Patient Preference And Adherence[JOURNAL]
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200 papers
Inhaled Medication Adherence Trajectory and Its Associated Factors in Patients with Chronic Obstructive Pulmonary Disease: A Group-Based Trajectory Modeling.
Xu H, Liang W, Liang Y … +3 more , Zeng Q, Huang J, Li R
Patient Prefer Adherence · 2026 · PMID 41907151 · Full text
OBJECTIVE: This study aims to identify the heterogeneous trajectories of inhaled medication adherence in COPD patients while examining their associated factors and exploring the longitudinal correlation between variables...
OBJECTIVE: This study aims to identify the heterogeneous trajectories of inhaled medication adherence in COPD patients while examining their associated factors and exploring the longitudinal correlation between variables, so as to provide the basis for precise intervention. METHODS: Adopting convenience sampling, chronic obstructive pulmonary disease (COPD) patients hospitalized at The First Affiliated Hospital of Guangzhou Medical University between December 2023 and September 2024 were recruited. General information, Test of the Adherence to Inhalers (TAI; scores of 50 indicate high adherence, 46-49 moderate adherence, and ≤45 low adherence), Chronic Obstructive Pulmonary Disease Knowledge Questionnaire (COPD-Q), Beliefs about Medicines Questionnaire-Specific (BMQ-Specific), Hospital Anxiety and Depression Scale (HADS), and Perceived Social Support Scale (PSSS) were assessed at hospitalization (T0) and 1 month (T1), 3 months (T2), and 6 months (T3) after discharge. The Group-Based Trajectory Model was employed to identify inhaled medication adherence trajectories. Associated factors of trajectories were determined using multinomial logistic regression, and the longitudinal association between variables was explored by the Group-Based Dual Trajectory Model. RESULTS: A total of 207 patients with COPD completed follow-up. The number and proportion of COPD patients with "medium-low adherence" showed a significant decrease from T0 to T1, followed by an increase from T1 to T3. Trajectories of inhaled medication adherence in COPD patients can be categorised into four classes: "high adherence-persisting group" (50.4%), "medium-low adherence-persisting group" (18.4%), "low adherence rising-persisting group" (15.0%), and "low adherence rising- declining group" (16.3%). Duration of inhalation device use, health literacy, beliefs about medicines, anxiety, and perceived social support were associated factors of trajectories of inhaled medication adherence ( < 0.05), with a significant positive correlation between trajectories of inhaled medication adherence and trajectories of beliefs about medicines. CONCLUSION: Nearly one-third of COPD patients exhibited poor inhaled medications adherence after discharge, with one month post-discharge serving as a critical turning point. Healthcare providers should prioritize monitoring adherence changes during this period. Four heterogeneous adherence trajectories were identified. Factors influencing each trajectory included: duration of inhaler device use ≤2 years, low level of health literacy, low level of beliefs about medicines, high level of anxiety, and low level of perceived social support. Early screening of these populations and implementation of targeted strategies are essential to enhance precision management.
Knowledge, Attitudes, and Practices Regarding Postoperative Management Among Patients with Fractures: A Cross-Sectional Study.
Wang Y, Chen H, Zhao X … +1 more , Wang X
Patient Prefer Adherence · 2026 · PMID 41907150 · Full text
BACKGROUND: Patients with fractures often face complex postoperative management requirements, and their knowledge, attitude, and practice regarding these aspects remain insufficiently understood. PURPOSE: This study aims...
BACKGROUND: Patients with fractures often face complex postoperative management requirements, and their knowledge, attitude, and practice regarding these aspects remain insufficiently understood. PURPOSE: This study aims to assess the knowledge, attitude, and practice (KAP) related to postoperative management among patients with fractures. PATIENTS AND METHODS: A cross-sectional study was conducted in the Trauma Orthopedics Department of the Second Affiliated Hospital of Wenzhou Medical University from July 2024 to August 2024. A self-designed questionnaire was administered to collect demographic information and to evaluate KAP scores. RESULTS: A total of 556 (n = 556) valid responses were analyzed. Of the respondents, 279 (50.18%) were female, and 380 (68.35%) reported fractures resulting from falls. The mean ± SD scores for knowledge, attitude, and practice were 15.24 ± 3.62 (possible range: 0-22), 31.43 ± 6.40 (possible range: 8-40), and 83.07 ± 17.24 (possible range: 21-105), respectively. Based on a 70% cutoff of the total score, 42.73% of participants had adequate knowledge, 82.59% had a positive attitude, and 72.53% reported proactive practice. Correlation analysis revealed significant positive correlations between knowledge scores and attitude scores (r = 0.782, P < 0.001), as well as between knowledge scores and practice scores (r = 0.832, P < 0.001). Additionally, attitude scores were positively correlated with practice scores (r = 0.804, P < 0.001). The structural equation model demonstrated that knowledge had a direct effect on attitude (standardized β = 0.913, P < 0.001) and practice (standardized β = 0.710, P < 0.001), while attitude also directly impacted practice (standardized β = 0.258, P = 0.021). CONCLUSION: Patients with fractures exhibited suboptimal knowledge but generally positive attitudes and proactive practices toward postoperative management. Tailored educational interventions to improve patient knowledge could significantly enhance attitude and practice.
