Patient preference and adherence最新文献

{"title":"Association of Physician-Patient Communication and Treatment Satisfaction with Adherence to Disease-Modifying Therapies Among Patients with Relapsing-Remitting Multiple Sclerosis: A Cross-Sectional Study.","authors":"Justyna Chojdak-Łukasiewicz, Aleksandra Kołtuniuk, Gianluca Pucciarelli, Sławomir Budrewicz, Anna Pokryszko-Dragan","doi":"10.2147/PPA.S636357","DOIUrl":"https://doi.org/10.2147/PPA.S636357","url":null,"abstract":"<p><strong>Background: </strong>Adherence to disease modifying therapies (DMTs) is essential for treatment outcomes in relapsing-remitting multiple sclerosis (RRMS). Non-adherence has been associated with an increased risk of relapses, disease progression and higher healthcare costs; therefore, it is essential to identify factors associated with adherence.</p><p><strong>Purpose: </strong>The aim of the study was to evaluate self-reported adherence to therapeutic recommendation among patients with RRMS and to examine its associations with treatment satisfaction and physician-patient communication.</p><p><strong>Material and methods: </strong>This cross-sectional online survey study included 165 patients with RRMS (67.27% women), with mean age 44.42 ± 10.43 years, treated at the Department of Neurology, Wroclaw Medical University. Adherence was assessed using the Adherence in Chronic Diseases Scale (ACDS), physician-patient communication with the 14-item Polish version of the Communication Assessment Tool (CAT), and treatment satisfaction with the SATMED-Q questionnaire. Associations with the ACDS score were examined by univariable linear regression and by a multivariable model specified a priori on conceptual and clinical grounds (CAT, SATMED-Q, age, sex, EDSS, comorbidities, place of residence, route of administration and disease duration), supported by regression diagnostics and by ordinal and robust-regression sensitivity analyses.</p><p><strong>Results: </strong>The mean ACDS score was 25.49 ± 2.51 (range 14-28). Applying the established cut-offs, 8 participants (4.8%) were classified as showing low, 80 (48.5%) intermediate and 77 (46.7%) high adherence. Patients reported high satisfaction with physician communication (mean CAT score: 61.61 ± 9.73) and with treatment (mean total SATMED-Q score 78.67 ± 15.91). In the a-priori multivariable model (n = 165; <i>R</i> <sup>2</sup> = 0.226, adjusted <i>R</i> <sup>2</sup> = 0.171, overall F p < 0.001), higher CAT scores (adjusted β = 0.058 per point, 95% CI 0.019 to 0.098, p = 0.004) and higher total SATMED-Q scores (adjusted β = 0.031, 95% CI 0.005 to 0.057, p = 0.018) were associated with higher self-reported adherence, whereas a higher EDSS score was associated with lower adherence (adjusted β = -0.552, 95% CI -0.857 to -0.247, p < 0.001). All three associations were of modest magnitude and were confirmed in ordinal and robust-regression sensitivity analyses (overall F(11,153) = 4.07, p < 0.001).</p><p><strong>Conclusion: </strong>In this single-centre cross-sectional sample of patients with RRMS, higher self-reported treatment satisfaction and more favourable ratings of physician-patient communication were associated with modestly higher self-reported adherence scores, while greater disability was associated with lower adherence. Longitudinal and intervention studies are required to establish directionality and to determine whether communication-focused or shared decision-making interventions can","PeriodicalId":19972,"journal":{"name":"Patient preference and adherence","volume":"20 ","pages":"636357"},"PeriodicalIF":2.6,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13660504/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149183563","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":"Longitudinal Changes in Exercise Adherence and Associations with Rehabilitation Outcomes After Total Knee Arthroplasty: A Prospective HAPA-Informed Study.","authors":"Jiao Wang, Shanbin Chen, Yuanyuan Li, Yuan Yuan, Jiahui Liu, Suiyuan Wang","doi":"10.2147/PPA.S630194","DOIUrl":"https://doi.org/10.2147/PPA.S630194","url":null,"abstract":"<p><strong>Background: </strong>Exercise adherence is important after total knee arthroplasty (TKA), but its postoperative pattern and behavioral correlates remain unclear.</p><p><strong>Objective: </strong>To characterize exercise adherence and examine its associations with HAPA-related factors and rehabilitation outcomes.</p><p><strong>Methods: </strong>This prospective study included 128 patients undergoing unilateral TKA. HAPA-related variables were assessed preoperatively. EARS, VAS, HSS, and range of motion (ROM) were assessed at 1, 3, and 6 months. Linear mixed-effects models, correlations, and regression were used.