Patient preference and adherence最新文献

{"title":"Medication Literacy and Social Support Among Adult Liver Transplant Recipients: A Cross-Sectional Study.","authors":"Huimin Niu, Juan Yao, Yahui Fu, Wenjin Yang, Lu Teng, Yijuan Gu, Li Yang","doi":"10.2147/PPA.S634448","DOIUrl":"10.2147/PPA.S634448","url":null,"abstract":"<p><strong>Purpose: </strong>Long-term medication self-management after liver transplantation remains challenging. This study assessed medication literacy among adult liver transplant recipients, examined its association with perceived social support, and descriptively explored self-reported immunosuppressant-taking behaviors.</p><p><strong>Patients and methods: </strong>A single-center cross-sectional survey was conducted among 161 adult liver transplant recipients attending outpatient follow-up at a tertiary grade A hospital in Nanjing, China. Medication literacy, perceived social support, demographic and clinical characteristics, and self-reported immunosuppressant-taking behaviors were collected using structured questionnaires. Group comparisons, multiple linear regression, and correlation analyses were performed. A post-hoc exploratory logistic regression was additionally conducted to examine factors associated with reporting any immunosuppressant non-adherence indicator.</p><p><strong>Results: </strong>Participants had a relatively high overall medication literacy score, although information acquisition was the weakest dimension. Educational level and perceived social support were independently associated with medication literacy. Family support showed the strongest correlation with medication literacy among social-support dimensions. More than half of participants reported at least one self-reported immunosuppressant-taking behavior indicating possible non-adherence, most commonly a deviation from the scheduled medication time, and higher perceived social support was associated with lower odds of immunosuppressant non-adherence in exploratory analysis.</p><p><strong>Conclusion: </strong>Medication literacy in adult liver transplant recipients was associated with educational level and perceived social support. The exploratory findings concerning immunosuppressant-taking behaviors require confirmation in prospective studies using validated and objective adherence measures.</p>","PeriodicalId":19972,"journal":{"name":"Patient preference and adherence","volume":"20 ","pages":"634448"},"PeriodicalIF":2.6,"publicationDate":"2026-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13599807/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149040281","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":"Patients' Experiences with and Perceptions of Personalized Glycemic Targets: A Qualitative Descriptive Study of Adults Living with Type 2 Diabetes  .","authors":"Allie S Carew, Robin Urquhart, Megan Aston, JianLi Wang, James Grove, Suyog More, Ferhan S Siddiqi, John L Sapp, Leah E Cahill","doi":"10.2147/PPA.S607575","DOIUrl":"10.2147/PPA.S607575","url":null,"abstract":"<p><strong>Purpose: </strong>Clinical practice guidelines for managing type 2 diabetes (T2D) recommend setting personalized glycemic targets for each patient based on factors such as diabetes duration, life expectancy, comorbidities, complications, and risk of hypoglycemia. This strategy aims to find a balance between the adverse effects of treatment linked to aggressive glycemic control, particularly hypoglycemia, and the potential long-term benefits, such as preventing coronary artery disease. However, there is limited research on patients' experiences with and perceptions of personalized glycemic targets. To address this gap, we sought to explore the experiences, perceptions, concerns, and preferences of individuals living with T2D regarding personalized glycemic targets. .</p><p><strong>Patients and methods: </strong>We used purposive sampling to recruit 25 adults who had been living with T2D for at least one year, from various healthcare settings, public libraries, and social media in Nova Scotia. From July to December 2024, we conducted semi-structured interviews (in-person or via Microsoft Teams), with durations ranging from 20 to 85 minutes. The interviews were recorded, transcribed, and analyzed using an inductive thematic analysis approach to uncover themes.</p><p><strong>Results: </strong>The dataset revealed four main themes: 1) personalized blood sugar goals and treatment plans could be beneficial; 2) personalized information and/or scientific evidence is desirable; 3) access to healthcare and relationships with healthcare providers may affect the implementation of personalized care; and 4) treatment burden needs to be considered when setting blood sugar target plans.