Patient Preference And Adherence[JOURNAL]
Sun
200 papers
What Matters Most to Patients with NSCLC When Choosing Anticancer Treatments in China? A Best-Worst Scaling Study.
Qiao J, Liu S, Bao S … +3 more , Tao Y, Zhao J, Chen Y
Patient Prefer Adherence · 2026 · PMID 41868731 · Full text
OBJECTIVE: This study aimed to evaluate treatment preferences for anticancer drugs among patients with non-small cell lung cancer (NSCLC), in order to provide evidence not only for clinical prescribing decisions but also...
OBJECTIVE: This study aimed to evaluate treatment preferences for anticancer drugs among patients with non-small cell lung cancer (NSCLC), in order to provide evidence not only for clinical prescribing decisions but also for broader applications such as health insurance reimbursement and policy-making. METHODS: A Best-Worst Scaling object-case (BWS-1) questionnaire was administered to NSCLC patients. Thirteen choice sets, each containing four attributes, were generated using Balanced Incomplete Block Design. Respondents were asked to identify the most and least important attribute within each set. The attributes include overall survival (OS), disease control rate, progression-free survival (PFS), dyspnea, pain, objective response, hemoptysis, fever, nausea and vomiting, monthly out-of-pocket expenditure, cough, mode of administration, fatigue. Relative attribute importance and preference heterogeneity were estimated using counting analysis and a conditional logit model (CLM). RESULTS: A total of 102 NSCLC patients were enrolled. High concordance was observed between counting analysis and conditional logit results. In the CLM, OS (=3.537, <0.01), disease control rate (=2.025, <0.01), and PFS (=1.574, <0.01) showed the strongest positive preferences. Fatigue (=-1.158, <0.01) and mode of administration (=-0.600, <0.01) were associated with lower relative importance. Cough showed a negative coefficient but was not statistically significant (=-0.185, =0.11). CONCLUSION: This study is the first to explore the NSCLC patient medication preference using a BWS-1. The findings suggest OS, disease control rate, and PFS are prioritized by patients when choosing treatment regimens.
Dilemmas of Self-Management in Patients with Pulmonary Arterial Hypertension: A Descriptive Phenomenological Study.
Cai J, Zhao N, Gao Y … +2 more , Pan L, Yang Q
Patient Prefer Adherence · 2026 · PMID 41868730 · Full text
OBJECTIVE: To explore how patients with PAH experience self-management challenges. METHODS: A descriptive phenomenological research was applied to conduct face-to-face, semi-structured, in-depth interviews with 12 patien...
OBJECTIVE: To explore how patients with PAH experience self-management challenges. METHODS: A descriptive phenomenological research was applied to conduct face-to-face, semi-structured, in-depth interviews with 12 patients diagnosed with PAH recruited from Fuwai Central China Cardiovascular Hospital in Henan Province, from January to June 2025. The collected data were analyzed using Colaizzi's phenomenological analysis method. RESULTS: Analysis revealed two overarching themes: (1) Individual-level barrier, comprising lack of awareness,insufficient knowledge about medications and disease management, and heavy financial burden; and (2) Contextual challenges, comprising uncertainty about the disease progression, lack of family and social support, poor accessibility to medications, and disruptions due to public health emergencies. CONCLUSION: Patients with PAH face significant multi-faceted barriers to effective self-management. Interventions should be multifaceted, involving structured patient education, psychological support, family involvement, and policy-level changes to improve drug accessibility and financial support.
A Qualitive Investigation of Geographic Disparities in Genetic Testing and Care Access for Amyotrophic Lateral Sclerosis: Insights From Patient Journey Mapping.
Sethi N, Levy OA, Richardson A … +2 more , Harari OA, Sellati R
Patient Prefer Adherence · 2026 · PMID 41868729 · Full text
PURPOSE: Amyotrophic lateral sclerosis (ALS) is a progressive neuromuscular disease that is associated with a high patient burden, reduced lifespan, and reduced quality of life. People living with ALS (PLwALS) often expe...
