Patient preference and adherence最新文献

{"title":"Medication Adherence Patterns for Patients with Atrial Fibrillation: A Mixed Methods Study to Understand Patient and Clinician Perspectives.","authors":"Mary T Imboden, Monique Gill, Kyle G Jones, Ritu Ghosal, Aisha Gilmore, Angie Johnson, Eleni Wilson, Ty J Gluckman, Mohammad Ateya, Feng Dai, Laura L Manzey, Kevin A Townsend, Staci J Wendt","doi":"10.2147/PPA.S632632","DOIUrl":"10.2147/PPA.S632632","url":null,"abstract":"<p><strong>Background: </strong>Medication adherence is essential for effective atrial fibrillation (AF) management; however, many patients with AF are non-adherent to these medications, necessitating an understanding of adherence barriers. This mixed-methods study aimed to identify factors influencing oral anticoagulant (OAC) adherence.</p><p><strong>Methods: </strong>A stratified random sample of 2000 patients with non-valvular AF and OAC prescriptions was surveyed from a large, seven state community health system, capturing barriers and facilitators to medication adherence using an adapted version of the Adherence Starts with Knowledge-12 scale. Twenty-eight semi-structured interviews were conducted with a sample of survey respondents to further explore drivers of adherence. Eligible clinicians were surveyed on patient adherence. Survey data were analyzed descriptively and using multivariable regression models. Interview data were analyzed thematically.</p><p><strong>Results: </strong>Of 213 patients with an adherence score available, 31.5% reported non-adherence. Nonadherent patients were more likely to report poor healthcare experiences. Receiving all necessary information from clinicians was positively associated with medication adherence. Interview analyses showed clinician communication about medications and believing that medication can help manage AF were important facilitators of medication adherence. While clinician response rate was low (3.0%), 87% of responding clinicians perceived high non-adherence among patients with AF, citing forgetfulness, cost, and side effects as the main reasons.</p><p><strong>Conclusion: </strong>Most patients reported adherence to their medications, whereas clinicians perceived relatively low adherence among their patients. However, clinicians aligned with patients on the need for improved communication and shared decision making around AF treatment. Interventions that promote clinician and patient communication may be pivotal for optimizing medication adherence, which may lead to improved patient care.</p>","PeriodicalId":19972,"journal":{"name":"Patient preference and adherence","volume":"20 ","pages":"632632"},"PeriodicalIF":2.6,"publicationDate":"2026-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13616161/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149070009","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":"Living Through Acute Helplessness and Ongoing Recovery: A Phenomenological Study of Patients with Guillain-Barré Syndrome Undergoing Therapeutic Plasma Exchange.","authors":"Vera Susanti, Yanny Trisyani, Aan Nuraeni","doi":"10.2147/PPA.S628967","DOIUrl":"10.2147/PPA.S628967","url":null,"abstract":"<p><strong>Background: </strong>Guillain-Barré Syndrome (GBS) is an acute neurological disorder marked by progressive weakness and potential respiratory failure, frequently requiring intensive care and Therapeutic Plasma Exchange (TPE). Although prior research has investigated the clinical impact and quality of life among GBS patients, most studies have examined physical and psychological dimensions separately. Few studies have addressed the meaning of patients' lived experiences within a biopsychosociospiritual framework, especially from the acute phase through recovery in the context of TPE.</p><p><strong>Purpose: </strong>This study aimed to explore the lived experiences of patients with GBS undergoing TPE across the acute phase and recovery within the clinical and sociocultural context of a developing country, Indonesia.</p><p><strong>Methods: </strong>A qualitative, descriptive-phenomenological design was employed at a national referral hospital in Indonesia, a developing-country setting with limited access to critical care and rehabilitation resources for GBS. Seven patients with GBS undergoing TPE, followed up to three years post-diagnosis, were purposively recruited. Data adequacy was achieved when no new themes emerged after the sixth interview, and one additional participant was included to confirm saturation. Semi-structured interviews were conducted between September and December 2025 at mutually agreed locations. Data were analyzed using the Colaizzi phenomenological method, and member checking enhanced credibility.