</p><p><strong>Results: </strong>EARS scores changed over time (P<0.001), increasing from 17.78±3.27 at 1 month to 18.43±3.64 at 3 months and remaining stable at 6 months (18.36±3.68). Compared with 1 month, EARS was higher at 3 months (difference=0.651, 95% CI 0.340-0.962) and 6 months (difference=0.601, 95% CI 0.290-0.912; both adjusted P<0.001); 3- and 6-month scores did not differ. VAS decreased, whereas HSS and ROM increased (all P<0.001). At 6 months, action self-efficacy (B=0.248, 95% CI 0.065-0.431) and maintenance self-efficacy (B=0.209, 95% CI 0.032-0.387) were independently associated with higher EARS scores. EARS correlated with VAS (<i>r</i>=-0.360), HSS (<i>r</i>=0.326), and ROM (<i>r</i>=0.361; all P<0.001).</p><p><strong>Conclusion: </strong>Exercise adherence improved mainly during the first 3 months and then stabilized. Self-efficacy was associated with adherence, while higher adherence was associated with less pain and better function. These findings do not establish causality.</p>","PeriodicalId":19972,"journal":{"name":"Patient preference and adherence","volume":"20 ","pages":"630194"},"PeriodicalIF":2.6,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13660775/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149183637","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":"What Do Patients with Long-Term Conditions Disclose About Medication Adherence During and After Hospital Discharge? A Qualitative Study at an Internal Medicines Ward in Norway.","authors":"Stine Eidhammer Rognan, Helene Berg Lie, Sofia Kälvemark Sporrong, Kajsa Rebecka Bengtsson, Yvonne Andersson, Liv Mathiesen","doi":"10.2147/PPA.S615812","DOIUrl":"https://doi.org/10.2147/PPA.S615812","url":null,"abstract":"<p><strong>Purpose: </strong>To explore how patients' life circumstances, perceptions, lived experiences and behaviors may influence medication adherence in the social context surrounding hospital discharge.</p><p><strong>Patients and methods: </strong>Ten patients aged 48-89 years were included at a hospital ward close to the presumed day of discharge, observed during healthcare personnel (HCP) encounters and interviewed 1-2 weeks after discharge. Medication adherence was reconstructed through medication reconciliation and by comparing observations of hospital encounters and discharge information with patients' post-discharge accounts of medication use. Data were analyzed using content analysis to identify themes across participants and narratives to explore individual experiences.</p><p><strong>Results: </strong>The analysis revealed the themes 1) \"beliefs about medicines\" and 2) \"self-efficacy\". We found that patient beliefs about medicines were often not fully explored during clinical encounters, however according to the patients, these factors play a key role in explaining adherence challenges. Although all patients stated that they intended to take their medications as instructed by the HCPs at the hospital, more than half of them had consciously or unconsciously changed the medication treatment compared to the discharge summary. The patient narratives illustrate multiple factors contributing to non-adherence after hospital discharge.</p><p><strong>Conclusion: </strong>This study suggests that important influences on medication adherence may remain insufficiently explored during routine discharge encounters. Our findings indicate that discharge processes could be strengthened by incorporating more structured and patient-centred conversations that invite patients to discuss their beliefs, concerns, and anticipated challenges with medication management. This could include asking open-ended questions about how patients understand their treatment, how they expect to manage it in daily life, and what uncertainties or barriers they foresee. Such conversations might help identify barriers to adherence and better support patients' self-management after discharge.</p>","PeriodicalId":19972,"journal":{"name":"Patient preference and adherence","volume":"20 ","pages":"615812"},"PeriodicalIF":2.6,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13654281/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149167331","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":"Psychological Experiences and Food Avoidance Behavior in Patients Following Esophageal Cancer Surgery: A Qualitative Study.","authors":"Jinqian Han, RuiChen Ma, Enshe Jiang, Mei Chan Chong, Wan Ling Lee","doi":"10.2147/PPA.S631994","DOIUrl":"10.2147/PPA.S631994","url":null,"abstract":"<p><strong>Background: </strong>Nutritional rehabilitation is essential for recovery after esophagectomy. However, food avoidance behavior is common and may compromise nutritional intake, quality of life, and postoperative recovery. This study aimed to explore the factors influencing food avoidance behavior and the psychological and contextual processes underlying such behavior after esophagectomy, with the aim of informing targeted psychosocial and behavioral interventions and individualized dietary management.