PURPOSE: Amyotrophic lateral sclerosis (ALS) is a progressive neuromuscular disease that is associated with a high patient burden, reduced lifespan, and reduced quality of life. People living with ALS (PLwALS) often experience delays in diagnosis of ~1 year, and while current treatment options can slow disease progression, improve quality of life, and offer modest benefits in functional decline, they do not reverse neuronal damage. Defining and understanding the experiences of PLwALS can help identify gaps and barriers to optimal care. PATIENTS AND METHODS: This non-interventional study was intended to obtain insights on the patient experience from the perspective of PLwALS. We sought to develop an ALS patient journey map from initial presentation through to end-of-life care for 4 regions (North America, Asia-Pacific, Latin America, and Europe/Middle East/Africa). The map was based on results from a global audit of data sources (including publications, patient narratives, society guidelines, academic reports, industry white papers [n=104]), and one-to-one, 60-minute, semi-structured interviews with PLwALS (n=12) or those caring for PLwALS (n=2). The initial patient journey map was subsequently reviewed during 2 advisory sessions with patient advocates (7 PLwALS and 2 caregivers) in September and November 2023. RESULTS: We identified several barriers and challenges that most impact PLwALS, caregivers, and clinicians, with many similarities but also some differences across the regions. CONCLUSION: These insights will enable targeted improvements in education, personalized care, resource allocation, care coordination, policy development, and funding, ultimately improving patient outcomes.
Attitudes of the Iranian Public Toward the Clinical Use of Artificial Intelligence in Medicine: A Cross-Sectional Survey.
Maleki MS, Sahebi L, Shahvari Z … +1 more , Samadi S
Patient Prefer Adherence · 2026 · PMID 41858643 · Full text
PURPOSE: The integration of Artificial Intelligence (AI) into healthcare is a global trend, yet its success hinges on public acceptance. This study aimed to provide one of the first comprehensive assessments of awareness...
PURPOSE: The integration of Artificial Intelligence (AI) into healthcare is a global trend, yet its success hinges on public acceptance. This study aimed to provide one of the first comprehensive assessments of awareness, trust, and preferences regarding the clinical use of medical AI among a sample of Iranian hospital visitors and to identify the key predictors shaping these views to inform national digital health policy. PATIENTS AND METHODS: A descriptive-analytical, cross-sectional survey was conducted between August 2024 and March 2025 at the Imam Khomeini Hospital Complex in Tehran, Iran. A validated questionnaire was administered to a convenience sample of 388 hospital visitors (inpatients, outpatients, and their companions). Data were analyzed using descriptive statistics and multivariate logistic regression. RESULTS: Of 388 participants, 53.6% (208/388) had heard of medical AI, yet only 2.6% claimed full knowledge. A phenomenon regarding conflicting attitudes, which we term the "trust-preference paradox", was observed: while ~87% expressed conditional trust in AI's diagnostic and therapeutic capabilities, a significant majority preferred human physicians in disagreement scenarios (Diagnosis: 66.2%; Treatment: 66.8%), primarily due to the desire for personalized care. Preference for AI diagnosis was significantly associated with being male (Odds Ratio [OR] 2.06), having a non-medical/computer science occupation (OR 2.64), and prior AI awareness (OR 1.72). The top perceived advantage was accuracy (46.1%), while the main drawback was lack of empathy (60.1%). A collaborative model where AI assists physicians was favored by 70.6%. CONCLUSION: Participants demonstrated high trust in AI's technical potential but strongly preferred human oversight in high-stakes decisions. Successful AI integration in Iran requires "human-in-the-loop" collaborative models and targeted education to bridge the gap between technical trust and clinical preference.
Men's Preferences for Exiting Abdominal Aortic Aneurysm Surveillance: A Deliberative Engagement Session Study.
Hughes J, Lumley E, Elstone A … +9 more , Michaels J, Nasim A, Radley SC, Shackley P, Stansby G, Wood E, MacGregor-Smith N, Hall J, O'Cathain A
Patient Prefer Adherence · 2026 · PMID 41858642 · Full text
PURPOSE: The national screening programme guidance for Abdominal Aortic Aneurysm (AAA) in England states that men with small AAAs will exit surveillance after 15 years. This study explored the informed preferences of men...
PURPOSE: The national screening programme guidance for Abdominal Aortic Aneurysm (AAA) in England states that men with small AAAs will exit surveillance after 15 years. This study explored the informed preferences of men for AAA surveillance. PATIENTS AND METHODS: A Deliberative Engagement Session was conducted in two workshops comprising 30 men in AAA surveillance and six of their family members. The workshops consisted of measurement of men's knowledge and preferences pre- and post-deliberation, presentations by experts, and deliberation by men and their family members, in terms of knowledge sharing and discussion. RESULTS: Before deliberation, only two of the 30 men in the session were aware of the existence of an exit strategy from AAA surveillance, and their knowledge levels about AAA were poor. Post-deliberation, knowledge levels increased from a median score of 6 (IQR 4 to 7) to a median score of 8 (IQR 8 to 9) correct answers to 11 multiple-choice questions about AAA and AAA screening (p < 0.001). Men in the session identified rate of growth of AAA, size of AAA, health issues that may make surgery risky, and the views of healthcare professionals as important factors to consider in any exit strategy. Most men in the session preferred a strategy whereby they were not discharged from surveillance but had longer intervals between scans (two yearly rather than yearly). Discussion revealed the importance to men and family members of the reassurance surveillance offered to them. In terms of how decisions should be made regarding exit, men in this session wanted to have estimates of the risks of different options, to discuss exit with a Nurse Specialist, and that the patient should decide. CONCLUSION: Based on informed preferences, men in this Deliberative Engagement Session preferred longer intervals between scans rather than exiting surveillance because of the reassurance offered by surveillance.