</p><p><strong>Conclusion: </strong>The analysis of findings showed that people with T2D viewed personalized glycemic targets favorably and emphasized the importance of adequate primary care supports to enable implementation.</p>","PeriodicalId":19972,"journal":{"name":"Patient preference and adherence","volume":"20 ","pages":"607575"},"PeriodicalIF":2.6,"publicationDate":"2026-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13599796/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149039509","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":"Burden of Treatment and Disease on People with Hemophilia: Global Real-World Survey.","authors":"Giancarlo Castaman, Cléa Percier, Naveen Shridhar, Neil Reynolds, Olivera Rajkovic-Hooley, Thomas Dewar, Victor Jiménez-Yuste","doi":"10.2147/PPA.S617007","DOIUrl":"10.2147/PPA.S617007","url":null,"abstract":"<p><strong>Introduction: </strong>Although prophylactic treatments can reduce bleeding risk for people with hemophilia (PwH), burdens associated with treatment and physical and psychological symptoms may persist.</p><p><strong>Aim: </strong>To determine treatment and disease burden associated with hemophilia from a global perspective.</p><p><strong>Methods: </strong>This cross-sectional patient survey captured patient-reported outcomes, experiences and clinical data from PwH in eight countries between December 2023 and March 2024. Treatment burden was measured using the child/adult Hemophilia Treatment Experience Measure (Hemo-TEM), validated questionnaires covering five domains. Disease burden was measured using the Patient-Reported Outcomes Measurement Information System 29+2 version 2.1 (PROMIS-29+2)/PROMIS Parent Proxy, validated questionnaires comprising eight domains. Here we report data on treatment, physical and psychological burdens for people with moderate and severe hemophilia without inhibitors by treatment class: standard half-life and extended half-life factor replacement for hemophilia A (HA) and hemophilia B (HB), and non-factor therapy for HA.</p><p><strong>Results: </strong>Data from 495 PwH and parents/guardians of PwH were analyzed. Across the five Hemo-TEM domains, adults with HA experienced similar degrees of treatment burden regardless of treatment class, with comparable results observed for adults with HB. Around one-third of PwH experienced soreness (33% HA; 31% HB) and pain (31% HA; 26% HB) due to their current treatment at least sometimes, and one in five experienced some level of treatment bother. PROMIS-29+2 scores indicated that people with HA and HB experienced similar degrees of physical and psychological burden regardless of treatment class. Anxiety and worry were prevalent among PwH.</p><p><strong>Conclusion: </strong>PwH continue to experience treatment- and disease-related burdens. Managing hemophilia still requires a balance between bleed protection, quality of life and ease of treatment administration.</p>","PeriodicalId":19972,"journal":{"name":"Patient preference and adherence","volume":"20 ","pages":"617007"},"PeriodicalIF":2.6,"publicationDate":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13589989/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149012803","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":"Decisional Needs of Young Women (Aged 15-24 Years) in Contraceptive Choice: A Systematic Review.","authors":"Lewei Tu, Huijie Wu, Miao Dong, Ying Xiao","doi":"10.2147/PPA.S619256","DOIUrl":"10.2147/PPA.S619256","url":null,"abstract":"<p><strong>Background: </strong>Despite the wide range of contraceptive options available to women, young women worldwide are at risk of unintended pregnancy. Teenagers aged 15-19 account for 15% of abortions, while young women aged 20-24 represent 26% of abortion cases. This review aimed to identify the decisional needs of young women aged 15-24 years when considering contraceptive options based on the ODSF framework.</p><p><strong>Methods: </strong>The PRISMA reporting guidelines guided our methodology while we were theoretically directed by the Ottawa Decision Support Framework. Our review included six databases in English and three databases in Chinese, with no publication date limits applied. Two reviewers independently screened citations and performed quality assessment with MMAT while extracting data. Sixteen studies (10 qualitative, 5 quantitative, and 1 mixed-methods) were included. The study results underwent thematic synthesis.</p><p><strong>Results: </strong>Sixteen studies (10 qualitative, 5 quantitative, and 1 mixed-methods) were included. Six decisional needs were identified: decisional conflict, inadequate knowledge, unrealistic expectations, unclear values, inadequate support and resources, and personal/clinical needs. Inadequate knowledge and inadequate support and resources were the most frequently reported needs. In resource-limited settings, cultural stigma, financial barriers, and limited access to contraceptive services further complicated contraceptive decision-making.