</p><p><strong>Results: </strong>Four main themes emerged: (1) bodily disruption and meaningful recovery; (2) emotional distress and self-acceptance; (3) communication barriers and efforts to rebuild relationships; and (4) spiritual distress and resilience. These themes illustrate the multidimensional journey from acute uncertainty to the reconstruction of meaning in life during recovery.</p><p><strong>Conclusion: </strong>The lived experiences of GBS patients undergoing Therapeutic Plasma Exchange demonstrate a progression from acute helplessness to sustained recovery. Recovery encompasses not only physical improvement but also the reconstruction of self-meaning, social relationships, and spiritual strength in adapting to life changes caused by the disease. These findings underscore the need for a holistic, patient-centered nursing approach throughout the illness and recovery.</p>","PeriodicalId":19972,"journal":{"name":"Patient preference and adherence","volume":"20 ","pages":"628967"},"PeriodicalIF":2.6,"publicationDate":"2026-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13616178/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149069983","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 Preferences Regarding Undergraduate Medical Student Participation in Clinical Care: A Multicenter Cross-Sectional Study in Syria.","authors":"Rawan Al-Deeb, Taim Al Kheder, Ahmad Bishr Nasra, Hala Kseibi, Muhammad Obada Al-Sibai, Shahd Almansour, Aya Amer, Louts Mohsen Sbaihi, Talal Habouch","doi":"10.2147/PPA.S644198","DOIUrl":"10.2147/PPA.S644198","url":null,"abstract":"<p><strong>Purpose: </strong>Direct patient involvement is essential to undergraduate clinical education, yet evidence on patient willingness, consent experiences, and context-specific preferences in Syria is limited. This study characterized patient preferences regarding undergraduate medical student participation in clinical care and examined factors associated with willingness to allow participation.</p><p><strong>Patients and methods: </strong>A multicenter cross-sectional study was conducted from December 2025 to February 2026 among 746 adult inpatients and outpatients recruited consecutively within selected teaching, Ministry of Health public, and private hospitals across several Syrian governorates. A structured Arabic questionnaire assessed previous exposure, willingness, acceptable activities and procedures, consent, confidentiality, and attitudes toward student involvement. Hospital-sector comparisons used Pearson chi-square tests with Benjamini-Hochberg false-discovery-rate adjustment across 53 comparisons. Multivariable logistic regression examined age, sex, hospital type, educational level, and previous exposure.</p><p><strong>Results: </strong>The median age was 41 years (IQR 25.75-54), and 64.2% were female. Observation and participation were accepted by 94.0% and 86.1%, respectively. A professional supervisor was endorsed as a condition for participation by 72.1%; supervised discussion was accepted by 93.3%, whereas rectal examination was accepted by 25.3%. Several hospital-sector differences remained significant after false-discovery-rate correction. In the adjusted model, older age (aOR 1.34 per 10-year increase, 95% CI 1.14-1.57) and previous exposure to a medical student (aOR 3.02, 95% CI 1.93-4.72) were associated with greater willingness. Educational level was associated overall (p=0.001), whereas sex and hospital type were not independently associated.</p><p><strong>Conclusions: </strong>In this multicenter convenience sample, willingness to permit undergraduate medical student involvement was high but lower for sensitive, invasive, and cross-gender interactions. Clear consent, appropriate supervision, privacy safeguards, and attention to patient preferences may support patient-centered clinical teaching.</p>","PeriodicalId":19972,"journal":{"name":"Patient preference and adherence","volume":"20 ","pages":"644198"},"PeriodicalIF":2.6,"publicationDate":"2026-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13616168/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149069964","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":"Acceptance of Cell and Gene Therapy Among Patients with Hematological Diseases in China: A Cross-Sectional Study.","authors":"Nianhang Wang, Huijuan Zhang, Rui Zhong, Yanwen Qiao, Hui Yang, Siyuan Chen, Erlie Jiang, Yongzhong Zhang, Chuan Wang","doi":"10.2147/PPA.S642214","DOIUrl":"10.2147/PPA.S642214","url":null,"abstract":"<p><strong>Background: </strong>Cell and gene therapy (CGT) offers breakthrough solutions for hematological diseases. Patient acceptance is a key determinant of its successful clinical translation. This study investigates CGT acceptance among hematological patients and explores its primary determinants.