The Impact of Perceived Usefulness of Wearable Devices on Treatment Adherence in Fracture Patients: The Chain Mediating Roles of Self-Efficacy and Meaning in Life.
Tan X, Cai S, Kan Y … +4 more , Xu N, Chen Y, Xu M, Huang D
Patient Prefer Adherence · 2026 · PMID 41858641 · Full text
BACKGROUND: Fractures patients often exhibit low treatment adherence, resulting in prolonged recovery and increased complications. Wearable devices provide real-time monitoring and feedback and are expected to improve ad...
BACKGROUND: Fractures patients often exhibit low treatment adherence, resulting in prolonged recovery and increased complications. Wearable devices provide real-time monitoring and feedback and are expected to improve adherence, but the psychological mechanisms remain underexplored. This study is among the first to extend the Technology Acceptance Model (TAM) to fracture rehabilitation by incorporating self-efficacy and meaning in life as mediators. OBJECTIVE: The purpose of this study was to analyze the effect of perceived usefulness of wearable devices on treatment adherence of fracture patients and its internal mechanism. METHODS: A cross-sectional study was conducted with 473 fracture patients (45.5% male, mean age 44.42 ± 16.24 years) from four tertiary hospitals in Zhejiang, China, between May and June 2025. Participants completed validated scales assessing perceived usefulness, self-efficacy, meaning in life, and treatment adherence. Structural equation modeling and SPSS Macro Process Model 6 with bias-corrected bootstrapping were used to test direct and mediating effects. RESULTS: Perceived usefulness significantly predicted treatment adherence β = 0.167, 95% CI = [0.042, 0.291]. Self-efficacy (indirect effect = 0.089, 95% CI=[0.019, 0.174]) and meaning in life (indirect effect = -0.135, 95% CI=[-0.215, -0.033]) mediated this relationship, with a chain mediation effect through both variables (indirect effect = 0.149, 95% CI = [0.077, 0.229]). The total effect accounted for 62% of adherence variance. CONCLUSION: The findings reveal a complex psychological mechanism wherein the perceived usefulness of wearable devices influences fracture patients' treatment adherence through multiple pathways, involving both positive and negative mediating effects. This underscores the importance of addressing patients' self-efficacy and meaning in life to maximize the effectiveness of technology-based rehabilitation interventions.
Pharmacist-Led Intervention to Enhance Direct Oral Anticoagulant Adherence and Treatment Outcomes in Atrial Fibrillation: A Pragmatic Clinical Trial.
Liu SY, Huang YM, Lin SY … +1 more , Wang CC
Patient Prefer Adherence · 2026 · PMID 41858640 · Full text
PURPOSE: This study aims to evaluate the impact of a pharmacist-led education program on medication adherence and treatment outcomes among patient with atrial fibrillation (AF) using direct oral anticoagulants (DOACs) fo...
PURPOSE: This study aims to evaluate the impact of a pharmacist-led education program on medication adherence and treatment outcomes among patient with atrial fibrillation (AF) using direct oral anticoagulants (DOACs) for stroke prevention. Additionally, we will compare self-reported adherence with claims data and examine whether DOAC blood concentration can serve as a biomarker for medication adherence and treatment outcomes. PATIENTS AND METHODS: We will conduct a pragmatic randomized controlled trial at National Taiwan University Hospital (NTUH). Patients aged 18 years or older, diagnosed with AF, and newly initiated on DOACs for primary or secondary stroke prevention will be randomized to either the intervention or control group. The intervention group will receive pharmacist-led education at baseline; the control group will receive usual care. The primary endpoint is patients' self-reported medication-use behavior, measured by the Traditional Chinese version of the Adherence to Refills and Medications Scale. We will also compare self-reported adherence with an objective adherence indicator, the DOAC trough concentration, determined by ultra-high-performance liquid chromatography coupled with tandem mass spectrometry. After randomization, participants will return to their routine clinical care, and all follow-up assessments will coincide with their regular clinic visits. Patients' DOAC use behaviors and blood concentrations will be measured at 3- and 6-month follow-ups. Baseline characteristics and treatment outcomes will be obtained from NTUH electronic medical records and the National Health Insurance claims data. CONCLUSION: This trial will evaluate the effectiveness of pharmacist-led education in improving DOAC adherence and treatment outcomes over a 6-month follow-up period. The findings will inform the development and implementation of future pharmacist-led care models. TRIAL REGISTRATION: The study protocol has been registered at ClinicalTrials.gov (identifier NCT07159399).