Symptom Burden in Patients with Acute Coronary Syndrome After Percutaneous Coronary Intervention: A Network and Latent Profile Analysis.
Hong S, Gan X, Zhou W … +8 more , Gao Y, Li R, Liu L, Hu X, Zheng Q, Huang M, Lou L, Tan L
Patient Prefer Adherence · 2026 · PMID 41890537 · Full text
PURPOSE: To describe the network structure and heterogeneity of symptom burden in patients with acute coronary syndrome (ACS) after percutaneous coronary intervention (PCI), and to examine factors associated with differe...
PURPOSE: To describe the network structure and heterogeneity of symptom burden in patients with acute coronary syndrome (ACS) after percutaneous coronary intervention (PCI), and to examine factors associated with different symptom burden profiles to inform risk-stratified management after PCI. PATIENTS AND METHODS: A convenience sample of 261 patients with ACS who underwent PCI at a tertiary hospital in Chongqing between November 2024 and August 2025 was recruited. Data were collected using a demographic questionnaire, the Cardiac Symptom Survey, and the Seattle Angina Questionnaire. Network analysis was conducted to identify inter-symptom associations and the structural characteristics of the symptom network. Latent profile analysis (LPA) was performed to classify symptom burden patterns, and multinomial logistic regression analysis was used to explore factors associated with profile membership. RESULTS: Network analysis indicated that depression was the most central symptom (strength = 0.886). Latent profile analysis identified three distinct symptom burden profiles: Low Symptom Burden (64.0%), Moderate Symptom Burden with Prominent Access-Site Pain (12.3%), and High Symptom Burden (23.8%). Body mass index (BMI) was a significant independent predictor of symptom burden; compared with patients with normal BMI, those who were overweight or obese were significantly more likely to belong to the High ( = 2.47, 95% : 1.31-4.67) or Moderate ( = 2.41, 95% : 1.04-5.59) burden groups. Furthermore, higher symptom burden was significantly associated with reduced health-related quality of life, particularly regarding angina frequency and disease perception ( < 0.05). CONCLUSION: Symptom burden in patients with ACS after PCI demonstrates substantial individual heterogeneity. Depression occupies a central position within the symptom network, and BMI is associated with moderate and high symptom burden profiles. These findings suggest that integrating symptom network characteristics and BMI status into post-PCI assessment may facilitate risk-stratified management and targeted psychological and weight-related interventions to improve recovery outcomes.
Effects of Education on Treatment Adherence and Fatigue in Individuals with Treatment-Inadherent Iron Deficiency Anemia: A Randomized Trial in Türkiye.
Kırlı İ, Polat H
Patient Prefer Adherence · 2026 · PMID 41890536 · Full text
PURPOSE: This study was conducted to determine the effects of education given to individuals with iron deficiency anemia on treatment compliance and fatigue. METHODS: The study included 63 patients, divided into interven...
PURPOSE: This study was conducted to determine the effects of education given to individuals with iron deficiency anemia on treatment compliance and fatigue. METHODS: The study included 63 patients, divided into intervention and control groups, who were admitted to or received inpatient treatment at the State Hospital Internal Medicine and Hematology Clinic between December 2023 and June 2024. The study was designed using an intervention design with a pretest, interim, and posttest control group. Our study examined treatment compliance and fatigue levels. RESULTS: At pre-test, there were no significant differences between the Intervention (MMAS-4: 0.58 ± 0.76; Fatigue: 69.86 ± 18.66; Energy: 22.72 ± 8.03) and Control groups (MMAS-4: 0.56 ± 0.67; Fatigue: 74.30 ± 20.95; Energy: 23.66 ± 9.44; p>0.05). At interim and post-test, treatment adherence significantly improved in the Intervention group (Interim 3.35 ± 0.71; Post-test 3.65 ± 0.84) compared to the Control group (Interim 0.59 ± 0.87; Post-test 0.38 ± 0.83; p<0.001).Fatigue scores decreased significantly in the Intervention group (Interim 69.86 ± 18.66; Post-test 34.38 ± 10.15) but increased in the Control group (Interim 74.30 ± 20.95; Post-test 85.32 ± 22.45; p<0.001). Energy scores improved in the Intervention group (Interim 22.72 ± 8.03; Post-test 37.56 ± 5.67) while declining in the Control group (Interim 23.66 ± 9.44; Post-test 20.45 ± 11.02; p<0.001). CONCLUSION: Nurse-led education significantly improved adherence and reduced fatigue, supporting integration of structured patient education in IDA management.
Perceived Barriers as Key Behavioral Predictors of Medication Adherence in Older Adults with Diabetes in Northern Iran: Insights from the Health Action Process Approach.
Dashteban Namaghi A, Bakhtiari A, Ghorbani S … +1 more , Zeinali A
Patient Prefer Adherence · 2026 · PMID 41890535 · Full text
BACKGROUND: Medication non-adherence remains a critical issue in older adults with type 2 diabetes. Understanding the behavioral determinants of adherence can help design more effective interventions. PURPOSE: This study...