</p><p><strong>Methods: </strong>A cross-sectional study was conducted (June-July 2025) with 385 hematological patients at a single specialized hematology center (Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences). Each participant completed a sociodemographic and clinical questionnaire, the Risk Perception Assessment Scale for Patients with Hematological Diseases, and the EuroQol 5-Dimensional 5-Level (EQ-5D-5L) questionnaire. Correlation and multivariable ordinal logistic regression analyses were performed using SPSS 26.0.</p><p><strong>Results: </strong>Most patients (76.6%) were cautious toward CGT. Risk perception (<i>OR</i> = 0.944; 95% <i>CI</i>: 0.921-0.967), gender (male vs female: <i>OR</i> = 1.754; 95% <i>CI</i>: 1.061-2.901), medical insurance status (insured vs uninsured: <i>OR</i> = 5.485; 95% <i>CI</i>: 2.020-14.895), disease types (acute leukemia vs other hematological diseases: <i>OR</i> = 2.936; 95% <i>CI</i>: 1.169-7.374), and prior experience with CGT-related clinical trials (with experience vs without: <i>OR</i> = 6.278; 95% <i>CI</i>: 2.798-14.083) were five key predictors. Physical risk and economic risk constituted the two primary risk barriers hindering CGT acceptance. Subgroup analysis further showed that household income and treatment modality were significant factors for patients with acute leukemia and those with myelodysplastic syndrome, respectively. All <i>P</i> < 0.05.</p><p><strong>Conclusion: </strong>Enhancing CGT acceptance among patients with hematological diseases may be facilitated through tailored educational interventions and expanded financial support. However, further multicenter and prospective studies are required to validate these cross-sectional associations and evaluate the actual effectiveness of specific interventions in clinical practice.</p>","PeriodicalId":19972,"journal":{"name":"Patient preference and adherence","volume":"20 ","pages":"642214"},"PeriodicalIF":2.6,"publicationDate":"2026-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13617002/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149075650","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":"Personalizing Traditional Chinese Medicine: A Longitudinal Study on How Constitution-Based Configurations Relate to Quality of Life During Comprehensive Intervention.","authors":"Jiaju Ren, Yanbo Zhu, Yuan He, Jiehui Cheng, Huimei Shi, Ooh Chye Tan, Pu Ge, Xinyuan Zhao, Xinyue Zhang, Jiayi Lin","doi":"10.2147/PPA.S635208","DOIUrl":"10.2147/PPA.S635208","url":null,"abstract":"<p><strong>Objective: </strong>Traditional Chinese Medicine (TCM) constitution theory underpins personalized health management, but most studies examine constitution types in isolation, whereas overlapping constitutions are the rule rather than the exception in practice. This study examined how combinations of TCM constitution subscale scores were related to health-related quality of life (QoL) over six months of constitution-based comprehensive intervention.</p><p><strong>Methods: </strong>In a single-arm prospective study, 509 adults aged 19-84 years completed a 6-month constitution-based self-management programme. Constitution was assessed with the 60-item Constitution in Chinese Medicine Questionnaire (CCMQ-60), which yields a Gentleness (Type A) score and scores on eight biased types (Qi-Deficiency, Yang-Deficiency, Yin-Deficiency, Phlegm-Dampness, Damp-Heat, Blood-Stasis, Qi-Depression, Special-Diathesis). QoL was measured with the 36-Item Short Form Health Survey (SF-36) at baseline, 3 months, and 6 months. Dynamic (panel) and \"bottom-up\" fuzzy-set qualitative comparative analysis (fsQCA) were used to identify constitution configurations associated with high QoL at each time point.</p><p><strong>Results: </strong>The mean SF-36 total score rose from 72.7 ± 16.1 at baseline to 75.1 ± 14.6 at 3 months and 75.6 ± 15.5 at 6 months (mean change 2.9 points, 95% CI 1.7 to 4.1; standardized change 0.21). No single constitution subscale was a necessary condition for high QoL (pooled consistency < 0.90). Dynamic fsQCA identified 5 overlapping configurations (consistency 0.946-0.953; solution coverage 0.540), each characterized by a high Gentleness score combined with low scores on most biased constitutions; unique coverage of individual configurations was small (0.006-0.049). Bottom-up analysis at a PRI threshold of 0.75 retained low Yang-Deficiency or low Blood-Stasis together with low Qi-Depression at baseline and 3 months (consistency 0.867-0.873), whereas at 6 months the retained pairs were low Qi-Deficiency with low Yang-Deficiency or low Blood-Stasis, and low Yang-Deficiency with low Phlegm-Dampness (consistency 0.856-0.866). Consistency of the configurations exceeded 0.90 in every age and sex stratum.