</p><p><strong>Methods: </strong>A descriptive qualitative design was used. Guided by the Roy Adaptation Model (RAM), a semi-structured interview guide was developed. Sixteen patients who had undergone esophagectomy were purposively recruited from a tertiary cancer hospital in central China. Directed content analysis was conducted, with NVivo 14.0 used to facilitate data organization and coding. The RAM guided the coding framework and category development.</p><p><strong>Results: </strong>Four main categories and ten subcategories were identified: physiological function factors (taste changes and swallowing discomfort; recurrent symptoms), self-concept factors (lack of nutritional knowledge; fear of disease recurrence; traumatic experiences of illness), role function factors (the patient role limiting social functioning; social role priorities overriding dietary management), and interdependence factors (passive dietary restriction in dependent relationships; lack of post-discharge follow-up; economic burden).</p><p><strong>Conclusions: </strong>Food avoidance behavior after esophagectomy reflects the interaction of physiological symptoms, illness-related beliefs and experiences, role-related challenges, caregiver influences, and limitations in post-discharge support. RAM-informed care should integrate individualized nutritional support, psychological counseling, behavioral guidance, caregiver education, and continuous follow-up to reduce unnecessary food avoidance and promote nutritional and psychological adaptation.</p>","PeriodicalId":19972,"journal":{"name":"Patient preference and adherence","volume":"20 ","pages":"631994"},"PeriodicalIF":2.6,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13655516/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149165890","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":"Psychological Factors Associated with Treatment Adherence in Patients Undergoing Maintenance Hemodialysis: A Cross-Sectional Network Analysis.","authors":"Yu-Qin Yin, Wu-Han Ouyang, Yi-Min Luo, Jia Luo","doi":"10.2147/PPA.S640531","DOIUrl":"https://doi.org/10.2147/PPA.S640531","url":null,"abstract":"<p><strong>Background: </strong>Patients undergoing maintenance hemodialysis require long-term complex treatment and strict self-management, and nonadherence to treatment is relatively common. Meaning in life, social support, and loneliness may be jointly associated with treatment adherence; however, the complex network of associations among these factors remains unclear.</p><p><strong>Methods: </strong>In this cross-sectional study, 481 patients with end-stage renal disease undergoing maintenance hemodialysis were recruited using convenience sampling from the hemodialysis centers of three hospitals in a city in China. Data were collected between December 2024 and February 2025 using the Treatment Adherence Scale for Patients with End-Stage Renal Disease Undergoing Maintenance Hemodialysis, the Meaning in Life Questionnaire, the Perceived Social Support Scale, and the Loneliness Scale. Network analysis was used to construct a partial correlation network comprising eight nodes. Strength centrality and expected influence were used to identify relatively central nodes, bridge expected influence was applied to analyze the strength of cross-community associations, and network accuracy and stability were examined.</p><p><strong>Results: </strong>In the network, treatment adherence showed positive partial correlations with presence of meaning (edge weight = 0.213) and family support (0.103), and negative partial correlations with emotional loneliness (-0.099) and social loneliness (-0.093). Social loneliness and significant other support were among the nodes with the highest strength centrality, while support from friends had the highest expected influence. Presence of meaning had the highest positive bridge expected influence, while social loneliness had the highest negative bridge expected influence. Strength centrality and expected influence showed good stability, with correlation stability coefficients of 0.595 for both indices.</p><p><strong>Conclusion: </strong>The findings suggest that social loneliness, support from friends and significant others, and presence of meaning may be important nodes in the psychological network related to treatment adherence. These findings may inform the selection of candidate targets for future nursing intervention research.