Patient Preference And Adherence[JOURNAL]
Sun
200 papers
Navigating Adversity: Psychosocial Transformation, Service Advocacy, and End-of-Life Perceptions Among Family Caregivers of PLWHA During Inpatient Treatment in Hunan, China.
Shi C, Long X, Dai Y … +4 more , Chen M, Li X, Lei Y, Yuan W
Patient Prefer Adherence · 2026 · PMID 42222241 · Full text
BACKGROUND: The HIV epidemic remains a global challenge. In China, family caregivers bear most caregiving responsibilities for people living with HIV/AIDS (PLWHA). However, the lived experiences of these caregivers regar...
BACKGROUND: The HIV epidemic remains a global challenge. In China, family caregivers bear most caregiving responsibilities for people living with HIV/AIDS (PLWHA). However, the lived experiences of these caregivers regarding psychosocial transformation, service advocacy, and end-of-life perceptions during hospitalization remain underexplored within the Chinese sociocultural context. METHODS: From August 2024 to January 2025, a descriptive qualitative design was utilized to interview 17 family caregivers of inpatients with HIV/AIDS at the Infectious Disease Ward of the Second People's Hospital in Chenzhou, Hunan Province. Data were collected through face-to-face in-depth interviews and analyzed using the thematic analysis method with NVivo 14. The criteria of credibility, dependability, transferability, and confirmability were applied to ensure rigor. RESULTS: Seventeen participants (nine females, 52.9%; eight males, 47.1%) aged 22 to 74 years were interviewed. Three major themes emerged: (1) positive transformation and growth (psychological resilience, caregiving responsibility, caregiving capital, and family bonds); (2) advocacy for enhanced services (psychological support, HIV education and medication management, healthcare accessibility, respectful non-discriminatory care, and financial relief); (3) complex death perceptions (diverse attitudes towards death, anticipatory grief, and dignified dying). CONCLUSION: The findings reveal that family caregivers of PLWHA experience positive personal growth, hold complex end-of-life perceptions, and advocate for service improvements. Healthcare policies and clinical practices are recommended to develop structured, family-centered support interventions, including professional psychological support, financial assistance, as well as integrated end-of-life care and death education for both PLWHA and their families.
Extended Consultations as a Trial Intervention in General Practice: Experiences of Patients with Complex Multimorbidities.
Fryd R, Barrett BA, Lundstrøm SL … +2 more , Frølich A, Aamann IC
Patient Prefer Adherence · 2026 · PMID 42222240 · Full text
BACKGROUND: Multimorbidity poses significant challenges for healthcare systems worldwide, particularly for patients with complex multimorbidity (CMM). The Complex Intervention for Multimorbidity version 2 (CIM2) was desi...
BACKGROUND: Multimorbidity poses significant challenges for healthcare systems worldwide, particularly for patients with complex multimorbidity (CMM). The Complex Intervention for Multimorbidity version 2 (CIM2) was designed to enhance integrated patient-centered care. AIM: This qualitative study aimed to explore patients' experiences with the CIM2 intervention, focusing on their perceptions of extended consultations and identifying factors that influenced their experiences, which were either beneficial or challenging. METHODS: This is a qualitative evaluation conducted as a part of the CIM2 intervention, drawing on data from 13 semi-structured interviews with patients with CMM. Eight of the interviews included the patients' spouses. The interviews were analyzed using thematic analysis. RESULTS: Three patients found the extension beneficial, appreciating the increased time for discussions and feeling genuinely heard by their GPs. Two patients perceived partial benefit, valuing the extra time but finding the consultation similar to regular appointments. However, six patients experienced no benefit, citing unclear communication about the consultation purpose, a lack of continuity when seen by an unfamiliar GP, and superficial interactions despite the extended time. Two patients did not recall attending the extended consultations. DISCUSSION: Although some patients appreciated the extra time and personalized attention, others found the consultations confusing, superficial, or indistinguishable from regular visits. Crucial factors influencing benefits included clear communication about the consultation's purpose, being heard and understood, and continuity with familiar GPs. Notably, those with the most fragmented care and highest treatment burden often derived the least benefit. These findings underscore the importance of better communication, preparation, and continuity. CONCLUSION: Although some patients with complex multimorbidity valued extended consultation time, time alone proved insufficient to ensure meaningful care experiences. Better communication regarding the purpose of the consultation and patient preparation was essential to improving the overall quality and relevance of the encounter.
Family Function and Self-Management in Glaucoma Patients: Chain Mediation of Psychological Capital and Coping Style.
Liu Y, Zhang J, Zhang Q … +2 more , Sa R, Xu H
Patient Prefer Adherence · 2026 · PMID 42222239 · Full text
PURPOSE: Glaucoma is an irreversible blinding disease, and patients' self-management ability directly influences both disease progression and quality of life. We aimed to study the relationship between family functioning...
PURPOSE: Glaucoma is an irreversible blinding disease, and patients' self-management ability directly influences both disease progression and quality of life. We aimed to study the relationship between family functioning and patient self-management behaviors, and mediating roles of psychological capital and coping styles. PATIENTS AND METHODS: Drawing from the theory of personal and family self-management, the present cross-sectional study proposed a conceptual model to assess the influence of family functioning on self-management behaviors in patients with glaucoma. The mediating effects of psychological capital and coping styles were also explored. We recruited 336 patients to participate in this study. A relational model was constructed using structural equation modeling, and bootstrap analyses were conducted to assess the mediation effects. RESULTS: A strong positive link was identified between family functioning and self-management behaviors (r = 0.506, < 0.01). Psychological capital and positive coping styles showed significant mediating effects, with effect sizes of 0.198 and 0.151, which represented 35.04% and 26.73% of the total effect, respectively. Furthermore, the combined chain mediating effect of these two variables was 0.049, representing 8.67% of the total effect. CONCLUSION: Family functioning not only has a direct impact on self-management but also indirectly enhances the self-management capacity of glaucoma patients through psychological capital and positive coping styles. The findings implicated that a family-centered approach should be adopted to place family functioning in a central role to improve the psychological resources and promote adoption of positive coping mechanisms, ultimately leading to better self-management outcomes in glaucoma patients.