BACKGROUND: Medication non-adherence remains a critical issue in older adults with type 2 diabetes. Understanding the behavioral determinants of adherence can help design more effective interventions. PURPOSE: This study aimed to identify behavioral predictors of medication adherence among community-dwelling older adults with type 2 diabetes in Iran using the full Health Action Process Approach (HAPA) model. METHODS: In this cross-sectional study, 257 older adults were recruited from diabetes care centers in Gorgan, Golestan Province, Iran. Data were collected through structured interviews using a validated HAPA-based questionnaire and the 8-item Morisky Medication Adherence Scale (MMAS-8). Multiple linear and logistic regression models were used to evaluate associations between HAPA constructs and adherence. RESULTS: Overall, 52% of participants were non-adherent. In univariate analyses, intention, coping self-efficacy, and action planning showed some association with adherence. In the adjusted model, only perceived barriers remained significant (B = 0.034, p = 0.001; OR = 1.035, 95% CI: 1.015-1.055), with higher scores, indicating fewer perceived barriers, linked to increased odds of adherence. CONCLUSION: The findings highlight the dominant role of perceived barriers in shaping adherence behavior among older adults, overshadowing the effects of intention and planning. This suggests that interventions to improve adherence in this population should prioritize reducing contextual and psychological obstacles.
Exploring the Effect of Doctor-Nurse Collaboration on Overall Satisfaction Among the Older Patients: A Moderated Mediation Model of Responsiveness and Environment.
Wang H, Wang H, Guan SN … +1 more , Li J
Patient Prefer Adherence · 2026 · PMID 41884222 · Full text
OBJECTIVE: Older patients often encounter challenges during outpatient visits that adversely affect their overall satisfaction. This study tested a moderated mediation model to examine how doctor-nurse collaboration infl...
OBJECTIVE: Older patients often encounter challenges during outpatient visits that adversely affect their overall satisfaction. This study tested a moderated mediation model to examine how doctor-nurse collaboration influences satisfaction through responsiveness to patient needs, and how the outpatient environment moderates this process within geriatric care settings. METHODS: An online cross-sectional survey utilizing a 5-point Likert scale was conducted to assess patient satisfaction by recruiting 9133 older patients (51.6% male). Descriptive statistics were used to analyze the factors associated with satisfaction. After controlling for confounders such as title of registered doctor, gender, and educational status, a moderated mediation analysis was performed using Stata 18.0. RESULTS: Both dimensions of doctor-nurse collaboration, interprofessional collaboration (X1) and attitudinal alignment (X2), directly enhanced patient satisfaction (β = 0.065, p < 0.001). Responsiveness to patient needs mediated this relationship (β = 0.253, p < 0.001). The outpatient environment significantly moderated the effect of collaboration on responsiveness in both the model1 (β = 0.288, p <0.001) and the model2 (β = 0.289, p <0.001). CONCLUSION: Effective collaboration between doctors and nurses is essential for addressing the professional and emotional needs of older patients, thereby improving their overall satisfaction. Moreover, integrating the outpatient environment into the doctor-patient collaboration model highlights the importance of considering physical settings and interpersonal dynamics as interrelated components to comprehensively understand patient satisfaction and its determinants.
Intention to Engage in Exercise Rehabilitation Among Patients with Cardiovascular Disease: A Scoping Review.
Song Y, Peng L, Wu L … +2 more , Liu X, Wang Y
Patient Prefer Adherence · 2026 · PMID 41884221 · Full text
PURPOSE: This paper compiles the scope of research on exercise rehabilitation intention among patients with cardiovascular diseases and identifies the current landscape, influencing factors, assessment instruments, and i...
PURPOSE: This paper compiles the scope of research on exercise rehabilitation intention among patients with cardiovascular diseases and identifies the current landscape, influencing factors, assessment instruments, and intervention strategies related to exercise rehabilitation intention, aiming to inform clinical efforts aimed at encouraging active patient engagement in rehabilitation. METHODS: Eleven Chinese and English databases were systematically searched between the database's creation and August 28, 2024, under the scoping review methodology. Two researchers independently performed literature screening and data extraction. RESULTS: A total of 25 studies were included (21 in English, 4 in Chinese), 16 specifically assessed exercise rehabilitation intentions in cardiovascular disease patients, approximately half (8/16) of the cardiovascular disease patients exhibited suboptimal exercise rehabilitation intention. The assessment tools for exercise rehabilitation intentions are diverse, with dimensions primarily focused on willingness and planning. Determinants included psychosocial, disease-related, and sociodemographic factors. Identified intervention strategies included group health education, individual psychological support, and motivational interviewing. CONCLUSION: Among cardiovascular disease patients exercise rehabilitation intentions remain inconsistent, as approximately half of the studies indicating medium-to-low average levels, which are influenced by several factors. Therefore, to accurately assess patients' levels of exercise rehabilitation intention, further research may focus on enhancing the dimensions, reliability, and validity of assessment tools. Exploring multifaceted and varied intervention strategies could potentially improve patients' exercise rehabilitation intention and compliance.
