TB patients.</p><p><strong>Purpose: </strong>This study aimed to systematically review how DHIs contribute to improved continuity of care, particularly in terms of medication adherence, clinical outcomes, and patient satisfaction.</p><p><strong>Methods: </strong>A systematic review was conducted using PRISMA guidelines. Relevant studies were identified from five significant databases, including PubMed, Scopus, Taylor and Francis, EBSCO-host, and ScienceDirect, up to November 2024 and one search engine was Google Scholar. The keywords used were \"pulmonary tuberculosis OR tbc OR tb AND mobile health applications OR mhealth OR mobile apps OR telehealth AND continuity of care OR patient compliance OR patient adherence OR adherence behaviour. Inclusion criteria focused on RCTs evaluating DHIs for adult TB patients. Data were extracted and analyzed thematically to assess intervention effectiveness on medication adherence and clinical outcomes.</p><p><strong>Results: </strong>A total of 17.380 patients from 21 studies TB patients were included. Interventions were classified into two categories: reminder-based (eg, SMS, phone calls, electronic medicine boxes with audio/visual alerts) and remote monitoring-based (eg, MERM, mobile applications, digital sensors, and VDOT). Compared to standard care, DHIs significantly improved medication adherence, treatment success rates, and patient satisfaction. Several studies also reported reduced time and cost burdens for patients.</p><p><strong>Conclusion: </strong>DHIs improve continuity of care among TB patients by increasing medication adherence and clinical outcomes. However, the effectiveness varies across different intervention types and settings, emphasizing the need for tailored strategies and integration into existing health systems.</p>","PeriodicalId":19972,"journal":{"name":"Patient preference and adherence","volume":"19 ","pages":"1807-1823"},"PeriodicalIF":2.0,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12204103/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144529193","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":"Knowledge, Attitudes, and Perceptions of Chronic Patients in Saudi Arabia Regarding the Use of Artificial Intelligence to Improve Medication Adherence.","authors":"Safaa M Alsanosi, Asayel Q Aldajani, Hasnaa A Gheliwi, Manar M Alotibi, Ghadi S Bokhari, Orjuwan A Almatrafi, Abdulelah K Alqawlaq, Jakleen Z Abujamai, Mohammed Shaikhomer, Yosra Z Alhindi, Asim M Alshanberi","doi":"10.2147/PPA.S519427","DOIUrl":"10.2147/PPA.S519427","url":null,"abstract":"<p><strong>Background: </strong>Artificial intelligence (AI) is advancing healthcare globally and in Saudi Arabia, enhancing patient care, diagnostics, and administrative efficiency, despite challenges such as data privacy and regulation. This study explores knowledge, attitudes, and perceptions (KAP) regarding AI in medication adherence among chronic patients in Makkah region, Saudi Arabia.</p><p><strong>Methods: </strong>A cross-sectional study was conducted among patients with chronic diseases in the Makkah region, Saudi Arabia, from 1 July to 31 December 2024. The study included adult patients with chronic diseases (≥18 years) receiving primary care in the Makkah region. KAP levels were analyzed using descriptive statistics and composite scores, with demographic associations evaluated through Pearson chi-square tests (p<0.05).</p><p><strong>Results: </strong>A total of 385 participants were included in the study. Most participants were women (60%), and those belonging to the 50 years or older group comprised the highest percentage (51.2%). The most reported chronic conditions were diabetes (30.7%), hypertension (19.7%), and asthma (14%). Knowledge levels were at a good level among 72.7% of the study participants, and 45.5% expressed a positive attitude towards AI's role. Perception was high among 50.9% of the respondents but low among 23.4%. Demographic factors, particularly age, significantly improved KAP (p-values of 0.048, 0.046, and 0.031, respectively). A positive attitude towards AI's role in medication adherence was observed in 58.2% of the participants with good knowledge levels compared to only 11.4% of those with poor knowledge (p=0.001). Variations in perception levels regarding AI's role in medication adherence were evident across demographics, with statistically significant associations found for age and overall knowledge level (p-values of 0.031 and 0.001, respectively).</p><p><strong>Conclusion: </strong>The results highlight AI's potential to enhance medication adherence and healthcare efficiency while maintaining a human-centred approach. To ensure effective integration, it's crucial to address concerns related to privacy, trust, and reduced human interaction. AI should be positioned as a supportive tool that complements-not replaces-human care, with transparent governance and targeted education playing key roles.