Knowledge, Attitude, and Practice Toward Long-Term Anticoagulation in Patients with Venous Thromboembolism: A Cross-Sectional Study.
Liu Z, Long J, Wang K … +3 more , Chen J, Liu C, Jian Z
Patient Prefer Adherence · 2026 · PMID 42222238 · Full text
BACKGROUND: This study aimed to explore the knowledge, attitude, and practice related to long-term anticoagulation therapy among patients with venous thromboembolism (VTE). METHODS: A cross-sectional study using a conven...
BACKGROUND: This study aimed to explore the knowledge, attitude, and practice related to long-term anticoagulation therapy among patients with venous thromboembolism (VTE). METHODS: A cross-sectional study using a convenience sampling approach was conducted at the Interventional Vascular Surgery Center of Affiliated Hospital of Shandong Second Medical University from July 2025 to October 2025. A self-developed questionnaire based on the KAP framework was used for data collection, comprising three dimensions: knowledge (12 items), attitude (7 items), and practice (12 items, of which 5 scored items were used to calculate the practice domain score). Age-stratified subgroup analyses were conducted, and structural equation modeling was performed using AMOS 26.0 with bias-corrected bootstrap resampling to assess direct and indirect effects. RESULTS: A total of 389 patients with VTE were included, with a mean age of 45.62 years. Male patients accounted for 55.53% of the respondents. The mean scores were 40.87 ± 10.35 (possible range: 12-60) for knowledge, 24.61 ± 5.32 (possible range: 7-35) for attitudes, and 19.41 ± 4.15 (possible range: 5-25) for practices. Based on the predefined 70% threshold, 206 patients (52.96%) met the criterion for adequate knowledge, whereas 183 (47.04%) were below this threshold. In addition, 231 (59.38%) had a positive attitude and 295 (75.84%) had proactive practice. Age-stratified analysis showed significant differences in knowledge, attitude, and practice scores across age groups (P < 0.001, P < 0.001, and P = 0.047, respectively), with patients aged <45 years showing higher knowledge and attitude scores than older groups. Correlation analysis showed that knowledge was positively correlated with attitude (r = 0.597, P < 0.001), knowledge was positively correlated with practice (r = 0.364, P < 0.001), and attitude was positively correlated with practice (r = 0.487, P < 0.001). Structural equation modeling (SEM) results showed that attitude had a direct effect on practice (β = 0.674, 95% CI: 0.327-1.068, P = 0.018), while knowledge indirectly affected practice through attitude (β = 0.473, 95% CI: 0.185-0.783, P = 0.025). CONCLUSION: Patients with VTE showed suboptimal knowledge, positive attitudes, and proactive practices towards long-term anticoagulation therapy. To enhance treatment adherence and safety, future clinical strategies should prioritize structured, attitude-oriented educational interventions that not only convey essential knowledge but also address patient concerns and behavioral barriers through individualized, longitudinal support mechanisms.
Barriers to Adherence to Remote Pelvic Floor Muscle Training Among Postpartum Women: A Qualitative Study Guided by the COM-B Model.
Zhou D, Ni X, Ding M … +1 more , Shi H
Patient Prefer Adherence · 2026 · PMID 42205407 · Full text
BACKGROUND: Pelvic floor muscle training (PFMT) is recognized as the first-line conservative intervention for postpartum pelvic floor rehabilitation. Remote pelvic floor muscle training, defined as a training modality co...
BACKGROUND: Pelvic floor muscle training (PFMT) is recognized as the first-line conservative intervention for postpartum pelvic floor rehabilitation. Remote pelvic floor muscle training, defined as a training modality conducted at home via mobile applications, online platforms, teleconsultation, or application-based reminders, without real-time on-site supervision, has expanded the accessibility of rehabilitation services; however, patient adherence remains suboptimal. Elucidating the barriers to adherence is critical for developing effective and well-accepted intervention strategies. This study, grounded in the Capability, Opportunity, Motivation-Behavior (COM-B) model, investigated various barriers to adherence among postpartum women engaged in remote pelvic floor muscle training. METHODS: A qualitative descriptive study was conducted at a pelvic floor rehabilitation clinic in Wuxi, China, between November and December 2025. Fifteen postpartum women aged 27-36 years (6 weeks to 6 months postpartum) participated. The sample included primiparous and multiparous women, both vaginal and cesarean deliveries, and mixed symptomatic and asymptomatic participants. All had prior experience with at least one remote PFMT modality within the preceding six months. Semi-structured interviews were analyzed using directed content analysis guided by the COM-B model. Thematic saturation was reached after 12 interviews and confirmed with 3 additional interviews. Analytical rigor was ensured through independent double-coding of all transcripts, inductive code allowance, audit trail, and member checking. RESULTS: Eleven barriers were identified across the three COM‑B domains. Capability barriers comprised knowledge deficits, skill deficits, and physical discomfort. Opportunity barriers comprised caregiving burden, limited professional support, inadequate family support, and technological constraints. Motivation barriers comprised low perceived urgency, lack of perceived benefits, low self‑efficacy, and habit formation difficulties. Barriers did not operate in isolation: inadequate knowledge reduced perceived urgency, limited professional feedback amplified skill uncertainty and lowered self‑efficacy, caregiving burden simultaneously restricted opportunity and depleted physical and cognitive resources, and technological friction converted convenience into a motivational cost. CONCLUSION: Postpartum women face multiple, interrelated barriers to remote PFMT adherence spanning all COM‑B domains. A blended care model that combines initial in‑person technique verification, low‑friction digital platforms with structured cues and progress tracking, periodic professional tele‑follow‑up, and family engagement components may more effectively address these barriers than standalone self‑guided remote delivery. These findings provide theory‑based, actionable guidance for designing hybrid postpartum rehabilitation services.