Intensive Adverse Drug Reaction Monitoring Program Improves Detection of Phenytoin-Induced Adverse Drug Reactions.
Dawdan S, Chaipichit N, Sribhutorn A … +1 more , Jarernsiripornkul N
Patient Prefer Adherence · 2026 · PMID 41884220 · Full text
PURPOSE: To compare the outcomes of routine versus intensive adverse drug reaction (ADR) monitoring programs among adult in-patients initially treated with phenytoin, and to identify risk factors associated with severe c...
PURPOSE: To compare the outcomes of routine versus intensive adverse drug reaction (ADR) monitoring programs among adult in-patients initially treated with phenytoin, and to identify risk factors associated with severe cutaneous adverse reactions (SCARs). PATIENTS AND METHODS: This retrospective cohort study recruited phenytoin-naïve patients treated at a general hospital in Northern Thailand. Potentially eligible admissions were identified through the electronic medical record by extracting all medication orders for phenytoin during October 2018 to May 2021. Patients were consecutively enrolled and divided into routine adverse drug reaction monitoring (n = 500, rADRM) and intensive adverse drug reaction monitoring (n = 500, iADRM) allocated based on ward-based monitoring models. All participants received standard counseling regarding phenytoin dosing and administration. The rADRM group underwent ADR monitoring during routine follow-up visits, while the iADRM group received additional individualized instruction on ADR recognition and access to a direct pharmacist contact for reporting suspected ADRs. Multivariable logistic regression was performed to identify independent risk factors for SCARs. RESULTS: Patients in the intensive adverse drug reaction monitoring group had a significantly higher detection rate of phenytoin-induced ADRs compared with those in the routine adverse drug reaction monitoring group (OR 2.301, 95% CI 1.091:4.853, p = 0.029), as well as a greater patient-initiated reporting (OR 4.527, 95% CI 2.274:9.010, p < 0.001). Type B ADRs occurred in 3.6% of patients, with the iADRM group documenting more SCARs (36.84% vs. 5.88%, p = 0.044). Discontinuation of phenytoin and prolonged hospitalization were observed in both groups (42.1 vs. 52.9%, p = 0.045). Multivariable logistic regression identified iADRM (OR 13.304, 95% CI 1.183-149.581, p = 0.036), comorbidities (OR 12.935, 95%Cl 1.514:110.48, p =0.019), omeprazole use (OR 57.112, 95%Cl 9.569:340.875, p <0.001), and increased age (OR 0.940, 95%Cl 0.893:0.989, p =0.023) as significant risk factors associated with SCARs. CONCLUSION: Intensive ADR monitoring facilitates earlier detection and reporting of phenytoin-associated ADRs including SCARs. Comorbidities, concomitant omeprazole use, and older age were associated with SCARs. Intensive monitoring programs may enhance patient engagement and improve medication safety by enabling timely recognition and management of adverse reactions.
Development and Psychometric Validation of the ASMA Medication Adherence Questionnaire for Adults with Type 2 Diabetes in Saudi Arabia: A Cross-Sectional Study.
Aloudah N
Patient Prefer Adherence · 2026 · PMID 41877857 · Full text
BACKGROUND AND PURPOSE: Medication adherence remains a major challenge in the management of type 2 diabetes, contributing to poor glycaemic control, preventable complications, and increased healthcare burden despite adva...
BACKGROUND AND PURPOSE: Medication adherence remains a major challenge in the management of type 2 diabetes, contributing to poor glycaemic control, preventable complications, and increased healthcare burden despite advances in treatment. Existing adherence measures often quantify medication-taking behaviour but provide limited insight into the behavioural, psychological, and contextual determinants that influence long-term adherence. The aim of this study was to develop and psychometrically evaluate a theory-informed, patient-derived questionnaire (ASMA) to assess medication adherence and its behavioural determinants among adults with type 2 diabetes mellitus. METHODS: His cross-sectional instrument development and validation study was conducted at a tertiary diabetes care centre in Riyadh, Saudi Arabia. Adults aged ≥18 years who had been receiving oral hypoglycaemic therapy for at least 12 months were recruited. Questionnaire items were derived from prior qualitative patient interviews and mapped to the Theoretical Domains Framework (TDF). Medication adherence outcomes were descriptively assessed using three self-reported items aligned with the ABC taxonomy of medication adherence, capturing initiation, implementation, and persistence of medication-taking behaviour. RESULTS: A total of 145 participants were included (59.3% female), with a median diabetes duration of 10.5 years (IQR 6.0-20.0). Most participants reported adherence across ABC phases: 91.8% reported always taking medication as prescribed (implementation), 97.9% reported initiation of therapy, and 84.2% reported persistent medication use. Sampling adequacy was acceptable (KMO=0.74), and Bartlett's test was significant (χ(325)=1214, p<0.001). Exploratory factor analysis supported a four-factor structure after item refinement. The retained domains were: Psychological and Behavioral Regulation (9 items), Perceived Control and Treatment Facilitation (5 items), Knowledge and Informational Support (3 items), and Beliefs about Consequences (2 items). Factor loadings ranged from 0.69 to 0.82 within the unidimensional four-item domain. The four-factor solution demonstrated conceptual coherence and adequate variance explanation. Internal consistency was good for the Psychological and Behavioral Regulation domain (α=0.81; ω=0.83), while other domains showed moderate reliability, likely reflecting fewer items. CONCLUSION: The ASMA questionnaire demonstrates preliminary evidence of structural validity and reliability as a multidimensional, theory-informed instrument. It may support the identification of modifiable behavioural determinants of medication adherence and inform targeted, patient-centred interventions in adults with type 2 diabetes. Further confirmatory validation is warranted.