</p>","PeriodicalId":19972,"journal":{"name":"Patient preference and adherence","volume":"20 ","pages":"640531"},"PeriodicalIF":2.6,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13653521/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149172192","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 Among Adults with Diabetes in Jazan, Saudi Arabia: Role of Pharmacist Support and Digital Health.","authors":"Fatimah Mohammed Sahli, Mansour Almuqbil, Sara Alrouwaijeh, Ayat Ahmad Alhazmi, Sharifah Jaber Alraythi, Salma Mohammed Alattas, Raghad Hamdan Meshari, Revan Hassan Kharizi, Amnah Ali Hadi Mobaraki, Osaylah Mohammed Alshlali, Lamis Mohammed Moafa, Rehab Ali Shwia, Rafiulla Gilkaramenthi, Syed Mohammed Basheeruddin Asdaq","doi":"10.2147/PPA.S628042","DOIUrl":"https://doi.org/10.2147/PPA.S628042","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Medication adherence is critical for achieving optimal glycemic control and preventing diabetes-related complications. However, poor adherence remains a major barrier to effective diabetes management worldwide. Evidence regarding factors associated with medication adherence among adults with diabetes in Saudi Arabia remains limited. This study aimed to assess medication adherence among adults with diabetes and examine associations of sociodemographic, clinical, pharmacist-related, and digital health factors with adherence levels.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A cross-sectional study was conducted among adults with type 1 or type 2 diabetes attending a specialized diabetes center in Jazan, Saudi Arabia, during February-March 2025. Participants were recruited using non-probability convenience sampling. Of 489 patients approached, 388 completed the questionnaire, yielding a response rate of 79.3%. Data were collected using a bilingual (Arabic/English) electronic questionnaire. Medication adherence was assessed using the 8-item Morisky Medication Adherence Scale (MMAS-8). Descriptive statistics, bivariate analyses, correlation analysis, and multinomial logistic regression were performed using IBM SPSS Statistics version 27.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Overall, 77.1% of participants demonstrated low medication adherence, while 16.5% and 6.4% demonstrated moderate and high adherence, respectively. In the adjusted multinomial logistic regression model, higher satisfaction with the current diabetes management plan was significantly associated with greater odds of moderate adherence (OR=1.650, 95% CI: 1.212-2.245, P=0.001) and high adherence (OR=2.038, 95% CI: 1.165-3.565, P=0.013) compared with low adherence. Insulin use was associated with moderate vs low adherence (OR=2.175, 95% CI: 1.008-4.692, P=0.048), but not with high adherence. Participants who did not use mobile applications or digital health tools had higher odds of high vs low adherence than those who used such tools (OR=2.685, 95% CI: 1.007-7.154, P=0.048). Age and comorbid conditions were not significantly associated with adherence level in the adjusted model. Frequency of pharmacist consultation was significant overall (P=0.001), although individual category comparisons did not demonstrate a consistent pattern across adherence levels. Multicollinearity diagnostics indicated no problematic collinearity (VIF=1.04-1.34; tolerance ≥0.75).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Medication adherence was predominantly low among study participants. Higher satisfaction with diabetes management was consistently associated with greater adherence, while insulin use and digital health tool use showed category-specific associations. The unexpected association between digital-tool non-use and high adherence should be interpreted cautiously and does not establish a causal effect of digital technology on adherence. Further longitudinal and prospective studies are warranted ","PeriodicalId":19972,"journal":{"name":"Patient preference and adherence","volume":"20 ","pages":"628042"},"PeriodicalIF":2.6,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13651746/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149170713","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":"Illness Perception and Delayed Healthcare-Seeking in Urban Chinese Women with Pelvic Organ Prolapse: A Qualitative Study Using the Common-Sense Model.","authors":"Li Wen, Zehua Cai, Xiaoqun Zhang, Yuxian Du, Liubing Huo, Shuqi Li, Sainan Liu, Lizhen Su, Wenwei Pan, Jianying Zhu","doi":"10.2147/PPA.S624681","DOIUrl":"https://doi.org/10.2147/PPA.S624681","url":null,"abstract":"<p><strong>Introduction: </strong>Pelvic organ prolapse (POP) is prevalent among postmenopausal women in China, yet many delay care for months or years. Guided by the Common-Sense Model of Self-Regulation (CSM), this study explored illness perceptions and coping experiences among Chinese women with moderate-to-severe POP who delayed healthcare-seeking.