Development and Psychometric Evaluation of a Novel Medication Adherence Scale for Patients with Chronic Diseases in Low- and Middle-Income Countries.
Khoiry QA, Alfian SD, Van Boven JFM … +2 more , Jatnika R, Abdulah R
Patient Prefer Adherence · 2026 · PMID 42200170 · Full text
INTRODUCTION: Existing instruments for assessing medication nonadherence lack sufficient insights into the specific barriers to Low-Middle-Income-Countries (LMICs), thus limiting their utility in developing tailored inte...
INTRODUCTION: Existing instruments for assessing medication nonadherence lack sufficient insights into the specific barriers to Low-Middle-Income-Countries (LMICs), thus limiting their utility in developing tailored intervention approaches. This cross-sectional scale development and validation study therefore aimed to develop and validate a patient-centered, self-reported scale to identify patients' medication adherence and barriers relevant to LMICs contexts among people with chronic diseases. METHODS: This study had three-phases: (i) item development, (ii) content and face validity, and (iii) psychometric analysis. After item development, the items were refined through Item Content Validity Index (I-CVI) assessment and patient pre-testing. The third phase evaluated psychometric properties along with an assessment of agreement with objective clinical indicators (blood pressure and fasting blood glucose) and comparison with the validated scales Medication Adherence Report Scale-5 (MARS-5) and VAS Adherence using 419 patients. Statistical analyses included confirmatory factor analysis (CFA) to determine model fit. We also determined reliability and assessed test-retest reliability. RESULTS: A final set of 15 items were selected, which were grouped into 4 dimensions: patient, medication, healthcare system, and socioeconomic related-barriers. The CFA showed that the data was fit for the model (χ179.477, P<0.001, RMSEA=0.052, CFI=0.961, GFI=0.947). The reliability test showed a good internal consistency (Cronbach's-α=0.727 and McDonalds- Ω=0.812) and test-retest reliability (correlation coefficient 0.802). The new scale exhibited strong negative correlations with MARS-5 (r=-0.707) and VAS Adherence (r=-0.725), and a moderate negative correlation with clinical measurements (r=-0.632). CONCLUSION: A psychometrically validated 15-item scale to assess medication adherence and its barriers in patients with chronic disease was developed, offering a reliable, contextually relevant tool that addresses information gaps and supports tailored interventions for improved patient outcomes in LMIC settings.
Factors Associated with the Transition from Discharge Preparation to Home Rehabilitation in Elderly Day Surgery: A Structural Equation Modeling Study.
Wu M, Huang C, Xu Y … +3 more , Zhao L, Dai W, Xia L
Patient Prefer Adherence · 2026 · PMID 42200169 · Full text
PURPOSE: To explore the key factors influencing the transition from discharge preparation to home-based rehabilitation in elderly day surgery patients. PATIENTS AND METHODS: A cross-sectional study was conducted on 340 e...
PURPOSE: To explore the key factors influencing the transition from discharge preparation to home-based rehabilitation in elderly day surgery patients. PATIENTS AND METHODS: A cross-sectional study was conducted on 340 elderly patients (≥60 years) who underwent day surgery at Huadong Hospital Affiliated to Fudan University in Shanghai from November 2024 to September 2025. Standardized scales were used to conduct questionnaire surveys, and the collected data were analyzed by means of correlation analysis, multiple linear regression and structural equation modeling (SEM). RESULTS: Correlation analysis revealed that discharge readiness was positively correlated with gender, health behavior capacity and discharge teaching quality, while it presented a negative correlation with family support (P<0.05). Multiple linear regression further verified that health behavior capacity served as a significant positive predictive factor for discharge readiness (=0.233, P<0.001). However, the SEM yielded inconsistent findings: family support exhibited the strongest positive direct predictive effect on discharge readiness with a path coefficient of 0.47, health behavior capacity showed a weak positive predictive effect (path coefficient = 0.31), and discharge teaching quality exerted only a trivial impact (path coefficient = 0.15). The contradictory results between correlation analysis and SEM might be attributed to the complex mediating or moderating relationships among latent variables in the holistic model. CONCLUSION: Family support is the core factor, and health behavior capacity is an important factor affecting the discharge readiness of elderly day surgery patients, while the current discharge teaching has a limited direct effect. In clinical practice, it is necessary to strengthen family support, improve patients' health behavior self-efficacy, and optimize the discharge teaching model with effective linkage to family support. Further research should adopt multi-center longitudinal studies with extended variables to obtain more comprehensive and accurate results.
Barriers and Facilitators to Treatment Adherence in Patients with Peripheral Artery Disease: A Qualitative Study of Patients with PAD, Relatives and Healthcare Professionals.
Lampridou S, Bolton Saghdaoui L, Judah G … +2 more , Davies AH, Wells M
Patient Prefer Adherence · 2026 · PMID 42200168 · Full text
BACKGROUND: Peripheral artery disease (PAD) is a chronic atherosclerotic condition, affecting 20% of adults over 60 in the UK. Guideline-recommended therapy (pharmacotherapy and lifestyle change) has been shown to reduce...