Experiences of Discharge Preparedness Among Patients with Chronic Heart Failure and Their Caregivers: A Phenomenological Study.
Wang Y, Wang C, Meng Y … +2 more , Zhu N, Yue B
Patient Prefer Adherence · 2026 · PMID 41877856 · Full text
OBJECTIVE: To explore the lived experiences of discharge readiness among older patients with chronic heart failure and their family caregivers during the hospital-to-home transition. PATIENTS AND METHODS: Guided by Husse...
OBJECTIVE: To explore the lived experiences of discharge readiness among older patients with chronic heart failure and their family caregivers during the hospital-to-home transition. PATIENTS AND METHODS: Guided by Husserlian descriptive phenomenology, we conducted in-depth, semi-structured interviews with 16 patient-caregiver dyads purposively sampled from three cardiology departments at a tertiary hospital in Heilongjiang Province, China, between July and September 2025. Data were analyzed using Colaizzi's seven-step method to uncover essential structures of the lived experience. RESULTS: Analysis revealed three core themes: (1) Cognitive ambiguity in illness understanding, characterized by reliance on symptom intuition and gaps in knowledge about disease mechanisms; (2) Emotional and relational struggles during psychological adjustment, including fear, role disruption, and efforts to preserve dignity; and (3) Perceived fragmentation of post-discharge support, marked by discontinuous care guidance, caregiver burden, and systemic barriers to healthcare access. CONCLUSION: This study illuminates how older patients with heart failure and their caregivers navigate the transition home amid persistent uncertainty, emotional strain, and fragmented support. Findings underscore the need for transitional care models that provide structured illness education, integrate dyadic psychological support, and establish nurse-coordinated follow-up to enhance self-management and reduce readmission risk.
Latent Physical Activity Patterns and Their Related Factors in Breast Cancer Patients During Chemotherapy Intervals.
Shi S, Chang G, Xie C … +3 more , Xiao J, Liu Y, Cai S
Patient Prefer Adherence · 2026 · PMID 41877855 · Full text
OBJECTIVE: Previous research on breast cancer patients has primarily examined singular behavioral indicators, often overlooking the coexistence and interaction between physical activity and sedentary behavior-particularl...
OBJECTIVE: Previous research on breast cancer patients has primarily examined singular behavioral indicators, often overlooking the coexistence and interaction between physical activity and sedentary behavior-particularly screen-based sedentary time. This study aims to identify the latent activity pattern categories among breast cancer patients during chemotherapy intervals and explore their associated factors to inform targeted behavioral interventions. METHODS: A cross-sectional survey was conducted with 292 breast cancer patients undergoing chemotherapy intervals at four general hospitals in Foshan, Guangdong Province. Latent Profile Analysis (LPA) was applied as a person-centered analytic approach to identify distinct activity pattern profiles. Data were collected using a general information questionnaire, the Adult Sedentary Behavior Questionnaire (ASBQ), the Chinese version of the International Physical Activity Questionnaire (IPAQ-SC), the Exercise Self-Efficacy Scale (ESES), the Perceived Social Support Scale (PSSS), and the Hospital Anxiety and Depression Scale (HADS). RESULTS: The activity patterns of breast cancer patients were categorized into three groups: Moderate Activity-Dominant Group (37.33%), Screen-Sedentary High-Risk Group (8.22%), and Activity-Sedentary Coexistence Group (54.45%). Logistic regression analysis showed that, compared to the Moderate Activity-Dominant Group, patients with low exercise self-efficacy and higher anxiety and depression levels were more likely to be classified into the Screen-Sedentary High-Risk Group and Activity-Sedentary Coexistence Group. Higher education levels and being on medical leave were associated with a higher probability of belonging to the Activity-Sedentary Coexistence Group (all < 0.05). CONCLUSION: Activity patterns in breast cancer patients show significant heterogeneity. Healthcare providers should pay attention to the individual physical activity characteristics of patients and offer personalized physical activity guidance. Tailored interventions that meet the needs of breast cancer patients should be developed to improve health outcomes.
Impact of a CMO-Based Pharmaceutical Care Model on 3-HIT Criteria in Older People Living with HIV: The DIS3HIT Project.