</p>","PeriodicalId":19972,"journal":{"name":"Patient preference and adherence","volume":"19 ","pages":"1781-1792"},"PeriodicalIF":2.0,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12184775/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144476288","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 Status Quo and Influencing Factors of Self-Management Behavior in Patients with Recurrent Gout in China: A Cross-Sectional Study.","authors":"Xinyi Hao, Aiping Wang","doi":"10.2147/PPA.S528000","DOIUrl":"10.2147/PPA.S528000","url":null,"abstract":"<p><strong>Objective: </strong>To understand the status quo and influencing factors of self-management behavior in patients with recurrent gout, and to provide evidence for the development of targeted interventions to improve the self-management behavior of gout patients.</p><p><strong>Methods: </strong>From October 2022 to July 2023, convenience sampling was used to conduct a questionnaire survey on 223 patients with recurrent gout who were admitted to the Department of Rheumatology and Immunology of the First Hospital of China Medical University. The cross-sectional study used a structured questionnaire (including information on Sociodemographic and Clinical Characteristics), Gout self-management Behavior Assessment scale, Gout Knowledge Measurement questionnaire, Chronic Disease self-efficacy Scale, Medical Coping Modes Scale, and Social Support Rating scale to investigate. SPSS26.0 software was used to analyze the data.</p><p><strong>Results: </strong>The score of self-management behavior of 223 patients with recurrent gout was 41-180 (124.759±24.81). Multiple linear regression analysis showed that: Age, gout stage, awareness of gout knowledge, whether there were other chronic diseases, the pain degree of the last gout attack, medical coping style, education level, the number of gout attacks in the past year and self-efficacy were the main associated factors of gout patients' self-management. These variables explained 48.80% of the influencing factors of self-management (P<0.001).</p><p><strong>Conclusion: </strong>At present, the self-management behavior of patients with recurrent gout is at an upper-middle level. To improve the self-management behavior of patients with recurrent gout, we should pay attention to the key groups such as young people, low education level and lack of gout knowledge. To improve the self-management behavior of recurrent gout patients by improving their disease perception, enhancing their self-efficacy and encouraging them to actively face the disease.</p>","PeriodicalId":19972,"journal":{"name":"Patient preference and adherence","volume":"19 ","pages":"1793-1806"},"PeriodicalIF":2.0,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12184777/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144476291","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 Self-Management Interventions on Behavioral and Clinical Outcomes in Individuals with Systemic Lupus Erythematosus: A Systematic Review of Empirical Evidence From 2003-2024.","authors":"Sirikarn Hanrop, Nirunya Narupan, Nattaya Praha, Lalipat Phianhasin, Suebsarn Ruksakulpiwat","doi":"10.2147/PPA.S521546","DOIUrl":"10.2147/PPA.S521546","url":null,"abstract":"<p><strong>Aim: </strong>To evaluate and synthesize evidence on the impact of self-management interventions in improving behavioral and clinical outcomes among individuals with systemic lupus erythematosus (SLE).</p><p><strong>Methods: </strong>A comprehensive search was conducted across eight electronic databases-CINAHL Plus with Full Text, ProQuest, PubMed, Medline with Full Text, SAGE, ScienceDirect, Scopus, and Web of Science-to identify studies published from inception to 2024. Randomized controlled trials and quasi-experimental studies assessing self-management interventions in individuals with SLE were included. Methodological quality was evaluated using the Joanna Briggs Institute critical appraisal tools. Data synthesis followed a convergent integrated analysis framework to identify recurring themes and subthemes.</p><p><strong>Results: </strong>A total of 15 studies met the inclusion criteria, consisting of 10 randomized controlled trials (66.67%) and 5 quasi-experimental studies (33.33%). The interventions targeted physical, mental, and behavioral health through various strategies. The most common interventions included counseling and education (7 studies, 22.58%), followed by physical activity programs (2 studies, 6.45%), and self-management sessions (2 studies, 6.45%). Other interventions, such as cognitive-behavioral therapy, strengthening exercises, and digital health tools, were also implemented. In-person interventions (46.67%) were the most common delivery format, followed by digital platforms (26.67%). Self-management interventions led to significant improvements in physical health (eg, reduced fatigue and improved functional capacity), mental health (eg, reduced anxiety and depression), and health behaviors (eg, enhanced adherence to treatment and self-care practices). Furthermore, the interventions contributed to an improved quality of life by addressing the physical, psychological, and social challenges faced by individuals with SLE.