BACKGROUND: Peripheral artery disease (PAD) is a chronic atherosclerotic condition, affecting 20% of adults over 60 in the UK. Guideline-recommended therapy (pharmacotherapy and lifestyle change) has been shown to reduce major cardiovascular and limb events and increase life expectancy; however, adherence is low. Currently, there is a paucity of patient-centred interventions that address all aspects of adherence. Our previous research highlighted that patients' perceptions of their disease and its treatment strongly influence adherence. However, the views of relatives and healthcare professionals (HCPs) have not been previously explored. PURPOSE: To explore the views, experiences, perceived barriers and facilitators to adherence to guideline recommended therapy from the perspectives of patients with PAD, their relatives and HCPs. METHODS: Semi-structured qualitative interviews were conducted with patients with PAD, their relatives and HCPs. Participants were purposively sampled to capture a wide range of perspectives. The Perceptions and Practicalities Approach framed the topic guide and guided analysis. Interviews were recorded, transcribed verbatim, and analysed thematically (inductively and deductively). Stakeholder groups of patients, public and clinicians supported the pilot testing of the topic guide and the data analysis. RESULTS: Fifteen patients (eight men and seven women, aged 48-82, 8/15 White British), four relatives (all women) and 18 HCPs (five from primary and 13 from secondary care) were interviewed. Seven themes were identified: (1) Knowledge & understanding, (2) Treatment concerns, (3) Motivation, (4) HCP influence, (5) Social & physical context, (6) Everyday reality, (7) Healthcare system factors. Patients, relatives and HCPs did not always align on perceptions. CONCLUSION: Our findings illustrate that patients' adherence to PAD treatment is a complex process shaped by their personal understanding, motivation and daily lives, as well as support from HCPs and the wider system. To enhance adherence, future interventions should focus on improving patient education, addressing misconceptions about the necessity of conservative treatment, fostering individual motivation through practical goal setting, and strengthening collaborative care across the healthcare system.
Development and Validation of a Machine Learning Model for Predicting Medication Adherence Among Home-Dwelling Elderly Patients: A Retrospective Cross-Sectional Study.
Zhang Y, Han Y, Yin X … +2 more , Tian Y, Wu M
Patient Prefer Adherence · 2026 · PMID 42200167 · Full text
BACKGROUND: Elderly chronic disease management is often complicated by multimorbidity and the need for lifelong polypharmacy, yet poor adherence severely impedes progress. Existing studies mainly focus on exploring influ...
BACKGROUND: Elderly chronic disease management is often complicated by multimorbidity and the need for lifelong polypharmacy, yet poor adherence severely impedes progress. Existing studies mainly focus on exploring influencing factors of medication adherence, while most predictive models lack model interpretability and rarely integrate psychological and social support factors for community elderly populations. Predictive models identifying risk of adherence could enable proactive intervention. OBJECTIVE: To develop an interpretable machine learning prediction model that fills the above research gap to predict the medication adherence of elderly patients with chronic diseases in China. METHODS: From January to December 2024, data were collected from chronic disease patients aged 60 years and older receiving home-based medication therapy through face-to-face interviews conducted by pharmacists. Variables included demographic information, comorbidities, chronic diseases and medications information, medication adherence, self-efficacy in rational drug use, medication beliefs, social support, and medication literacy. The dataset was randomly divided into a training set and a test set at a 7:3 ratio. Multivariate logistic regression analysis was performed on all data, and predictors were selected from the training set via the Least Absolute Shrinkage and Selection Operator (LASSO). Six machine learning algorithms were applied in R software to develop predictive models using the training set, and their performance was compared on the test set. The Shapley Additive Explanations (SHAP) approach was used to interpret the optimal model. RESULTS: A total of 1722 patients were included in the statistical analysis. The gradient boosting machine (GBM) exhibited the best predictive performance among the six models (AUC = 0.811, 95% CI 0.774-0.840), with its core predictors being self-efficacy in rational drug use, medication practice, concern beliefs, and availability of social support. Through SHAP analysis, the interpretability of the model was significantly enhanced, providing a clear decision-making basis for clinicians. CONCLUSION: We constructed a prediction model for home medication adherence in elderly patients with chronic diseases, which incorporates important social and psychological factors affecting patients' adherence and provides robust evidence for developing targeted interventions.
Illness Perception and Medication Adherence Trajectories in Patients with Acute Coronary Syndrome: A 6-Month Longitudinal Study.
Xue Q, Wu C, Qu G … +3 more , Chen Y, Zeng X, Han R
Patient Prefer Adherence · 2026 · PMID 42200166 · Full text
OBJECTIVE: To investigate the trajectories of illness perception and medication adherence in patients with acute coronary syndrome, as well as the predictive relationship between the two. METHODS: A total of 311 patients...