Roldán Galnares M, Morillo-Verdugo R, Robustillo-Cortes MLA … +8 more , Vélez-Díaz-Pallarés M, Company Albir MJ, Proy Vega B, Losa López L, Marín Ventura L, Ferris Villanueva M, Mora Atorrasagasti O, Gutiérrez E
Patient Prefer Adherence · 2026 · PMID 41877854 · Full text
BACKGROUND: People living with HIV (PLWH) are increasingly affected by ageing-related issues, including multimorbidity and polypharmacy, which heighten the risk of drug-related problems. The 3-HIT phenomenon- defined as...
BACKGROUND: People living with HIV (PLWH) are increasingly affected by ageing-related issues, including multimorbidity and polypharmacy, which heighten the risk of drug-related problems. The 3-HIT phenomenon- defined as the simultaneous presence of high pharmacotherapeutic complexity, clinically relevant drug-drug interactions, and poor adherence to concomitant medication-represents a significant challenge in the care of older PLWH. OBJECTIVE: To evaluate the impact of a Capacity-Motivation-Opportunity (CMO) pharmaceutical care model on reducing the prevalence of the 3-HIT criteria in PLWH aged ≥50 years and to assess pharmacotherapeutic goal achievement according to patient stratification. METHODS: A prospective, multicentre intervention study was conducted in nine Spanish hospitals (March 2023-March 2024), including PLWH aged ≥50 on antiretroviral and concomitant therapy. Participants were stratified into three levels of pharmaceutical care according to the CMO model (Capacity, Motivation, Opportunity). Clinical, virological, and pharmacotherapeutic data were collected at baseline and week 24. Interventions were tailored to individual needs and stratification level. RESULTS: Among 154 participants (mean age 62.6 years (SD: 7.47); 75.3% male), the predominance of male participants was consistent with the demographic profile of ageing PLWH cohorts in Spain. Polypharmacy was highly prevalent (96.1%), and 17.5% of participants simultaneously met all three 3-HIT criteria at baseline. After 24 weeks, 3-HIT prevalence decreased significantly to 9.4% (p<0.05), with marked improvements in adherence to concomitant medication (from 50% to 76.6%). The proportion of individuals achieving at least one pharmacotherapeutic goal increased from 58.4% at baseline to 73.8% at follow-up. The intervention was associated with sustained pharmaceutical actions, particularly regarding adherence support, treatment validation, and care coordination. CONCLUSION: Implementation of a structured, stratified pharmaceutical care model based on the CMO methodology significantly reduces 3-HIT prevalence in older PLWH, primarily through improved adherence to concomitant medication, while maintaining virological control. These findings support the inclusion of CMO-based approaches in clinical practice to optimise pharmacotherapy and improve outcomes in ageing HIV populations.
Adherence to Self-Care and Associated Factors Among Patients with Type 2 Diabetes in Southwestern Iran.
Shojaei Z, Khasraji Z, Charkazi A … +1 more , Pahlavanzadeh B
Patient Prefer Adherence · 2026 · PMID 41877853 · Full text
BACKGROUND: Effective self-care is essential for managing type 2 diabetes and preventing complications. However, adherence remains suboptimal. This study assessed self-care behaviors and associated factors among patients...
BACKGROUND: Effective self-care is essential for managing type 2 diabetes and preventing complications. However, adherence remains suboptimal. This study assessed self-care behaviors and associated factors among patients with type 2 diabetes in southwestern Iran. METHODS: A cross-sectional study was conducted on 153 patients (selected from 160 invited individuals; response rate: 95.6%) in Behbahan and Susangerd between October 2023 and March 2024. Questionnaires were checked for completeness, and complete-case analysis was performed. Self-care was assessed using the Persian version of the Summary of Diabetes Self-Care Activities (SDSCA). Differences among components were tested using Cochran's Q, and multivariate logistic regression identified factors associated with adherence, with significance set at p < 0.05. An operational cutoff of ≥3.5 days per week was used to define "adequate" self-care. RESULTS: Adherence differed significantly among components (p < 0.001). It was highest for Diabetes Diet (OR 7.57, 4.63-12.39) and Non-Smoking (OR 5.23, 3.25-8.41) compared with General Diet (39.2%), whereas Glucose Monitoring (OR 0.41, 0.25-0.67), Foot Care (OR 0.07, 0.03-0.17), and Physical Activity (OR 0.03, 0.01-0.10) were substantially lower. Only 8.5% adhered to five or more components. Higher income, older age, longer disease duration, and being single were associated with better adherence to specific behaviors. CONCLUSION: Overall self-care was suboptimal, particularly for physical activity and foot care. Targeted interventions focusing on patient education and follow-up, especially for individuals with lower income or education, are urgently needed to improve adherence and reduce diabetes-related complications.
Public Perceptions of Ethical and Professional Practice in Jordanian Community Pharmacies: A Cross-Sectional Study.
Jarad OF, Hasan HE, Khabour OF … +2 more , Alzoubi KH, Al-Delaimy WK
Patient Prefer Adherence · 2026 · PMID 41873419 · Full text
BACKGROUND: Ethical and professional pharmacy practice is fundamental to supporting patient safety and trust. Despite advances in Good Pharmacy Practice (GPP), evidence from developing systems indicates gaps in ethical p...