</p><p><strong>Conclusion: </strong>Self-management interventions positively impact behavioral and clinical outcomes in individuals with SLE. Future research should explore long-term sustainability, integration of digital health strategies, and personalized approaches. Expanding access to self-management programs, particularly in low-resource settings, may further enhance outcomes for individuals with SLE.</p>","PeriodicalId":19972,"journal":{"name":"Patient preference and adherence","volume":"19 ","pages":"1763-1779"},"PeriodicalIF":2.0,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12182245/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144476290","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":"Real-Life Experiences of Self-Capacity Management in Patients with Chronic Heart Failure: A Qualitative Study.","authors":"Angran Wang, Ning Zhang, Mengtian Li, Qin Mao, Anna Ma, Guodong Wang, Meng Li, Qiong Li","doi":"10.2147/PPA.S519773","DOIUrl":"10.2147/PPA.S519773","url":null,"abstract":"<p><strong>Background: </strong>Capacity overload is a persistent risk throughout the progression of heart failure. And effective capacity management can help patients control fluid retention and improve capacity overload, which is crucial for improving the prognosis of patients with chronic heart failure (CHF). However, current research often focuses on physiological and pathological mechanisms, with limited exploration of the psychological and social factors influencing patients' self-management behaviors. Additionally, while many studies have addressed the importance of capacity management, there are remains a gap in understanding how patients' experiences with capacity management strategies can be optimized to improve adherence and long-term outcomes.</p><p><strong>Objective: </strong>This study aims to explore the personal experiences of CHF patients regarding self-capacity management, identify the barriers they face in implementing self-management behaviors, and examine factors contributing to non-adherence. The goal is to provide a foundation for future intervention strategies.</p><p><strong>Methods: </strong>A qualitative descriptive design was employed, using semi-structured in-depth interviews with CHF patients. The transcribed data were coded and analyzed thematically based on Colaizzi's phenomenological data analysis method. NVivo 14 software was employed for the analysis.</p><p><strong>Results: </strong>The findings reveal that individuals with CHF encounter various barriers to effective self-capacity management. These barriers not only hinder their understanding and application of management strategies but also reduce their intrinsic motivation to adopt and sustain healthy behaviors. Four themes were identified: (1) Symptom distress leading to changes in daily behavior, (2) Barriers to implementing capacity management behaviors, (3) Low awareness of capacity management, and (4) Lack of knowledge regarding capacity management.</p><p><strong>Conclusion: </strong>Healthcare providers must consider age-related differences and varying levels of knowledge receptivity among patients. Tailored educational programs that cater to individual patient needs are essential for enhancing accessibility and ensuring continuity of care. Regular post-education assessments, alongside continuous supervision and guidance, are crucial to improve patient understanding, promote behavioral changes, validate the effectiveness of educational interventions, and support the long-term adoption of self-management practices.</p>","PeriodicalId":19972,"journal":{"name":"Patient preference and adherence","volume":"19 ","pages":"1747-1762"},"PeriodicalIF":2.0,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12182096/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144476289","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":"Socioeconomic Factors Associated with Non-Adherence to Antihypertensive Treatment Among Older Adults Affiliated to the \"Pension 65\" Program in Peru.","authors":"Juliana Anabella Schutt-Cerdan, Yngrid Estrella Marcelo-Lluen, Susan M Oblitas-Guerrero, Norma Del Carmen Gálvez-Díaz, Jacksaint Saintila","doi":"10.2147/PPA.S523651","DOIUrl":"10.2147/PPA.S523651","url":null,"abstract":"<p><strong>Background: </strong>Hypertension is one of the leading causes of morbidity and mortality among older adults, and its management largely depends on treatment adherence. Previous studies have shown that socioeconomic factors such as income, education, and access to healthcare can significantly influence adherence. However, little is known about how these factors affect older adults living in extreme poverty in Peru, particularly beneficiaries of the \"Pension 65\" program. This study aims to explore these associations in a highly vulnerable population.