OBJECTIVE: To investigate the trajectories of illness perception and medication adherence in patients with acute coronary syndrome, as well as the predictive relationship between the two. METHODS: A total of 311 patients with acute coronary syndrome (ACS) were recruited from the Department of Cardiology, The Second Affiliated Hospital of Chongqing Medical University, using convenience sampling. Participants were assessed at three time points: T1 (within 1 week post-admission), T2 (3 months post-onset), and T3 (6 months post-onset). Data were collected using the Brief Illness Perception Questionnaire (BIPQ) and the Medication Adherence Rating Scale (MARS). Cross-lagged panel modeling (CLPM) and parallel latent growth modeling (LGM) were constructed to analyze the causal relationship between illness perception and medication adherence. RESULTS: A total of 287 valid questionnaires were returned (valid response rate: 92.28%). From baseline (T1) to 6-month follow-up (T3), illness perception scores significantly decreased from 61.71 ± 7.05 to 36.59 ± 6.56 (F=41.667, P<0.001), while medication adherence scores declined from 6.92 ± 0.89 to 6.02 ± 1.13 (F=35.223, P<0.001). Cross-lagged analysis revealed significant reciprocal relationships: illness perception at each time point positively predicted subsequent medication adherence (T1→T2: β=0.425, P<0.01; T2→T3: β=0.389, P<0.001), and vice versa (T1→T2: β=0.430, P<0.001; T2→T3: β=0.427, P<0.001). Parallel latent growth modeling indicated that higher initial levels of illness perception negatively predicted its own slope (β=-0.306, P=0.012) and the slope of medication adherence (β=-0.318, P=0.024). Similarly, the intercept of medication adherence negatively predicted its own slope (β=-0.301, P=0.012). Furthermore, the slope of illness perception positively predicted the slope of medication adherence (β=0.329, P=0.002). CONCLUSION: The illness perception and medication adherence of patients with acute coronary syndrome are on the rise, and illness perception and medication adherence can predict each other.
Digital Health Engagement Regarding Lumbar Disc Herniation in Terms of Exercise Adherence: Integrating Variable-Centered and Person-Centered Perspectives.
Xu X, Qu Q, Chen T … +1 more , Shao X
Patient Prefer Adherence · 2026 · PMID 42200165 · Full text
BACKGROUND: Exercise adherence is pivotal for Lumbar Disc Herniation (LDH) rehabilitation, yet remains suboptimal. Digital health offers support, but patient engagement varies significantly. Current research lacks an int...
BACKGROUND: Exercise adherence is pivotal for Lumbar Disc Herniation (LDH) rehabilitation, yet remains suboptimal. Digital health offers support, but patient engagement varies significantly. Current research lacks an integrated perspective examining variable-centered general mechanisms and person-centered heterogeneity in digital health engagement and adherence. AIM: This study aimed to: (1) elucidate the variable-centered mechanism by testing the mediating role of health information seeking behavior (HISB) between eHealth literacy and exercise adherence; and (2) identify person-centered latent profiles of digital health engagement to predict adherence levels. METHODS: This cross-sectional study (from July to November 2025) involved 346 LDH patients. Digital health engagement was operationalized using the eHealth Literacy Scale (eHEALS) and the Health Information Seeking Behavior Scale (HISB). Exercise adherence was assessed using a validated LDH-specific scale. Data were analyzed using Structural Equation Modeling (SEM) and Latent Profile Analysis (LPA). RESULTS: SEM confirmed eHealth literacy positively predicted adherence directly and indirectly via HISB (mediation effect: 30.6%). LPA identified four profiles: "Digital Disengaged" (36.4%), "Passive Spectators" (36.1%), "Digital Champions" (22.3%), and "Distress-Driven Seekers" (5.2%). While youth and higher socioeconomic status predicted "Digital Champions", severe functional disability (ODI) was the strongest predictor for "Distress-Driven Seekers" (OR=2.76, <0.05). "Distress-Driven Seekers" achieved high adherence, comparable to "Digital Champions" (>0.05) and superior to others (<0.001). CONCLUSION: HISB serves as a crucial mechanism linking eHealth literacy to rehabilitation adherence. Severe disability distress drives high-intensity information seeking, compensating for low literacy and enabling high adherence in "Distress-Driven Seekers". Personalized digital health interventions should be developed to accommodate diverse engagement patterns. Notably, "Distress-Driven Seekers" require targeted clinical guidance and "information prescriptions" to mitigate risks of medical misinformation, health anxiety, and potential secondary injuries caused by inappropriate self-management.
A Four-Year Monocenter Epidemiological Analysis of 30-Day Unplanned Readmission Patients.
Chen Q, Rao D, Liang Y … +4 more , Li Y, Wang H, Liu A, Huang J
Patient Prefer Adherence · 2026 · PMID 42200164 · Full text
PURPOSE: Describe the distribution and clinical characteristics of unplanned readmission patients. PATIENTS AND METHODS: This study employed a retrospective observational design to investigate patients who were unplanned...
PURPOSE: Describe the distribution and clinical characteristics of unplanned readmission patients. PATIENTS AND METHODS: This study employed a retrospective observational design to investigate patients who were unplanned readmissions at a general hospital in Guangdong Province between January 2016 and December 2019. It compared and analyzed the distribution patterns and clinical characteristics of patients readmitted unplanned across different subgroups. RESULTS: We collected data on 15,585 patients. Among unplanned readmissions, patients aged 41 or older (10,618, 68.13%), females (8243, 52.89%), married individuals (10,660, 68.4%), and employees (3834, 24.6%) had higher proportions. Most patients had some form of insurance (12,026, 77.16%). Significant differences were observed in the sociodemographic statistics of unplanned readmission patients across different time periods. The average duration of unplanned readmission was approximately two weeks. Among patients aged 41 and above, nearly half (6803; 43.65%) had unplanned readmissions lasting more than 2 weeks. Most patients had undergone surgery (11,395, 73.12%), with the highest proportions undergoing urological (2575, 16.5%) and gynecological (2437, 15.6%) surgery. CONCLUSION: Unplanned readmission patients are primarily middle-aged and older adults aged 40 and above, women, married individuals, and employed persons. They bear a heavy disease burden, and while most have health insurance, a significant proportion remain uninsured. These patients are mainly referred from surgical departments, particularly urology and obstetrics and gynecology. Unplanned readmissions most frequently occur within two weeks of discharge, and hospitalization costs rise significantly with age; therefore, greater attention should be paid to this issue in discharge instructions.
Association Between Mind Mapping Combined with Teach-Back and Follow-Up Adherence After Percutaneous Coronary Intervention: An Exploratory Study.