BACKGROUND: Ethical and professional pharmacy practice is fundamental to supporting patient safety and trust. Despite advances in Good Pharmacy Practice (GPP), evidence from developing systems indicates gaps in ethical performance. This study aimed to assess the ethical dimensions of community pharmacists' practice in Jordan from the public's perspective, focusing on counseling quality, privacy, autonomy, and fairness. METHODS: A cross-sectional survey was conducted among 710 community pharmacy clients across Jordan using a validated questionnaire measured five ethical domains and an attitude scale. Composite scores for patient satisfaction, ethical conduct, and pharmacist attitude were calculated. Descriptive statistics and logistic regression were used to identify demographic predictors. RESULTS: Participants were predominantly female (57.9%) and from central Jordan (69.6%). Mean domain scores were: history-taking (51.3 ± 34.3), counseling (60.3 ± 29.6), privacy (67.8 ± 26.1), autonomy (60.2 ± 36.6), and justice (86.5 ± 24.0). Counseling was strongest for medication use and timing but weakest for safety aspects-adverse effects (41.4%), storage (40.1%), and drug interactions (31.7%). Justice and professionalism received the highest perception scores, while privacy and autonomy received moderate ratings. Gender (female) and south region predicted higher satisfaction and ethical perception ( < 0.05). CONCLUSION: Community pharmacists in Jordan were perceived as demonstrating strong fairness and professionalism, but gaps remain in safety-oriented counseling and privacy assurance. These findings highlight areas where communication practices, privacy infrastructure, and ethics-oriented training may warrant further attention. Strengthening these areas could contribute to supporting patient trust and the ethical quality of community pharmacy services.
Advancing the Understanding of Temporal Dynamics in Rehabilitation Adherence: Methodological Reflections on the Study by Shao et al [Letter].
Li J, Ning L
Patient Prefer Adherence · 2026 · PMID 41873418 · Full text
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Factors Associated with Adherence to the Atrial Fibrillation Better Care (ABC) Pathway Among Rural Patients with Atrial Fibrillation: A Path Analysis Based on the Integrated Theory of Health Behavior Change (ITHBC).
Huang J, Chen J, Ye Q … +7 more , Cai X, Feng Y, Lai X, Diao X, Dai Q, Zhang X, Li K
Patient Prefer Adherence · 2026 · PMID 41868736 · Full text
BACKGROUND: The atrial fibrillation better care (ABC) pathway is an effective strategy for the integrated management of atrial fibrillation (AF). However, the adherence rate of ABC pathway in rural Chinese patients with...
BACKGROUND: The atrial fibrillation better care (ABC) pathway is an effective strategy for the integrated management of atrial fibrillation (AF). However, the adherence rate of ABC pathway in rural Chinese patients with AF is extremely low. AIM: To explore the factors and mechanisms of adherence to the ABC pathway based on the integrated theory of health behavior change (ITHBC) among rural patients with AF. METHODS: In this cross-sectional study, we recruited 940 patients with AF from rural areas in China from July 2022 to September 2023. Patients completed a questionnaire covering AF-related demographic and clinical characteristics, AF knowledge, AF health beliefs, AF self-management ability, and social support. Adherence to ABC pathway was assessed based on AF-demographic and clinical characteristics. Path analysis was used to explore the relationship between variables. RESULTS: Adherence to ABC pathway among rural patients with AF was extremely low (5.7%). AF self-management ability ( = 0.449; <0.001) and social support ( = 0.429; <0.001) directly and positively affected adherence to ABC pathway. Additionally, AF knowledge ( = 0.211; <0.001), AF health beliefs ( = 0.350; <0.001) and social support ( = 0.085; <0.001) can also indirectly and positively affect adherence to ABC pathway through AF self-management ability. AF knowledge ( = 0.121; <0.001) can indirectly affect adherence to the ABC pathway through a series of mediations via AF health beliefs and AF self-management ability. CONCLUSION: AF knowledge, AF health beliefs, and social support are important intervention components that should be closely integrated with AF self-management ability.
Experiences of Effective Psychological Adjustment in Patients Undergoing Maintenance Hemodialysis: A Qualitative Study.
Zhang L, Guo Y, Meng X … +3 more , Li Y, He M, Zhang H
Patient Prefer Adherence · 2026 · PMID 41868735 · Full text
PURPOSE: Patients receiving long-term maintenance hemodialysis (MHD) are prone to psychological distress, which adversely affects their self-management capabilities and overall quality of life. This study explores the ex...