</p><p><strong>Conclusion: </strong>The review identified six decisional needs among young women considering contraceptive options. The findings support the applicability and validity of the Ottawa Decision-Support Framework (ODSF) in the context of young women's contraceptive decision-making, representing an important theoretical contribution of this review. Healthcare providers and policymakers should improve access to reliable contraceptive information, provide patient-centered and culturally sensitive counseling, and develop tailored decision-support tools. However, the restriction to English- and Chinese-language literature may limit the generalizability of the findings across diverse linguistic and cultural contexts.</p>","PeriodicalId":19972,"journal":{"name":"Patient preference and adherence","volume":"20 ","pages":"619256"},"PeriodicalIF":2.6,"publicationDate":"2026-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13588239/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149008873","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":"Development and Validation of a Self-Management Motivation Scale for Children with Chronic Diseases.","authors":"Xiaojing Ye, Xin Zhang, Cong Chen, Xiaonan Wu, Yulu Ren, Xulu Wang, Xiaofen Zheng, Runping Wang, Chintana Wacharasin, Chunmei Zhang","doi":"10.2147/PPA.S597373","DOIUrl":"10.2147/PPA.S597373","url":null,"abstract":"<p><strong>Background: </strong>Self-Determination Theory highlights the role of motivation in sustaining self-management behaviors among children with chronic diseases, but validated instruments for assessing this construct in pediatric populations are limited. This study developed and validated a self-management motivation scale for children aged 8-18 years with chronic diseases.</p><p><strong>Methods: </strong>Scale development proceeded in sequential phases. First, the initial item pool was developed by integrating evidence from relevant literature with findings from semi-structured interviews (n = 22). Second, items were refined through a two-round Delphi consultation with 20 experts to evaluate item importance and relevance, with expert authority and consensus assessed, followed by two rounds of cognitive interviews (n=13) and a pilot survey, yielding a 24-item preliminary scale. Third, item analysis was conducted in 143 children to remove poorly performing items. Finally, psychometric evaluation was performed in 386 children, including content validity, factor structure through EFA (n = 155) and CFA (n = 231), convergent and discriminant validity, internal consistency, split-half reliability, and test-retest reliability (n=30).</p><p><strong>Results: </strong>The final scale comprised 21 items across four dimensions: autonomous motivation, introjected regulation, external regulation, and amotivation. Content validity was strong (I-CVI=0.875-1.000; S-CVI/Ave=0.988). A four-factor structure emerged from the exploratory factor analysis, explaining 75.84% of the variance. Confirmatory factor analysis demonstrated a good model fit (χ²/df=1.755, RMSEA=0.057, CFI=0.965, IFI=0.965, TLI=0.960). AVE ranged from 0.612 to 0.778 and CR from 0.887 to 0.942, supporting convergent validity; discriminant validity was also satisfactory. At the subscale level, Cronbach's α, split-half reliability, and test-retest reliability coefficients ranged from 0.879 to 0.941, 0.865 to 0.932, and 0.763 to 0.944, respectively.</p><p><strong>Conclusion: </strong>The scale demonstrated satisfactory reliability and validity for assessing self-management motivation in children with chronic diseases. Further longitudinal and multicenter studies are needed to examine its predictive validity and intervention responsiveness.</p>","PeriodicalId":19972,"journal":{"name":"Patient preference and adherence","volume":"20 ","pages":"597373"},"PeriodicalIF":2.6,"publicationDate":"2026-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13588242/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149008941","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 Practices Regarding Oral Cancer Among Patients with Oral Cancer in Hunan Province, China: A Cross-Sectional Study.","authors":"Yanxu Lu, Qian Peng, Tong Su, Cheng Peng, Jingru Li, Ying Wu, Jing Xiong","doi":"10.2147/PPA.S631189","DOIUrl":"10.2147/PPA.S631189","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to assess oral cancer-related knowledge, attitudes, and practices (KAP) among patients in Hunan Province, thereby providing a scientific basis for precise prevention, control, and effective intervention strategies against oral cancer.