Wang X, Wei J, Wu Y … +3 more , Lei L, Zhou T, Lin L
Patient Prefer Adherence · 2026 · PMID 42200163 · Full text
BACKGROUND: Suboptimal follow-up adherence after percutaneous coronary intervention (PCI) compromises secondary prevention and elevates the risk of major adverse cardiovascular events (MACEs). Conventional health educati...
BACKGROUND: Suboptimal follow-up adherence after percutaneous coronary intervention (PCI) compromises secondary prevention and elevates the risk of major adverse cardiovascular events (MACEs). Conventional health education is often insufficient, necessitating a structured, practical, and evidence-based nursing protocol. OBJECTIVE: To identify factors influencing post-PCI follow-up adherence and assess the association between a mind mapping combined with teach-back educational intervention and levels of adherence and MACEs. METHODS: This single-center retrospective study analyzed data from a real-world nursing quality improvement initiative, including patients undergoing PCI during January, 2024-November, 2024. Patients were divided into mind mapping + teach-back or routine education group. Propensity score matching was employed to balance baseline characteristics. Follow-up adherence (≥ 3 complete visits) and 12-month MACE incidence were compared. Multivariable logistic regression was used to identify adherence factors. Kaplan-Meier and Log rank tests were utilized to compare MACE-free survival. RESULTS: After matching (63 patients per group), baseline characteristics were balanced. High follow-up adherence was observed more frequently in the mind mapping + teach-back group (79.4% vs. 61.9%, = 0.031). The combined intervention was independently associated with higher adherence (OR = 2.658, 95% CI: 1.042-6.783, = 0.041). The mind mapping + teach-back group showed a lower observed 12-month MACE incidence (11.1% vs. 20.6%, = 0.048) and a higher MACE-free survival rate (log-rank = 0.042). CONCLUSION: In this exploratory study, the mind mapping combined with teach-back method was associated with better follow-up adherence; a lower incidence of MACE was also observed, although this finding is exploratory given the limited sample size and event numbers. It may represent a promising and operable nursing practice tool. These findings suggest a potential benefit that warrants further investigation; our results provide preliminary evidence to inform the design of future prospective randomized controlled trials, rather than immediate integration into clinical practice.
Developmental Trajectories and Influencing Factors of Inhaled Corticosteroid (ICS) Adherence in Pediatric Asthma Under a Remote Collaborative Management model-Latent Class Growth Analysis.
Li W, Yu X, Gao Y … +5 more , Qin Y, Lu J, Li T, Hu X, Zhang C
Patient Prefer Adherence · 2026 · PMID 42183339 · Full text
BACKGROUND: This study aimed to explore the developmental trajectories and influencing factors of inhaled corticosteroid (ICS) medication adherence among pediatric asthma patients managed through the remote collaborative...
BACKGROUND: This study aimed to explore the developmental trajectories and influencing factors of inhaled corticosteroid (ICS) medication adherence among pediatric asthma patients managed through the remote collaborative model based on the China Childhood Asthma Action Plan (CCAAP). METHODS: A total of 249 pediatric asthma patients who were followed up at a respiratory specialty outpatient clinic between January 2022 and November 2024 were recruited using convenience sampling. The instruments consisted of a general information questionnaire, the Chinese version of the Bronchial Asthma Medication Adherence Scale, an asthma knowledge questionnaire, and an inhaled medication error rate assessment form. Medication adherence was evaluated at baseline and at 1, 3, and 6 months. Latent Category Growth Analysis (LCGA) was employed to identify adherence trajectories, and unordered multinomial logistic regression was conducted to examine the influencing factors. RESULTS: Four distinct adherence trajectories were identified, including the Declining Adherence group (6.02%), the Rapid Improvement group (8.03%), the Persistent Adherence group (71.08%), and the Gradual Improvement group (14.86%). The groups differed significantly in parental education, peak flow meter usage, concerns regarding steroid medication, history of severe exacerbations, asthma knowledge level, and 6-month medication error rate. Multivariate analysis indicated that pre-visit asthma knowledge, 6-month medication error rate, peak flow meter usage, concerns about steroid medication, and parental education were significant determinants of the Rapid Improvement group. Severe exacerbations at 3 months were related to the Gradual Improvement group, whereas recent severe exacerbations and the 6-month medication error rate were associated with the Declining Adherence group. CONCLUSION: ICS adherence within the CCAAP telemedicine-based management model demonstrates substantial heterogeneity. Identifying distinct trajectories enables early detection of non-adherence risk and supports personalized intervention strategies, which may significantly improve asthma control and resource allocation in remote care settings. Implementing stratified management based on these findings can enhance long-term treatment efficacy and pediatric asthma outcomes.
Determinants of Baseline Ophthalmic Screening and Its Association with Long-Term Treatment Persistence in Patients with Rheumatic Diseases Initiating Hydroxychloroquine: A Nationwide Cohort Study.
Kim A, Park GU, Lee SG
Patient Prefer Adherence · 2026 · PMID 42183338 · Full text
PURPOSE: Hydroxychloroquine (HCQ) is a cornerstone therapy for various rheumatic diseases (RDs), but prolonged exposure carries a risk of irreversible retinal toxicity. Current guidelines recommend baseline ophthalmic sc...