</p><p><strong>Conclusion: </strong>During the programme, high QoL was associated with a high Gentleness score combined with low scores on several biased constitutions rather than with any single constitution type, and the pairs of biased constitutions that distinguished high QoL at 6 months differed from those at baseline and 3 months. Because the study had no control group, these configurational patterns are descriptive and hypothesis-generating; they point to combinations of constitutions that could be prioritized and tested in controlled evaluations of constitution-based personalized health management.</p>","PeriodicalId":19972,"journal":{"name":"Patient preference and adherence","volume":"20 ","pages":"635208"},"PeriodicalIF":2.6,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13615766/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149063294","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 Mediating Role of Patient Activation in the Association Between Illness Perception and Self-Management Behavior Among Patients with Oral Cancer.","authors":"Ying Gao, Haiyan Liu, Shan Gao, Zhaoxia Li, Rongrong Ma, Xiao Zhang, Jianhua Liu, Wenyuan Ma","doi":"10.2147/PPA.S619049","DOIUrl":"10.2147/PPA.S619049","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to examine the relationships among illness perception, patient activation, and self-management behavior in oral cancer patients, and to explore the mediating role of patient activation between illness perception and self-management behavior.</p><p><strong>Methods: </strong>A cross-sectional study was conducted among 220 oral cancer patients recruited from two tertiary hospitals in Shandong Province, China, using a convenience sampling method. Data were collected using the Brief Illness Perception Questionnaire (BIPQ), Patient Activation Measure (PAM), and the Cancer Patient Self-Management Scale. Pearson correlation analysis, multiple linear regression, and structural equation modeling (SEM) were performed to analyze the relationships among variables. The mediating effect was tested using the bootstrap method.</p><p><strong>Results: </strong>A total of 220 valid questionnaires were collected. The mean scores for illness perception, patient activation, and self-management behavior were 41.69±12.23, 59.17±12.81, and 133.71±35.95, respectively. Several demographic and clinical characteristics were associated with self-management behavior in the regression analysis. Negative illness perceptions were significantly associated with lower self-management behavior (<i>r</i>= -0.875,<i>P</i><0.01), whereas patient activation was positively correlated with self-management behavior (<i>r</i>=0.882,<i>P</i><0.01). Negative illness perceptions were also associated with lower patient activation (<i>r</i>=-0.896,<i>P</i><0.01). Structural equation modeling showed that patient activation partially mediated the relationship between negative illness perceptions and self-management behavior (<i>β</i>=-0.53; 95% CI: -0.87 to -0.19), with the mediating effect accounting for 56.58% of the total effect.</p><p><strong>Conclusion: </strong>Patient activation plays a significant mediating role in the relationship between negative illness perceptions and self-management behavior in oral cancer patients, accounting for 56.58% of the total effect. This finding suggests that enhancing patient activation may partially reduce the adverse impact of negative illness perceptions on self-management behavior and represents an important target for clinical interventions aimed at improving self-management among oral cancer patients.</p>","PeriodicalId":19972,"journal":{"name":"Patient preference and adherence","volume":"20 ","pages":"619049"},"PeriodicalIF":2.6,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13615745/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149063321","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":"Barriers and Facilitators to Shared Decision-Making in EGFRm Non-Small Cell Lung Cancer: Patient Perspectives.","authors":"Virginia Harrison, Gerald Goh","doi":"10.2147/PPA.S598088","DOIUrl":"10.2147/PPA.S598088","url":null,"abstract":"<p><strong>Introduction: </strong>The Global Lung Cancer Coalition Patient Charter highlights that every patient should have involvement in decision-making. In lung cancer, patient involvement in treatment decision-making is often perceived as difficult to achieve.</p><p><strong>Purpose: </strong>This study explored the experiences of patients with epidermal growth factor receptor mutated (EGFRm) non-small cell lung cancer (NSCLC) to identify the barriers and facilitators to their involvement in decision-making.