</p><p><strong>Methods: </strong>A descriptive phenomenological design was used. Seventeen women (mean age 61 years; delay range: 12-360 months) were purposively recruited from a tertiary hospital in Guangdong Province. Semi-structured interviews were conducted and analyzed using Colaizzi's seven-step method.</p><p><strong>Results: </strong>Three main themes emerged: (1) Cognitive representation: Participants lacked POP awareness, attributing symptoms to normal aging or childbirth, minimizing severity due to absence of pain. (2) Coping strategies: Avoidance and concealment behaviors were common due to shame and fear of being a burden. Adult children, especially daughters-in-law, often triggered eventual care-seeking. (3) Appraisal and outcomes: Women reported positive postoperative outcomes but profound regret about delayed care, advocating for better health education.</p><p><strong>Conclusions: </strong>This study, one of the first CSM-based investigations in this population, explains how cognitive misattributions, emotional distress (shame, fear), and maladaptive coping collectively sustain prolonged healthcare delay in POP. Nurses should implement CSM-based interventions to correct misconceptions, reduce stigma, and engage family members. Findings are exploratory and hypothesis-generating. Future research requires longitudinal designs and rural sample replication.</p>","PeriodicalId":19972,"journal":{"name":"Patient preference and adherence","volume":"20 ","pages":"624681"},"PeriodicalIF":2.6,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13652042/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149168512","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 Association Between Tuberculosis-Related Stigma and Sleep Quality Among Hospitalized Tuberculosis Patients: The Indirect Role of Anxiety.","authors":"Rong Yao, Xia Zhao, Jinxia Du, Min Huang, Fanghui Xie, Yinping Hu, Dingling He, Lingling Yu, Yin Huang, Xiaoyi Yang, Yan Zhou","doi":"10.2147/PPA.S639585","DOIUrl":"https://doi.org/10.2147/PPA.S639585","url":null,"abstract":"<p><strong>Background: </strong>To investigate the relationship between perceived stigma and sleep quality among hospitalized tuberculosis patients, and to examine the indirect role of anxiety in this relationship.</p><p><strong>Methods: </strong>A cross-sectional study design was employed. A convenience sample of 2179 tuberculosis patients was selected and assessed using the TB-Related Stigma Scale (TSS), the Self-Rating Anxiety Scale (SAS), and the Pittsburgh Sleep Quality Index (PSQI). The indirect effect of anxiety was examined using the PROCESS macro (Model 4; Hayes, 2018) with 5000 bootstrap resamples to generate 95% bias-corrected confidence intervals for indirect effects.</p><p><strong>Results: </strong>Perceived stigma was positively associated with PSQI scores (<i>r</i> = 0.143, p < 0.01), indicating that higher perceived stigma was associated with poorer sleep quality. Perceived stigma was also positively correlated with anxiety (<i>r</i> = 0.180, p < 0.01), and anxiety was positively associated with PSQI scores (<i>r</i> = 0.446, p < 0.01), suggesting that higher anxiety was also associated with poorer sleep quality.</p><p><strong>Conclusion: </strong>Perceived stigma was indirectly associated with sleep quality through anxiety. These findings suggest that perceived stigma and anxiety may be potential contributing factors related to sleep quality in this population. Given the cross-sectional design, they should be interpreted as hypotheses-generating rather than evidence of causal intervention effects; future intervention studies may consider combined approaches-such as cognitive behavioral therapy together with social support and anxiety-management interventions-to examine whether targeting perceived stigma and anxiety improves sleep outcomes.</p>","PeriodicalId":19972,"journal":{"name":"Patient preference and adherence","volume":"20 ","pages":"639585"},"PeriodicalIF":2.6,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13651734/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149171886","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":"Effects of the Integration of Medical Treatment and Prevention on Glycaemic Control Among Patients with Diabetes in Qianjiang District, China: A Difference-in-Differences Study.","authors":"Huawei Tan, Xiaochong He","doi":"10.2147/PPA.S637259","DOIUrl":"https://doi.org/10.2147/PPA.S637259","url":null,"abstract":"<p><strong>Background: </strong>The Integration of Medical Treatment and Prevention (IMTP) is one approach to integrated disease management within China's primary healthcare system. Evidence on its association with glycaemic control and potential behavioural pathways among patients with diabetes remains limited.