PURPOSE: Hydroxychloroquine (HCQ) is a cornerstone therapy for various rheumatic diseases (RDs), but prolonged exposure carries a risk of irreversible retinal toxicity. Current guidelines recommend baseline ophthalmic screening to ensure safety and support treatment longevity. This study aimed to evaluate real-world adherence to baseline screening, identify its determinants, and assess its association with long-term HCQ treatment persistence. PATIENTS AND METHODS: We conducted a nationwide retrospective cohort study using the South Korean Health Insurance Review and Assessment Service (HIRA) database. Adult patients with RDs who initiated HCQ between 2014 and 2018 and maintained therapy for ≥30 consecutive days were included. Baseline ophthalmic screening was defined as fundoscopy or optical coherence tomography (OCT) performed within 12 months of HCQ initiation, a pragmatic window reflecting real-world clinical practice. Determinants of screening were identified using multivariable logistic regression, and the association between screening and HCQ persistence was analyzed using Cox proportional hazards models. RESULTS: Of the 19,876 patients included, only 32.5% underwent baseline screening. Independent predictors of higher screening rates included older age, female sex, treatment initiation at tertiary or general hospitals, a later initiation year, and a diagnosis of systemic lupus erythematosus, Sjögren's syndrome, or Behçet's disease. Conversely, concomitant use of conventional synthetic disease-modifying antirheumatic drugs or glucocorticoids predicted lower rates. During follow-up, baseline ophthalmic screening was independently associated with significantly improved HCQ persistence (adjusted HR for discontinuation: 0.91; 95% CI: 0.88-0.94); this relationship held true specifically for patients undergoing baseline OCT (adjusted HR: 0.93; 95% CI: 0.88-0.98). CONCLUSION: These findings highlight the gap between guideline recommendations and real-world practice. The observed association between baseline ophthalmic screening, particularly utilizing OCT, and improved HCQ persistence suggests that such screening may potentially serve as an indicator of comprehensive clinical management within routine practice.
The Effect of Medical Robot Information Transfer on Information Adherence of Cancer Patients: Evidence from a Scenario Experiment.
Tan F, Yang D, Gui G
Patient Prefer Adherence · 2026 · PMID 42164231 · Full text
PURPOSE: Previous studies have explored the impact of medical robots on patient care, but few studies have looked at the impact of information delivery by medical robots on patient information compliance. PATIENTS AND ME...
PURPOSE: Previous studies have explored the impact of medical robots on patient care, but few studies have looked at the impact of information delivery by medical robots on patient information compliance. PATIENTS AND METHODS: In this study, 290 subjects were recruited on a professional data collection platform from November 21 to December 10, 2024 to conduct scenario experiments to explore the effect of medical robot information transmission on cancer patients' information compliance and its mechanism. RESULTS: The experimental results show that medical robot information transmission has a significant impact on patient information compliance. Among them, patients' preference for emotional information transmission by medical robots was higher than that for professional information transmission. At the same time, we found that information processing fluency and perceived psychological stress have a chain mediating effect on medical robot and patient information compliance. CONCLUSION: This study further expands the extension of information processing theory, strengthens the role of emotional factors and cognitive factors in human-computer interaction, and provides a new program for effective clinical nursing.
Barriers and Facilitators of Compliance with Iron-Folic Acid Supplementation Among Pregnant Women in Southern Afghanistan: A Qualitative Study.
Stanikzai MH, Le CN, Isaramalai SA … +6 more , Punsaward C, Ezadi Z, Sayam H, Shohaimi S, Dadras O, Suwanbamrung C
Patient Prefer Adherence · 2026 · PMID 42158645 · Full text
BACKGROUND: Compliance with iron-folic acid (IFA) supplementation is essential to prevent maternal anemia and associated adverse maternal and neonatal outcomes. Despite national policy support, adherence remains suboptim...
BACKGROUND: Compliance with iron-folic acid (IFA) supplementation is essential to prevent maternal anemia and associated adverse maternal and neonatal outcomes. Despite national policy support, adherence remains suboptimal in Afghanistan, and contextual evidence on determinants of compliance is limited. This study aimed to explore barriers and facilitators of IFA supplementation compliance among pregnant women in southern Afghanistan. METHODS: This exploratory qualitative study was conducted between November and December 2025 among 24 pregnant women attending antenatal care services at four comprehensive health centers in southern Afghanistan. Participants were purposively selected to participate in two focus group discussions (n=16) and eight in-depth interviews (n=8). Data were analyzed using a hybrid deductive-inductive thematic approach informed by the Health Belief Model. RESULTS: Four key facilitators of compliance were identified: perceived health benefits, social support (cues to action), perceived susceptibility to anemia, and self-efficacy. Seven major barriers emerged: lack of supplement availability, long waiting times, transportation and mobility constraints, unfavorable attitudes of healthcare providers, fear of side effects, forgetfulness, and myths and misconceptions. Findings indicate that compliance was shaped not only by individual beliefs but also by structural health system challenges and sociocultural norms. CONCLUSION: Compliance with IFA supplementation among pregnant women in southern Afghanistan is influenced by interconnected individual, health system, and community-level factors. Interventions to improve adherence should integrate behavioral strategies with efforts to strengthen health system capacity and address sociocultural barriers.
Experiences, Values and Goals of People Living with Obstructive Hypertrophic Cardiomyopathy: Exploratory Patient Interviews.
Fifer S, Pendleton A, Ingles J … +3 more , Godsell J, Zhong Y, Krause T
Patient Prefer Adherence · 2026 · PMID 42158644 · Full text
PURPOSE: This qualitative study explored the experiences, values and goals of patients living with symptomatic obstructive hypertrophic cardiomyopathy (HCM). PATIENTS AND METHODS: A cohort of patients were recruited betw...