</p><p><strong>Patients and methods: </strong>An online Bulletin Board where participants answered quantitative and qualitative questions, interacting with an online moderator, was used to capture the experiences of 28 self-selected adult patients with EGFRm NSCLC recruited through a patient organisation.</p><p><strong>Results: </strong>56% (15/27) of patients felt involved in their treatment decisions; they received sufficient information from their doctor and were able to ask the questions they needed. Information most important in supporting treatment decision involvement was: treatment effectiveness; impact on prognosis; mechanism of action; impact of treatment on daily life; treatment administration; possible side effects and their management. 37% (10/27) of patients did not feel involved in their treatment decisions. Half (5/10) were not asked about their treatment preferences. Patients who did not feel involved reported a lack of understanding about EGFR, confusion over medical terms that led to misunderstandings, and no personalisation of treatment information. 43% (12/28) of patients reported that their doctors used visual aids (CT scans, hand drawing/annotating diagrams and charts). When used, these enhanced patients' understanding and involvement. Most patients (96%, 27/28) wanted to understand treatment effectiveness; progression free survival, overall survival, overall response rate but struggled to understand the medical terminology.</p><p><strong>Conclusion: </strong>These findings from a small, self-selected group of patients highlight the importance of clear information, personalised and tailored to individual patients, in enabling patients with EGFRm NSCLC to be involved in their treatment decisions. Validation in a broader patient population would be valuable.</p>","PeriodicalId":19972,"journal":{"name":"Patient preference and adherence","volume":"20 ","pages":"598088"},"PeriodicalIF":2.6,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13614322/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149063794","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":"Challenges in Hemophilia Care and Requirements for Pediatric-to-Adult Transition: Single-Center Experience from a Resource-Limited Setting.","authors":"Nongnuch Sirachainan, Ketsuda Kempka, Anusara Tiengtrakulthong, Pichika Chantrathammachart, Pantep Angchaisuksiri, Ampaiwan Chuansumrit","doi":"10.2147/PPA.S633744","DOIUrl":"10.2147/PPA.S633744","url":null,"abstract":"<p><strong>Introduction: </strong>Adolescents and young adults with hemophilia (AYAwH) face several challenges that might affect their physical, psychological, social, and academic/occupational functioning. These factors may lead to non-adherence to treatment.</p><p><strong>Aim: </strong>The study aimed to identify the obstacles, limitations, and needs related to the pediatric-to-adult transition of care in AYAwH.</p><p><strong>Methods: </strong>A retrospective, mixed-methods study included 21 AYAwH (20 hemophilia A, 1 hemophilia B) aged 16-30 years. Satisfaction survey data and one-on-one interview responses were analyzed using both quantitative and qualitative approaches.</p><p><strong>Results: </strong>Their mean (SD) age was 23.8 (4.5) years old. The median (range) dose of factor prophylaxis was 9.35 (4.9-37) IU/kg/dose, 2-3 times/week. The three most common challenges in care were route of administration, lack of self-infusion skills, and pain. The majority of the AYAwH (85.7%) stated that hemophilia had the greatest impact on their quality of life. Additionally, 28.3% stated unwillingness to be transferred to the adult clinic, with the three biggest concerns being long waiting times at the adult clinic, changes in the insurance system, and a lack of a proper transition system. Key factors identified as contributing to a successful transfer to adult care included a multidisciplinary team, comprehensive education, and a structured transfer system.</p><p><strong>Conclusion: </strong>Hemophilia care in a limited-resource setting posed some challenges, mostly related to treatment and chronic arthropathy. There were also some concerns regarding the transfer of care to adults. Key requirements for a successful transfer included a multidisciplinary care team, continuous education, and a structured transition system.</p>","PeriodicalId":19972,"journal":{"name":"Patient preference and adherence","volume":"20 ","pages":"633744"},"PeriodicalIF":2.6,"publicationDate":"2026-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13604932/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149040286","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":"Pro-Rich Inequality in Health-Related Quality of Life Among Primary Care Diabetes Patients: A Cross-Sectional Study.","authors":"Haofei Li, Junyi He, Runhong Li, Yiyin Cao, Xu Jin, Yujin Wang, Mengyao Tian, Yanping Wang, Dongfu Qian, Weidong Huang, Yuchun Tao","doi":"10.2147/PPA.S625768","DOIUrl":"10.2147/PPA.S625768","url":null,"abstract":"<p><strong>Objective: </strong>This cross-sectional study aimed to assess HRQoL and to examine income-related inequalities among diabetes patients in Harbin, a cold-region city in China, where such evidence remains limited.