Patient preference and adherence最新文献

{"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}

{"title":"Respiratory Syncytial Virus (RSV) Vaccine Acceptance Among the Elderly in Al-Qassim Region, Saudi Arabia.","authors":"Moath Aljohani, Dawood Al-Oraini","doi":"10.2147/PPA.S630028","DOIUrl":"10.2147/PPA.S630028","url":null,"abstract":"<p><strong>Objective: </strong>The Respiratory Syncytial Virus (RSV) vaccine has recently been introduced in Saudi Arabia for adults aged 60 and older. There are limited published studies on this topic in Saudi Arabia for this age group. This study aimed to assess RSV vaccine acceptance among older adults in the Al-Qassim region of Saudi Arabia.</p><p><strong>Methods: </strong>The data were collected via online forms that invited participants aged 60 years and older, living in the Al-Qassim region, to participate. The study tool included items related to sociodemographic variables, chronic disease history, knowledge of the RSV disease, and perceived susceptibility and severity. In addition to previous RSV uptake and willingness to vaccinate, along with previous vaccination history for other indicated vaccines such as herpes zoster, Influenza, and Pneumococcal.</p><p><strong>Results: </strong>341 responses met the inclusion criteria. The majority of participants were aged < 70 years (74.5%), males (57.5%), and 38.1% had a university education or higher. 67.7% had at least one chronic disease, with diabetes being the most common (41.8%). The majority (83.6%) have never heard of RSV. Only 5 (1.5%) respondents reported prior uptake, while 16.1% demonstrated RSV acceptance overall. The most prominent facilitator among vaccine-acceptant individuals was physician or healthcare professional recommendation (45.5%). The most cited barriers among vaccine-hesitant or undecided individuals (n=286) were the perception of the RSV vaccine as \"a new vaccine\" (50.0%) and concerns about vaccine safety and effectiveness (44.1% and 26.2%, respectively). Only higher uptake of other indicated vaccines showed a significant association with vaccine acceptance (aOR 1.575, 95% CI 1.220-2.033, p < 0.001).</p><p><strong>Conclusion: </strong>The study demonstrated very low vaccine uptake and willingness, with reported barriers like concerns about the vaccine's recent introduction and uncertainty about its safety and effectiveness. Efforts tailored to educate the elderly about the vaccine's importance, safety, and effectiveness are needed to improve vaccine uptake.</p>","PeriodicalId":19972,"journal":{"name":"Patient preference and adherence","volume":"20 ","pages":"630028"},"PeriodicalIF":2.6,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13571643/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148963646","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":"Vision Restoration to People with Long-Term Blindness Using the Brain-Computer Interface Technology: A Sociotechnical Research Framework to Improve Usefulness for Users.","authors":"Zdenek Smutny, Milan Hudec, Ines Kožuh","doi":"10.2147/PPA.S615486","DOIUrl":"10.2147/PPA.S615486","url":null,"abstract":"<p><p>Invasive and non-invasive brain-computer interface (BCI) represent a promising technology for treating various diseases and disabilities. BCI-based invasive solutions also include visual prostheses. Currently, there is rapid development of cortical prostheses and bold statements, eg, about the potential of Neuralink's experimental neuroprosthetic Blindsight to restore vision. However, questions arise about the usefulness of such solutions for people with long-term blindness, considering other compensatory aids and referring to the empirical basis of cases where vision has been successfully restored surgically in the past. These cases reveal that biological restoration of sight does not guarantee functional vision. Moreover, technological limitations, such as low-resolution phosphene-based vision, individual variability or postoperative complications, reduce usability and usefulness for potential users. Therefore, we draw on literature on visual prostheses, documented cases of vision restoration, and employ a sociotechnical approach used in design science to discuss aspects that influence the usefulness of the vision restoration to people with long-term blindness, with emphasis on cortical prostheses. This approach emphasises the need to include or inscribe social values into designed BCI solutions to reveal what people with blindness need and what can be achieved with current technology. Research on user values and needs must shape the visual prostheses design, and their functions must be helpful to the user and synergistically complement his or her sociotechnical context (eg, interacting with other used aids and smart environments, or supporting needed social skills). Sociotechnical research can guide iterative design, improve future user acceptance and adoption, align prosthetic development with real-life needs, and prevent users from reverting to life with blindness due to cognitive overload or poor functional adaptation. Thus, we call for systematic and long-term sociotechnical research, which is lacking in this area. For this purpose, a relevant sociotechnical research framework and future research agenda are presented.