</p><p><strong>Methods: </strong>A cross-sectional survey was conducted in two tertiary hospitals in Hunan Province, China. A Chinese KAP questionnaire collected sociodemographic characteristics and assessed knowledge, attitudes, and practices.</p><p><strong>Results: </strong>A total of 326 patients were included; most were male (89.9%), married (88.7%), and rural residents (55.8%). Median scores were 7.0 (IQR 6.0-8.0) for knowledge, 53.0 (IQR 48.0-56.5) for attitude, and 31.0 (IQR 28.0-34.0) for practice; total KAP score was 91.0 (IQR 84.0-96.0). Structural equation modeling showed K→A (β=0.499, P=0.020) and A→P (β=0.571, P<0.001); the indirect effect of knowledge on practice via attitude was significant (β=0.285, P=0.024) with 83.6% mediation (P<0.001). In multivariable analysis, attitude predicted practice (B=0.425, P<0.001); absence of hypertension was associated with higher practice (B=1.348, P=0.023), whereas ≥2-generation family history of oral cancer was associated with lower practice (B=-4.510, P=0.008). KAP domains were positively correlated, strongest for attitude-practice (r=0.518, P<0.01).</p><p><strong>Conclusion: </strong>Participants demonstrated insufficient knowledge, positive attitudes, and suboptimal practices. Attitude fully mediated the knowledge-practice relationship, indicating that improving attitudes may be pivotal for behavior change. A feasible clinical implication is to implement structured, hospital-based education plus follow-up reinforcement, prioritizing patients with comorbid hypertension and those with strong family-history burden of oral cancer.</p>","PeriodicalId":19972,"journal":{"name":"Patient preference and adherence","volume":"20 ","pages":"631189"},"PeriodicalIF":2.6,"publicationDate":"2026-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13584965/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148991102","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":"Humanistic Care Needs of Elderly Chronic Disease Inpatients from the Perspective of Patient Journey Mapping: A Qualitative Study.","authors":"Jing Zhao, Yuelin Zhang, Ge Bai, Yancen Wu, Tao Xue, Yanli Wang","doi":"10.2147/PPA.S636608","DOIUrl":"10.2147/PPA.S636608","url":null,"abstract":"<p><strong>Purpose: </strong>Based on patient journey maps, this study identified the behavioral challenges and needs for compassionate care among older inpatients with chronic diseases at different stages of diagnosis and treatment, and explored the pain points and preferences in their care experiences, thereby providing targeted insights to optimize compassionate care practices, enhance continuity of care, and improve patients' quality of life.</p><p><strong>Patients and methods: </strong>This descriptive qualitative study was conducted from January to April 2026 at a tertiary Grade A hospital in Hohhot, Inner Mongolia. Semi-structured in-depth interviews were conducted with 14 elderly inpatients with chronic diseases (ages 60-98; who had multiple comorbidities, primarily hypertension, coronary heart disease, and diabetes; most lived with their spouses). Semistructured in-depth interviews were conducted. Content analysis was used to systematically analyze the interview data. Using a patient journey map as a framework, themes were categorized along a horizontal timeline (four stages: admission, inspection, treatment, and discharge) and a vertical axis of tasks (three dimensions: behavioral challenges, emotional experiences, and humanistic care needs), and a visual journey map was constructed.</p><p><strong>Results: </strong>A total of 35 themes were identified, distributed across four stages and three dimensions. At the behavioral level, these included a high treatment burden during the admission stage; low psychological capital and excessive coping during the diagnostic stage; dependence on nursing care and avoidance of information during the treatment stage; and decreased adherence to self-management and reduced social participation during the discharge stage; The emotional dimension encompassed feelings of depression and helplessness, feelings of guilt toward family members, anxiety and worry, and a sense of being respected; the needs dimension involved a safe and supportive environment, age-appropriate information support, psychological buffering, personalized listening, visual medication guidance, and ongoing feedback channels. Ultimately, this resulted in the creation of a humanistic care journey map for elderly inpatients with chronic diseases.