</p><p><strong>Methods: </strong>We conducted a retrospective quasi-experimental study of 5676 adults with diabetes in Qianjiang District during 2023Q1-2024Q4. Four primary healthcare (PHC) facilities implemented IMTP in January 2024 (treatment group), while 26 formed the control group. Patient-level propensity score matching via the Super Learner machine learning algorithm (PSM-SLMLA) at the 2023Q4 baseline retained 1240 patients per group (19,840 patient-quarter observations). Weighted difference-in-differences (DID) models included facility and quarter fixed effects with facility-clustered inference.</p><p><strong>Results: </strong>IMTP was associated with a 3.73% relative reduction in HbA1c (95% CI, 0.04%-7.29%; β = -0.0380; 95% CI, -0.0757 to -0.0004; P = 0.048), equivalent to approximately 0.27 HbA1c percentage points at the pre-intervention mean. Pre-intervention coefficients were not jointly significant (P = 0.857), and sensitivity estimates remained negative. Exploratory indirect associations were -0.0021 through active follow-up behaviour (95% bootstrap CI, -0.0037 to -0.0007; P = 0.004) and -0.0006 through staple-food intake behaviour (95% bootstrap CI, -0.0026 to -0.0001; P = 0.014); the exercise adherence estimate included zero. Formal interaction tests did not identify heterogeneity (all P for interaction > 0.05).</p><p><strong>Conclusion: </strong>IMTP was associated with modest short-term glycaemic improvement. Active follow-up behaviour may be a potential pathway. Increased staple-food intake raises a dietary-compensation hypothesis, but concurrent behavioural and HbA1c measurements preclude causal interpretation.</p>","PeriodicalId":19972,"journal":{"name":"Patient preference and adherence","volume":"20 ","pages":"637259"},"PeriodicalIF":2.6,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13652037/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149171077","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":"A Conceptual Framework for Individualized Patient Education in Healthcare: A Scoping Review.","authors":"Sevda Gardashkhani, Mansour Ghafourifard, Akram Ghahramanian, Abbas Ebadi, Neda Gilani","doi":"10.2147/PPA.S642480","DOIUrl":"https://doi.org/10.2147/PPA.S642480","url":null,"abstract":"<p><strong>Introduction: </strong>Individualized patient education has received increasing attention as a strategy to improve patient engagement, self-management, and health outcomes. However, its definition, components, and implementation remain conceptually unclear. This scoping review aimed to synthesize existing evidence, clarify the concept of individualized patient education, and develop a conceptual framework by identifying its core dimensions and implementation approaches.</p><p><strong>Methods: </strong>This scoping review followed the Joanna Briggs Institute methodology and PRISMA-ScR guidelines. A comprehensive search was performed across Scopus, PubMed, Embase, Web of Science, CINAHL, PsycINFO, Google Scholar, and ProQuest databases from inception to November 2025. Studies addressing individualized patient education or related concepts were included regardless of study design. Data were synthesized using inductive thematic analysis.</p><p><strong>Results: </strong>Forty-two studies met the inclusion criteria. The synthesis revealed five interrelated dimensions that define the scope and process of individualized patient education: (1) comprehensive individual assessment, (2) collaborative planning and individualized goal setting, (3) development of individualized educational content, (4) flexible implementation of education, and (5) individualized evaluation, reinforcement, and follow-up. Importantly, the synthesis showed that individualization is not limited to adapting educational content; rather, it encompasses the entire educational process-from assessment and planning through delivery, evaluation, and follow-up-in response to patients' clinical, cognitive, psychological, cultural, and contextual characteristics and needs.</p><p><strong>Conclusion: </strong>By integrating these dimensions into a conceptual framework, this review clarifies the defining characteristics, processes, and components of individualized patient education. The framework conceptualizes individualized patient education as a multidimensional, patient-centered, and iterative process. It provides a coherent basis for research, the development of standardized interventions, and clinical practice in person-centered care.</p>","PeriodicalId":19972,"journal":{"name":"Patient preference and adherence","volume":"20 ","pages":"642480"},"PeriodicalIF":2.6,"publicationDate":"2026-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13658426/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149183611","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}