</p><p><strong>Methods: </strong>In July 2025, 433 adults with diabetes were recruited from two community health centers in Harbin using random sampling from electronic health records. HRQoL was measured using the EuroQol 5-Dimension 5-Level (EQ-5D-5L) utility index and the EuroQol Visual Analogue Scale (EQ-VAS). Income-related inequality was quantified using the concentration index (CI) and the Erreygers-corrected CI. Wagstaff decomposition was applied to identify contributing factors, and horizontal inequity (HI) indices were computed after adjusting for need variables. Sensitivity analyses included Tobit model.</p><p><strong>Results: </strong>The mean EQ-5D-5L utility index was 0.9303 (SD = 0.1294), and the mean EQ-VAS score was 77.60 (SD = 12.88). Significant pro-rich inequality was observed for both outcomes (standard CI: 0.0093 for EQ-5D-5L and 0.0131 for EQ-VAS; Erreygers index: 0.0249 and 0.0405, respectively). Household income was the largest contributor to inequality, accounting for 73.30% of the inequality in EQ-5D-5L utility index and 53.77% of the inequality in EQ-VAS score. Other notable contributors included blood glucose control, exercise habits, marital status, and digital health literacy for EQ-5D-5L, and adherence to chronic disease follow-up and exercise habits for EQ-VAS. After adjusting for need variables, the HI remained positive for both measures (0.0095 for EQ-5D-5L and 0.0135 for EQ-VAS).</p><p><strong>Conclusion: </strong>Income-related inequalities in HRQoL were evident among primary care diabetes patients in this cold-region setting. Socioeconomic disparities and modifiable health behaviors are important correlates of HRQoL inequality, warranting further investigation in longitudinal studies.</p>","PeriodicalId":19972,"journal":{"name":"Patient preference and adherence","volume":"20 ","pages":"625768"},"PeriodicalIF":2.6,"publicationDate":"2026-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13604009/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149039894","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 a New Media Health Education Program in Patients with Chronic Kidney Disease.","authors":"Chunyan Zhang, Na Li, Guanghui Jiang, Mengqiu Zhao, Huimin Zhang, Zhifa Lun, Ying Liu","doi":"10.2147/PPA.S625265","DOIUrl":"10.2147/PPA.S625265","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the effectiveness of a new media-based stratified health education program in patients with chronic kidney disease (CKD).</p><p><strong>Methods: </strong>This single-center, prospective, non-randomized, quasi-experimental controlled intervention study screened 312 patients and enrolled 276 eligible patients (observation group, n=134; control group, n=142). After 1:1 propensity score matching, 100 patients per group were included in the matched analysis. The control group received conventional health education, whereas the observation group received a new media-based stratified health education program for 12 months. Health knowledge awareness, CKD self-management behavior, eGFR, UACR, and nursing satisfaction were evaluated.</p><p><strong>Results: </strong>After 12 months, health knowledge awareness was higher in the observation group than in the control group (89.00% vs 56.00%, P<0.001). CKD self-management scores were also higher in the observation group (all P<0.001). Both groups showed declining eGFR and increasing UACR; however, the changes were smaller in the observation group (both between-group follow-up comparisons P<0.01). The overall three-category nursing satisfaction distribution differed between groups (P<0.001), whereas the dichotomized satisfaction rate did not differ significantly (89.00% vs 82.00%, P=0.160).</p><p><strong>Conclusion: </strong>New media-based stratified health education was associated with better health knowledge and self-management outcomes in patients with CKD. The observed renal function differences should be interpreted cautiously because of the non-randomized design, residual confounding, and the 12-month follow-up. The binary nursing satisfaction rate was not significantly different between groups.</p>","PeriodicalId":19972,"journal":{"name":"Patient preference and adherence","volume":"20 ","pages":"625265"},"PeriodicalIF":2.6,"publicationDate":"2026-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13604015/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149040294","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}