</p><p><strong>Conclusion: </strong>Elderly hospitalized patients with chronic illnesses exhibit distinct humanistic care needs at different stages throughout their hospitalization. The patient journey map developed in this preliminary study helps nurses identify key nursing priorities and provide targeted support tailored to each stage. In particular, the phased approach to information delivery may better prepare healthcare providers while strengthening connections with family members and community resources, facilitating a smoother transition for patients from hospital to home life. Before implementing this pathway routinely, further prospective feasibility assessments are needed.</p>","PeriodicalId":19972,"journal":{"name":"Patient preference and adherence","volume":"20 ","pages":"636608"},"PeriodicalIF":2.6,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13573789/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148970689","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":"Nurse and Patient Perspectives on Self-Management and mHealth Service Requirements of Patients with Neurogenic Bladder Following Spinal Cord Injury: A Qualitative Study Based on the Integrated Theory of Health Behavior Change.","authors":"Lulu Zheng, Weiyue Cong, Li Li, Yuantong Zang, Na Li, Guanzhong Yan","doi":"10.2147/PPA.S627888","DOIUrl":"10.2147/PPA.S627888","url":null,"abstract":"<p><strong>Purpose: </strong>Guided by the Integrated Theory of Health Behavior Change (ITHBC), this study aimed to explore self-management barriers and mobile health (mHealth) service requirements among patients with spinal cord injury-related neurogenic bladder from patient and nurse perspectives, providing evidence for developing a nurse-patient collaborative home-based self-management platform. The ITHBC highlights the synergistic interaction among knowledge and beliefs, self-regulation, and social support, fitting this study's goal of identifying multidimensional self-management barriers. Dual-perspective exploration also compensates for limitations of single-perspective studies and more comprehensively identifies clinical barriers and practical requirements.</p><p><strong>Patients and methods: </strong>This study adopted a descriptive qualitative design. Participants including 15 patients with neurogenic bladder following spinal cord injury and 11 nurses were recruited via purposive sampling from the Department of Rehabilitation Medicine and the Department of Spinal Surgery at a tertiary hospital in Inner Mongolia from August to December 2025. Semi-structured interviews were conducted, with telephone interviews for patients and face-to-face interviews for nurses. The ITHBC served as the conceptual framework; interview data were analyzed using Colaizzi's seven-step method.</p><p><strong>Results: </strong>Four themes were extracted: (1) knowledge and belief barriers; (2) self-regulation barriers; (3) social support barriers; (4) mHealth service requirements.</p><p><strong>Conclusion: </strong>Patients with neurogenic bladder following spinal cord injury suffer multidimensional self-management barriers, and conventional follow-up fails to meet their long-term home rehabilitation requirements. Guided by ITHBC, a mobile home-based self-management platform developed by integrating the requirements elicited from patients and nurses, may help address these self-management challenges and strengthen the social support chain, offering a new avenue for optimizing neurogenic bladder care. Nevertheless, implementation challenges including increased workload and legal liability warrant careful consideration. It should be noted that this is only a qualitative exploratory study. The conceptual mobile health platform proposed in this paper requires iterative development and effectiveness verification in future research before clinical implementation.</p>","PeriodicalId":19972,"journal":{"name":"Patient preference and adherence","volume":"20 ","pages":"627888"},"PeriodicalIF":2.6,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13571609/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148963653","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 and Relevance of the SPUR Behavioural Diagnostic Tool in the Management of Patients with Wilson's Disease: The WilSPUR Study.","authors":"Olivier Guillaud, Eduardo Couchonnal, Rodolphe Sobesky, Claire Vanlemmens, Jean-Baptiste Hiriart, Gersende Guédon, Kévin Dolgin","doi":"10.2147/PPA.S602505","DOIUrl":"10.2147/PPA.S602505","url":null,"abstract":"<p><strong>Background: </strong>Wilson's disease (WD) is a rare autosomal-recessive disorder of copper metabolism that can cause hepatic and/or neuropsychiatric manifestations, most often presents in young people. Lifelong treatment adherence is essential to prevent neurological deterioration, hepatic decompensation and death, yet non-adherence is frequent. Centres of the French national WD network evaluated the feasibility and the perceived utility of SPUR, a behavioural diagnostic tool, in the management of people living with WD.