</p><p><strong>Objective: </strong>To identify the socioeconomic factors associated with non-adherence to antihypertensive treatment in older adults enrolled in the \"Pension 65\" program in Peru.</p><p><strong>Methods: </strong>A cross-sectional and analytical study was conducted among 108 older adults enrolled in the \"Pension 65\" program in Peru. Participants were selected using non-probabilistic convenience sampling. Data on sociodemographic and economic characteristics were collected through a validated questionnaire, and non-adherence to antihypertensive treatment was self-reported. Logistic regression models were applied to identify factors independently associated with non-adherence.</p><p><strong>Results: </strong>Being male (OR = 28.3, 95% CI: 5.3-149.7), single (OR = 10.9, 95% CI: 2.501-48.0), having an incomplete primary education (OR = 7.7, 95% CI: 1.9-30.5), and being affiliated with the Comprehensive Health Insurance (SIS) (OR = 25.3, 95% CI: 5.3-119.6) were significantly associated with a higher likelihood of non-adherence to treatment. Furthermore, individuals who had never held formal employment (OR = 4.4, 95% CI: 1.6-11.8), those with an income below $120 USD per month (OR = 8.8, 95% CI: 2.1-35.6), and those who did not receive financial support (OR = 3.2, 95% CI: 1.1-9.3) were more likely to be non-adherent to treatment.</p><p><strong>Conclusion: </strong>The findings indicate that various socioeconomic factors hinder adherence to antihypertensive treatment in this vulnerable population. These results highlight the need for interventions, including public policies aimed at improving health education and strengthening access to healthcare services, particularly for older adults with economic constraints.</p>","PeriodicalId":19972,"journal":{"name":"Patient preference and adherence","volume":"19 ","pages":"1717-1729"},"PeriodicalIF":2.0,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12170445/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144317622","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 of Dietary Management and Social Adaptation in Young End-Stage Renal Disease Maintenance Hemodialysis Patients: A Qualitative Study.","authors":"Linghan Zhou, Liping Kang, Dongyang Wang, Qingmiao Li, Junfan Wei, Mengtian Li, Meng Li, Huawei Li","doi":"10.2147/PPA.S526917","DOIUrl":"10.2147/PPA.S526917","url":null,"abstract":"<p><strong>Purpose: </strong>To explore the experiences of young hemodialysis patients regarding diet therapy and social adjustment.</p><p><strong>Methods: </strong>This study used purposive sampling to select 19 young hemodialysis patients for semi-structured interviews at a tertiary hospital in Henan Province, China. We followed the Consolidated Criteria for Reporting Qualitative Research (COREQ) guidelines for qualitative research to ensure comprehensive reporting.</p><p><strong>Results: </strong>We identified five topic categories: \"Diet therapy perceptions\", including Lack of knowledge, imprudent attitude. \"Diet therapy behaviors\", including Vigilant Diet, Anxiety about water, Control of salt. \"Access to dietary information\", including Active acquisition, Passive acquisition. Family roles\", including Changes in dietary habits, Support of information, Reducing family involvement. Challenges of social adjustment\", including Barriers to work, Socialization Pain Points, Emotional distress, Looking for a way out.</p><p><strong>Conclusion: </strong>Young MHD patients recognize the importance of diet therapy and social reintegration but face barriers including knowledge gaps, inadequate support, and self-perceived burden. Key interventions should focus on: improved knowledge dissemination, optimized dietary education, nocturnal dialysis options, emotion regulation strategies, and enhancing self-efficacy. Strengthening national and societal support systems is critical for sustainable outcomes. Future research should employ longitudinal studies to track psychological adaptation and develop tailored, technology-assisted interventions for this population.</p>","PeriodicalId":19972,"journal":{"name":"Patient preference and adherence","volume":"19 ","pages":"1731-1745"},"PeriodicalIF":2.0,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12170795/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144317621","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}