PURPOSE: Patients receiving long-term maintenance hemodialysis (MHD) are prone to psychological distress, which adversely affects their self-management capabilities and overall quality of life. This study explores the experiences and strategies related to positive psychological adjustment in this population, with the aim of informing interventions to improve disease adjustment and quality of life. PATIENTS AND METHODS: This study, guided by the Roy adaptation model, utilized an interpretative phenomenological methodology. Adopting the patient perspective, semi-structured interviews were used to investigate the experiences of patients undergoing maintenance hemodialysis. From May to July 2025, a purposive sampling approach was employed to recruit 15 patients receiving maintenance hemodialysis from Henan Province, China, who demonstrated positive psychological adjustment. The data was organized via NVivo 12.0 and analyzed via Colaizzi's method. RESULTS: Four primary themes were identified: (1) Balancing acceptance of physiological limitations with proactive adjustment to life on maintenance hemodialysis; (2) Accurate Self-Repositioning; (3) Pursuing a renewed life by exploring and embracing novel social roles; (4) Drawing upon the strength of kinship and friendship to restore confidence in life. CONCLUSION: The psychological adjustment of patients undergoing maintenance hemodialysis is a dynamic process characterized by accepting their health status, reconstructing personal values, and reshaping social roles, with robust social support systems playing a pivotal role in this process. This experiential framework offers critical insights for informing clinical patient management and designing targeted psychological interventions.
Effect of Nurse-Led Swallowing Rehabilitation on Swallowing Function, Quality of Life, and Adherence in Patients with Oral Cancer: A Single Center Randomized Controlled Trial.
Hu ZY, Xie LN, Liang GM … +3 more , Liu YW, Wen XX, Hou JW
Patient Prefer Adherence · 2026 · PMID 41868734 · Full text
OBJECTIVE: Oral cancer patients frequently experience high rates of dysphagia, multiple complications, and poor rehabilitation compliance post-surgery. This study aims to evaluate the effectiveness of specialized nurse-l...
OBJECTIVE: Oral cancer patients frequently experience high rates of dysphagia, multiple complications, and poor rehabilitation compliance post-surgery. This study aims to evaluate the effectiveness of specialized nurse-led dysphagia rehabilitation program in improving patients' swallowing function, quality of life, adherence, and nutritional status. METHODS: A single center randomized controlled trial design was employed. 89 patients admitted to the Department of Oral and Maxillofacial Surgery at Zhejiang Cancer Hospital between July 17, 2025, and October 20, 2025, were randomly assigned to an intervention group (n=45) or a usual care group (n=44). The intervention group received a comprehensive rehabilitation program (diagnostic phase, perioperative phase, pre-discharge preparation phase, adjustment and adaptation phase) implemented by a multidisciplinary team led by specialized nurses, supported by a WeChat mini-program. The usual care group received a standard rehabilitation program. Outcome measures included functional oral intake scale, swallowing-related quality of life scale, swallowing function exercise compliance scale, and body mass index. Assessments were conducted at baseline (T0), 1 week post-surgery (T1), 2 weeks (T2), and 4 weeks (T3). Generalized estimating equations were used to analyze changes in outcomes over time. RESULTS: Post-intervention, the intervention group demonstrated significantly superior scores compared to the usual care group in swallowing function (at T2 and T3), quality of life (at T1, T2, and T3), and adherence (at T1, T2, and T3). Nutritional status was also significantly better in the intervention group at T1 and T2. Generalized estimating equations analysis revealed statistically significant group-by-time interaction effects for swallowing function, quality of life, adherence, and nutritional status. CONCLUSION: Compared with conventional rehabilitation protocols, a swallowing rehabilitation program led by specialized nurses effectively improves swallowing function, quality of life, adherence, and early nutritional status in patients after oral cancer surgery.
The Patient Persona of the Self-Management Experience of Home-Based Rehabilitation for Spinal Cord Injury Patients: A Qualitative Study [Letter].
Liu X, Ning L
Patient Prefer Adherence · 2026 · PMID 41868733 · Full text
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Public Knowledge, Attitudes, and Practices Toward Obesity and Anti-Obesity Medications in Palestine: A Cross-Sectional Study.
Albarghouthy HM, Abdallah TW, Salahaldin MM … +3 more , Mashni LI, Abukeshek A, Hallak H
Patient Prefer Adherence · 2026 · PMID 41868732 · Full text
BACKGROUND: Obesity is a rising public health concern in Palestine and is increasingly recognized as a chronic disease requiring long-term management. Understanding knowledge, attitudes, and practices (KAP) related to ob...
BACKGROUND: Obesity is a rising public health concern in Palestine and is increasingly recognized as a chronic disease requiring long-term management. Understanding knowledge, attitudes, and practices (KAP) related to obesity and anti-obesity medications is essential for improving prevention and treatment efforts. This study assessed KAP levels and awareness of anti-obesity medications among overweight and obese Palestinian adults. METHODS: A cross-sectional survey was conducted between September and December 2024 using a validated electronic questionnaire distributed through social media platforms. Overweight and obese adults aged 18-80 years were invited to participate. RESULTS: Among 380 respondents, 85% demonstrated good knowledge of obesity, 65.5% showed positive attitudes, and 50.5% reported good practices. Awareness of anti-obesity medications was high (75.8%), although only 8% had used them. CONCLUSION: Despite strong knowledge and generally positive attitudes toward obesity management, practical engagement in healthy behaviors remains suboptimal. Public-health programs and educational interventions are needed to bridge the gap between awareness and effective practice, including better integration of evidence-based pharmacologic options.
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