</p>","PeriodicalId":19972,"journal":{"name":"Patient preference and adherence","volume":"20 ","pages":"615486"},"PeriodicalIF":2.6,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13571630/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148963616","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":"Factors Associated with Self-Management Behavior in Patients with Breast Cancer-Related Lymphedema.","authors":"Yuanjin Jiang, Qi Lan, Junzhen Jiang, Xueping Mao","doi":"10.2147/PPA.S620941","DOIUrl":"10.2147/PPA.S620941","url":null,"abstract":"<p><strong>Purpose: </strong>To construct and validate a structural equation model (SEM) examining the factors associated with self-management behavior in patients with breast cancer (BC)‑related lymphedema (BCRL), and to explore the direct and indirect relationships through which illness perception, psychological coherence, and perceived social support relate to self-management behavior.</p><p><strong>Patients and methods: </strong>Patients with BCRL who attended or were hospitalized in the breast surgery department of our hospital from January 2023 to January 2026 were identified. Medical records and previously completed questionnaire data, including demographic information, the Lymphedema Self-Management Behavior Questionnaire (LSMBQ) for BC patients, the Brief Illness Perception Questionnaire (BIPQ), the Sense of Coherence Scale-13 (SOC-13), and the Perceived Social Support Scale (PSSS), were retrospectively extracted and analyzed.</p><p><strong>Results: </strong>A total of 236 eligible participants were included. The mean total scores were: LSMBQ, 54.48 ± 10.80 (moderate level), BIPQ, 43.96 ± 7.61; SOC‑13, 63.30 ± 9.34; and PSSS, 40.47 ± 6.83. The SEM demonstrated good fit. Social support and psychological coherence showed significant positive direct associations with self-management behavior, whereas illness perception showed a significant negative direct association. Social support was also indirectly associated with self-management behavior through psychological coherence and illness perception.</p><p><strong>Conclusion: </strong>Self-management behavior in patients with BCRL was at a moderate level. Social support, psychological coherence, and illness perception were important associated factors. Healthcare professionals should consider enhancing patients' social support and psychological coherence to facilitate better self-management.</p>","PeriodicalId":19972,"journal":{"name":"Patient preference and adherence","volume":"20 ","pages":"620941"},"PeriodicalIF":2.6,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13571627/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148963552","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":"Identifying Key Intervention Attributes Driving Acceptability of Spouse/Partner-Centered HIV Interventions in Vietnam Using Conjoint Analysis.","authors":"Thi Huong Dang, Thi Thanh Thuy Dinh, Lynn T Nguyen, Truong Giang Nguyen, Le Minh Giang, Sung-Jae Lee, Chunqing Lin","doi":"10.2147/PPA.S635620","DOIUrl":"10.2147/PPA.S635620","url":null,"abstract":"<p><strong>Purpose: </strong>HIV care increasingly addresses the psychosocial challenges faced by people living with HIV. Spouse/partner-centered interventions have shown benefits for women living with HIV (WLWH) globally. However, evidence from Vietnam - a strongly family-oriented context - remains limited. Conjoint analysis (CA) is a method for assessing intervention acceptability by examining how specific intervention attributes influence respondents' willingness to engage. This study uses CA to identify key attributes driving acceptability of spouse/partner-centered interventions among Vietnamese WLWH and their partners, and to explore associations between participant characteristics and individual-level attribute impact scores.</p><p><strong>Methods: </strong>Fifty WLWH and thirty male partners completed an anonymous REDCap survey rating six hypothetical spouse/partner-centered intervention scenarios varying in key attributes (including format, duration, spouse/partner involvement, session type, facilitator, and targeted outcomes). Willingness to participate in each intervention was rated on a 5-point Likert scale. Mixed-effects ordered logistic regression was applied to assess the likelihood of participation. Exploratory Spearman correlation analyses explored associations between participant characteristics and individual-level attribute impact scores.</p><p><strong>Results: </strong>In the full-sample analysis, session type had the strongest impact on the likelihood of participation (impact score = -1.65; p = 0.029), followed by spouse/partner involvement (impact score = 0.99; p = 0.022), intervention duration (impact score = 0.94; p = 0.003), and facilitator type (impact score = 0.89; p = 0.039). Exploratory analyses found no significant associations between participant characteristics and attribute impact scores (all p > 0.05).