PURPOSE: This qualitative study explored the experiences, values and goals of patients living with symptomatic obstructive hypertrophic cardiomyopathy (HCM). PATIENTS AND METHODS: A cohort of patients were recruited between March and August 2023 via the Australian Genetic Heart Disease Registry and Cardiomyopathy Association of Australia. Patients were eligible if aged 18 years or older, English speaking and diagnosed with obstructive HCM, with symptomatic status reflective of New York Heart Association class II and above. Patients first completed the Kansas City Cardiomyopathy Questionnaire (KCCQ-23) and then underwent a 60-75-minute semi-structured video interview. Interviews were analyzed using thematic analysis, which was facilitated by NVivo software. RESULTS: Ten patients participated in structured interviews (6 women and 4 men, mean age: 64.5 years). All were receiving pharmacologic therapy and 50% had undergone septal reduction therapy. Results showed that patients continue to experience notable impact from their obstructive HCM (KCCQ-23 summary score: 63.6; clinical summary score: 66.1). Patients frequently reported living with symptoms for years before diagnosis, often attributing limitations to poor fitness. Symptom burden was substantial, including dyspnea, fatigue, palpitations, chest pain, dizziness and syncope, with variability linked to exertion and environmental factors. Emotional responses ranged from resilience to anxiety, frustration, and fear of sudden death. Lifestyle adjustments were common: patients limited physical activity, modified daily routines, and reduced social engagement. Treatment goals prioritized efficacy and safety, with strong preference for therapies that alleviate symptoms and improve quality of life. Patients valued delaying surgery and favoured oral, once-daily regimens, while placing little importance on objective clinical measures (e.g. echocardiographic findings). CONCLUSION: The study provides a unique window into lived experiences of patients with symptomatic obstructive HCM in Australia, demonstrating the impact extends far beyond symptoms. It highlights the need to consider individual patient priorities and treatment goals to provide a tailored, patient‑centric approach.
Factors Influencing Attendance to Physical Therapy Services Among Children with Cerebral Palsy in Saudi Arabia.
Alghamdi MS, Awali A, Alshehri MA … +2 more , Alonazi M, Alenazi AM
Patient Prefer Adherence · 2026 · PMID 42153179 · Full text
OBJECTIVE: To examine child, caregiver, and physical therapy (PT) service-related factors associated with regular versus irregular attendance to PT services among children with cerebral palsy (CP). METHODS: A cross-secti...
OBJECTIVE: To examine child, caregiver, and physical therapy (PT) service-related factors associated with regular versus irregular attendance to PT services among children with cerebral palsy (CP). METHODS: A cross-sectional study was conducted with 108 caregivers of children with CP aged 2-12 years in Saudi Arabia. Caregivers completed an online survey about child and caregiver characteristics, PT characteristics, perceived difficulties related to PT services, and caregiver-reported burden. Attendance was categorized as regular or irregular based on caregiver report and differences were examined. Regular attendance reflected consistent participation in scheduled sessions, whereas irregular attendance reflected missed, delayed, or inconsistent attendance. RESULTS: Regular attendance was reported by 42.6% of participants. Regular attendance was associated with younger age of children ( = 0.003, = 0.59) and lack of children's educational enrollment ( = 0.014, φ = 0.24). No significant differences were found between groups for child sex, Gross Motor Function Classification System level, CP type, caregiver characteristics, or PT service characteristics. Irregular attendees reported greater difficulties related to appointment booking policies (r = 0.30), access to therapists (r = 0.26), agreement on treatment plans (r = 0.22), child behavior management (r = 0.25), and caregiver-child interaction during home exercises (r = 0.29), as well as higher financial (r = 0.21) and psychological burden (r = 0.19). CONCLUSION: Attendance to PT services for children with CP was associated more with caregiver-perceived difficulties and burden than with demographic or service characteristics. Addressing service processes and caregiver experiences may support more consistent PT attendance.
Integrated Internet-Based Pharmaceutical Care and Its Association with Clinical Outcomes and Medication Adherence in Older Adults with Multimorbidity: A Prospective Observational Study.
Zhao J, Liu P, Liao H … +7 more , Chen Y, Li L, Yan Y, Li T, Tang X, Nie L, Yang J
Patient Prefer Adherence · 2026 · PMID 42146995 · Full text
OBJECTIVE: To compare clinical outcomes, quality of life (QoL), medication behaviors, and readmission risk between older adults with multimorbidity receiving integrated Internet-based pharmaceutical care and those receiv...
OBJECTIVE: To compare clinical outcomes, quality of life (QoL), medication behaviors, and readmission risk between older adults with multimorbidity receiving integrated Internet-based pharmaceutical care and those receiving conventional pharmaceutical care. METHODS: This prospective observational study enrolled 196 older adults with multimorbidity who received either conventional or integrated Internet-based pharmaceutical care according to the service model in routine practice. After 6 months, BG and BP control rates, hospitalization rates, and patient satisfaction were compared. Frailty, health-related quality of life, medication self-management, and adherence were assessed using the FRAIL scale, EQ-5D/EQ-VAS, SEAMS, and ARMS-12, respectively. Logistic regression was used to examine the association between care model and 12-month readmission. RESULTS: At the 6-month follow-up, the integrated Internet-based pharmaceutical care group had significantly higher BG and BP control rates and patient satisfaction than the conventional care group (P < 0.05). The integrated Internet-based care group also had lower FRAIL scores and higher EQ-5D and EQ-VAS scores. SEAMS scores were significantly higher, and ARMS scores were significantly lower in the Internet-based care group (P < 0.001). The integrated Internet-based pharmaceutical care model was significantly associated with a lower risk of 12-month readmission (OR = 0.424, 95% CI: 0.203-0.884, P = 0.022). CONCLUSION: Integrated Internet-based pharmaceutical care was associated with favorable medication-related and clinical outcomes in older adults with multimorbidity. Further studies are needed to confirm these findings and clarify their generalizability.
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