</p><p><strong>Methods: </strong>In this non-interventional, prospective, multicentre, non-comparative study, 100 adults with WD from four French centres completed the self-administered digital SPUR questionnaire, which estimates a non-adherence risk (NAR, 0-100) and identifies the individual behavioural drivers of that risk. Healthcare professionals (HCPs) then reported whether the SPUR results changed their perception of the patient, changed their support, and were useful overall.</p><p><strong>Results: </strong>The mean NAR was low (15.8/100). The predominant behavioural drivers were social (societal and immediate) and financial. Perceived health condition and perceived mental well-being were both inversely associated with the NAR. HCPs considered SPUR useful in 82% of cases, although the tool changed their perception of the patient in only 26.3% and their support in only 27.4% of cases. These findings are exploratory given the subjective clinician-reported endpoint and the selected cohort.</p><p><strong>Conclusion: </strong>Clinicians perceived SPUR as useful in a selected, hepatology-recruited WD cohort. Because the study had no comparator group, no objective adherence measure and no outcome follow-up, its effect on adherence behaviour and clinical outcomes remains to be established in prospective, controlled studies using objective adherence markers.</p>","PeriodicalId":19972,"journal":{"name":"Patient preference and adherence","volume":"20 ","pages":"602505"},"PeriodicalIF":2.6,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13571612/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148963475","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":"Development and Internal Validation of an Explainable Machine Learning Model for Physical Activity Adherence Among Community-Dwelling Patients with Type 2 Diabetes Mellitus.","authors":"Yiming Zhao, Mo Zhou, Feng Sun, Chuning Lin, Huimin Niu, Xinyi Zhang, Feng Jiang, Chuyan Wu","doi":"10.2147/PPA.S624754","DOIUrl":"10.2147/PPA.S624754","url":null,"abstract":"<p><strong>Background: </strong>Physical activity adherence is critical for effective diabetes management, yet non-adherence remains common in community settings. This study sought to construct and internally evaluate an interpretable machine learning model for identifying poor physical activity adherence among patients with Type 2 diabetes mellitus (T2DM) in a community-based setting.</p><p><strong>Methods: </strong>This single-center cross-sectional study included 207 patients with T2DM receiving community-based care at the Shiqiao Community Health Service Center, China, between January and September 2025. Candidate predictors were selected using Elastic Net regularization followed by multivariable logistic regression. Multiple machine learning algorithms were developed and compared using a randomly allocated training dataset (70%, n = 145) and an internal validation dataset (30%, n = 62). Model discrimination and clinical utility were assessed using the area under the receiver operating characteristic curve (AUC) and decision curve analysis (DCA), respectively. Shapley Additive exPlanations (SHAP) was used to interpret individual predictor contributions to model outputs.</p><p><strong>Results: </strong>Among the 207 participants, 113 (54.6%) demonstrated high physical activity adherence. The final model incorporated five key predictors: Summary of Diabetes Self-Care Activities (SDSCA) score, estimated glomerular filtration rate (eGFR_CKD-EPI_2009), family history of diabetes, International Physical Activity Questionnaire (IPAQ) score, and albumin (ALB). The SVM model achieved the highest discrimination ability among the tested algorithms and was subsequently selected as the final model (AUC = 0.787, 95% CI: 0.671-0.903). SHAP analysis provided transparent visualization of the relative contribution of each predictor to model outputs.</p><p><strong>Conclusion: </strong>This study provides an explainable machine learning approach for identifying key variables associated with physical activity adherence among individuals with T2DM in community diabetes management. Further validation in independent populations is needed before the model can be considered for risk assessment and personalized behavioral intervention planning in community diabetes care.</p>","PeriodicalId":19972,"journal":{"name":"Patient preference and adherence","volume":"20 ","pages":"624754"},"PeriodicalIF":2.6,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13571637/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148963488","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}