</p><p><strong>Conclusion: </strong>CA identified key intervention attributes influencing willingness to participate in spouse/partner-centered interventions. Session type, spouse/partner involvement, intervention duration, and facilitator type should be considered when developing culturally appropriate interventions for WLWH in Vietnam and similar settings. The absence of significant associations in the exploratory analyses highlights the value of larger studies with more choice scenarios to better identify factors associated with individual variation in intervention preferences.</p>","PeriodicalId":19972,"journal":{"name":"Patient preference and adherence","volume":"20 ","pages":"635620"},"PeriodicalIF":2.6,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13571676/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148963563","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":"Decision Fatigue and Associated Factors Among Patients with Hematologic Malignancies: Implications for Patient-Centered Decision Support.","authors":"Haiyan Hu, Min Wang, Xiaocui Wang, Luojin Zhang, Xiaomei Han, Jingfang Hong","doi":"10.2147/PPA.S624982","DOIUrl":"10.2147/PPA.S624982","url":null,"abstract":"<p><strong>Background: </strong>Patients with hematologic malignancies frequently face complex, repeated treatment decisions that may increase decision fatigue (DF) risk. However, evidence on DF and its correlates in this population remains scarce. This study aimed to investigate the level of DF and identify associated factors among patients with hematologic malignancies.</p><p><strong>Methods: </strong>A cross-sectional study was conducted with 322 patients receiving treatment at a tertiary hospital in Anhui, China, between October 2024 and May 2025. Participants completed validated scales assessing DF, decision preparation, decision self-efficacy, anxiety, depression, and sleep quality. Independent-samples t-tests, one-way analysis of variance (ANOVA), Pearson correlation analysis, and multiple linear regression were performed to identify factors associated with DF.</p><p><strong>Results: </strong>The mean DF score was 13.30 ± 5.02, which was close to the midpoint of the 0-27 Decision Fatigue Scale. DF was negatively correlated with decision preparation and decision self-efficacy (both <i>P</i> < 0.001), and positively correlated with anxiety, depression, and poor sleep quality (all <i>P</i> < 0.001). Female gender, caregiver presence, shorter disease duration, disease recurrence, lower decision preparation, lower decision self-efficacy, and poorer sleep quality were independently associated with higher DF levels (all <i>P</i> < 0.05). The regression model explained 69.0% of the variance in DF.</p><p><strong>Conclusion: </strong>Patients with hematologic malignancies exhibit decision fatigue levels near the scale midpoint, which are associated with multiple psychological and contextual factors. These findings can inform the development of patient-centered decision support strategies, though longitudinal and interventional studies are needed to confirm causal pathways and intervention efficacy.</p>","PeriodicalId":19972,"journal":{"name":"Patient preference and adherence","volume":"20 ","pages":"624982"},"PeriodicalIF":2.6,"publicationDate":"2026-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13570657/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148956347","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":"Diagnostic Prediction Models for Oral Frailty in Older Adults: A Systematic Review and Critical Appraisal.","authors":"Yuzhu Fan, Shuang Zhang, Yinuo Wang, Zhirun Cheng, Xueer Yu, Yuanyuan Chen, Hui Shi, Wangqin Shen","doi":"10.2147/PPA.S621510","DOIUrl":"10.2147/PPA.S621510","url":null,"abstract":"<p><strong>Background: </strong>Oral frailty is a clinically relevant marker of vulnerability in older adults, but the quality, performance, and applicability of multivariable models for its identification remain uncertain.</p><p><strong>Objectives: </strong>To identify and critically appraise multivariable prediction models for oral frailty and summarize their predictors, performance, validation, and risk of bias.</p><p><strong>Methods: </strong>Nine English and Chinese language databases were searched from inception to 14 July 2026, supplemented by citation and website searches. Two reviewers independently selected studies, extracted data, and assessed risk of bias and applicability using the Prediction Model Risk of Bias Assessment Tool (PROBAST). Owing to substantial heterogeneity, findings were synthesized narratively.</p><p><strong>Results: </strong>Twenty-three reports representing 22 independent studies and 22 models were included. Twenty-one studies were conducted in China, 21 used cross-sectional data, and 21 defined oral frailty as an Oral Frailty Index-8 score ≥4. All models were diagnostic and identified prevalent oral frailty at assessment; none predicted incident oral frailty. Logistic regression and nomograms were the most common approaches, although two studies compared multiple machine-learning algorithms. Common predictors included age, nutritional vulnerability, physical frailty or sarcopenia, chronic disease burden, smoking, and oral-function indicators. Reported area under the receiver operating characteristic curve (AUC) values ranged from 0.713 to 0.985. Internal validation was reported for 20 models, while six models underwent external validation (four temporal and two geographical); one model reported apparent performance only. Calibration was incompletely assessed, and no model had an overall low risk of bias.</p><p><strong>Conclusions: </strong>Existing models show generally moderate-to-high discrimination, but the evidence remains methodologically immature. Predominantly cross-sectional designs, high risk of bias, predictor-outcome overlap, incomplete calibration, and limited external validation, especially across geographical settings, preclude routine clinical use. Current models should be regarded as candidate diagnostic screening aids that complement standardized assessment; rigorous external validation and prospective prognostic modelling are priorities.</p><p><strong>Prospero registration: </strong>CRD420251229868.</p>","PeriodicalId":19972,"journal":{"name":"Patient preference and adherence","volume":"20 ","pages":"621510"},"PeriodicalIF":2.6,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13564451/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148956312","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":"Health-Related Quality of Life Among Patients with Treatment-Resistant Schizophrenia Receiving Clozapine-Based Therapy in South Kalimantan, Indonesia.","authors":"Karina Erlianti, Mohammed Alfaqeeh, Irma Melyani Puspitasari, Fredrick Dermawan Purba, Auliya A Suwantika","doi":"10.2147/PPA.S628920","DOIUrl":"10.2147/PPA.S628920","url":null,"abstract":"<p><strong>Background: </strong>Treatment-resistant schizophrenia (TRS) is associated with impairment and reduced health-related quality of life (HRQoL). Although clozapine is the standard treatment for TRS, evidence regarding HRQoL across clozapine-based regimens in low- and middle-income settings remains limited. This study evaluated HRQoL among clinically stable outpatients with TRS receiving clozapine-based therapy in Indonesia.</p><p><strong>Methods: </strong>A cross-sectional study was conducted at the mental hospital between November 2024 and January 2025. Participants (n = 147) received clozapine as monotherapy or in combination with first-generation antipsychotics (FGAs), second-generation antipsychotics (SGAs), or both. HRQoL was assessed using the Indonesian EQ-5D-5L and EQ-VAS. Differences across regimens were assessed using the Kruskal-Wallis test, followed by Mann-Whitney U pairwise comparisons with Bonferroni correction. Spearman's rank correlation assessed the association between EQ-5D-5L utility and EQ-VAS. Adjusted general linear models examined associations between treatment regimen and HRQoL after accounting for sociodemographic and characteristics.</p><p><strong>Results: </strong>Mean EQ-5D-5L utility and EQ-VAS scores were 0.804 ± 0.10 and 73.64 ± 9.46. Mobility was the least affected domain (95.2% reporting no problems), whereas impairment was observed in usual activities and anxiety/depression. EQ-5D-5L utility was positively correlated with EQ-VAS (Spearman's <i>ρ</i> = 0.606, p < 0.001). Both utility and EQ-VAS differed across treatment regimens (both p < 0.001), with the clozapine + FGA group showing the lowest scores. After adjustment, treatment regimen remained associated with utility (p = 0.002) and EQ-VAS (p < 0.001).</p><p><strong>Conclusion: </strong>Clinically stable outpatients with TRS receiving clozapine-based therapy demonstrated favorable HRQoL, although impairments persisted in psychological well-being and daily functioning. Treatment regimen remained associated with both HRQoL measures after adjustment. These findings represent associations rather than causal effects and support individualized treatment selection, monitoring of treatment burden, and integration of psychosocial interventions.</p>","PeriodicalId":19972,"journal":{"name":"Patient preference and adherence","volume":"20 ","pages":"628920"},"PeriodicalIF":2.6,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13564454/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148956320","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":"Latent Class Analysis of Medication Adherence and Its Influencing Factors Among Rural Hypertensive Patients in Shanxi Province, China.","authors":"Wenhua Sun, Ruifeng Liang, Jiawei Liu, Siyi Li, Jue Wang","doi":"10.2147/PPA.S606748","DOIUrl":"10.2147/PPA.S606748","url":null,"abstract":"<p><strong>Purpose: </strong>To establish latent classes of medication adherence and related influencing factors of hypertensive patients residing in rural areas of Shanxi Province as references to improve medication adherence.</p><p><strong>Patients and methods: </strong>Patients diagnosed with primary hypertension were randomly selected from three counties in Shanxi Province from May to July 2024 using a multistage cluster random sampling method. Patient data were collected using a questionnaire that captured basic demographic information, medication knowledge, medication beliefs, and medication adherence. Latent class analysis (LCA) was employed to differentiate medication adherence patterns among the participants. Univariate and multinomial logistic regression analyses were conducted to compare socio-demographic characteristics, medication usage, medication-related knowledge, and medication beliefs in order to identify significant predictors across medication adherence classes.</p><p><strong>Results: </strong>LCA identified three distinct subtypes of medication adherence among hypertensive patients (n = 739) in rural Shanxi Province: high (58.3%), low (19.8%), and forgetful (21.9%). The entropy value of 0.910 indicated excellent classification quality. Multinomial logistic regression analysis indicated that patients with no/mild/moderate burden of hypertension treatment and mild depression were more likely to be assigned to the low medication adherence group. Conversely, higher self-efficacy scores were positively associated with categorization into the high medication adherence group (<i>p</i> < 0.05). As compared to the forgetful non-adherent group, male participants and higher medication knowledge scores were more likely to be classified into the high medication adherence group (<i>p</i> < 0.05).</p><p><strong>Conclusion: </strong>Medication adherence among hypertensive patients residing in rural areas can be categorized into three main types (high, low, and forgetful) and five primary influencing factors were identified (sex, treatment burden, depressive mood, medication knowledge, and self-efficacy). Enhancing family support, improving medication-related knowledge, and strengthening self-efficacy can effectively improve medication adherence of hypertensive patients.</p>","PeriodicalId":19972,"journal":{"name":"Patient preference and adherence","volume":"20 ","pages":"606748"},"PeriodicalIF":2.6,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13564455/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148956326","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 Hyperuricemia and Sleep Among Patients: A Cross-Sectional Study.","authors":"Qi Zhang, Juan Wu, Xiaoxue Wang, Xiaorong Li, Jiaqi Yang, Bingqing Zhang, Yun Zhang, Xuejun Zeng","doi":"10.2147/PPA.S617542","DOIUrl":"10.2147/PPA.S617542","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to assess patients' knowledge, attitudes, and practices (KAP) regarding hyperuricemia and sleep.</p><p><strong>Patients and methods: </strong>A cross-sectional study was conducted from August 6 to October 21, 2024, at Peking Union Medical College Hospital. Participants with hyperuricemia were recruited using electronic convenience sampling via a QR-code-based questionnaire distributed through WeChat. A self-developed questionnaire was used to collect baseline characteristics and KAP data. Knowledge, attitude, and practice scores ranged from 0-20, 8-40, and 7-35, respectively. For logistic regression analyses, KAP scores were dichotomized at the median values (knowledge: 13, attitude: 32, practice: 23).</p><p><strong>Results: </strong>A total of 691 valid questionnaires were analyzed, and 68.3% of participants had hyperuricemia for more than 2 years. The mean (SD) knowledge, attitude, and practice scores were 13.61 (5.31), 33.25 (5.05), and 24.48 (5.05), respectively. Based on the median cut-offs, 361 participants had higher knowledge scores and 330 had lower scores; 371 had higher attitude scores and 320 had lower scores; and 360 had higher practice scores and 331 had lower scores. Positive correlations were observed among KAP scores (r=0.352-0.565, all P<0.001). Having family members or friends with hyperuricemia was positively associated with knowledge (OR=1.518, 95% CI: 1.052-2.189, P=0.026), whereas uncertainty about snoring during sleep was negatively associated (OR=0.558, 95% CI: 0.323-0.963, P=0.036). Higher knowledge scores, having family members or friends with hyperuricemia, and irregular sleep were positively associated with attitude, whereas age ≥65 years was negatively associated. Higher knowledge scores, higher attitude scores, and age 45-64 years were positively associated with practice, whereas rare sleep regularity was negatively associated. Structural equation modeling showed direct associations among KAP, and knowledge also had an indirect association with practice (β=0.200, 95% CI: 0.132-0.268, P<0.001).</p><p><strong>Conclusion: </strong>Patients with hyperuricemia exhibited inadequate knowledge, positive attitudes, and insufficient practices regarding hyperuricemia and sleep. Targeted educational and behavioral interventions may help improve disease and sleep management.</p>","PeriodicalId":19972,"journal":{"name":"Patient preference and adherence","volume":"20 ","pages":"617542"},"PeriodicalIF":2.6,"publicationDate":"2026-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13557157/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148920357","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}