CT-Based Visual Atherosclerosis Education Improves Secondary Prevention Adherence: A Retrospective Cohort Study Using Cluster Analysis.
Hou X, Qiu S, Chen X
Patient Prefer Adherence · 2026 · PMID 41858639 · Full text
PURPOSE: Suboptimal adherence to pharmacotherapy for modifiable atherosclerotic risk factors (hypertension, dyslipidaemia, and diabetes) remains a major barrier to effective secondary prevention, particularly in newly di...
PURPOSE: Suboptimal adherence to pharmacotherapy for modifiable atherosclerotic risk factors (hypertension, dyslipidaemia, and diabetes) remains a major barrier to effective secondary prevention, particularly in newly diagnosed middle-aged individuals. PATIENTS AND METHODS: This retrospective cohort study evaluated the effects of a novel visually aided atherosclerosis education intervention in which clinicians used computed tomography (CT) images to show atherosclerotic calcification and explain plaque progression on adherence. Non-smoking males aged 45-60 years (n = 153) who underwent health screening at Peking Union Medical College Hospital (March-October, 2024) were stratified into educated (CT-based visualisation of atherosclerotic calcification progression and risk factor education, n = 76) and non-educated (n = 77) groups. K-means cluster analysis was used to classify participants based on low-density lipoprotein cholesterol (LDL-C), glycated haemoglobin (HbA1c), and systolic blood pressure (SBP) control as a proxy for adherence. Group differences in cluster distribution (reflecting adherence patterns) were assessed using the chi-square test. RESULTS: Cluster analysis identified four distinct adherence patterns: cluster 1 (Optimal Control, 67 patients), cluster 2 (Suboptimal Lipid Control, 61 patients), cluster 3 (Suboptimal Glycaemic Control, 14 patients), and cluster 4 (Suboptimal BP Control, 11 patients). The educated group had significantly more individuals in Cluster 1 (Optimal Control: 53.9% vs 33.8% in the uneducated group, p = 0.012) and fewer suboptimally controlled risk factors (46.1% vs 66.2%, p = 0.012). CONCLUSION: Structured, visually aided atherosclerosis education significantly improved adherence to secondary prevention measures and optimised risk factor control. Integrating this evidence-based intervention into routine clinical practice may enhance patient engagement and improve long-term outcomes.
Factors Influencing the Implementation of Unaccompanied Care for Older Inpatients in Chinese Tertiary Hospitals: A Qualitative Study.
He Y, Li R, Jiao T … +3 more , Liu C, Chen Y, Li L
Patient Prefer Adherence · 2026 · PMID 41858638 · Full text
BACKGROUND: In China, tertiary hospitals are piloting an "unaccompanied care" model in which trained care attendants, instead of constantly present family caregivers, provide 24-hour bedside and daily living care for old...
BACKGROUND: In China, tertiary hospitals are piloting an "unaccompanied care" model in which trained care attendants, instead of constantly present family caregivers, provide 24-hour bedside and daily living care for older inpatients under nurses' supervision. This hospital-based service aims to relieve family caregiving shortages and advance integrated care but remains non-standardised and faces major implementation challenges. OBJECTIVE: Guided by a social-ecological framework, this study examined the multilevel factors influencing the implementation of unaccompanied care and generated evidence to inform the optimization of service design, risk communication with family members, and the allocation of staffing and financial resources. METHODS: We used a qualitative descriptive design with a phenomenological orientation. Using purposive sampling with maximum variation, we recruited 36 participants: 21 older inpatients and family caregivers and 15 healthcare professionals (administrators, clinicians, nurses) and staff from companion-care companies. Data were collected through semi-structured interviews conducted between November 2024 and January 2025 and analysed using Colaizzi's seven-step method. RESULTS: A total of five main themes and 15 sub-themes were identified: personal cognition, economy, and triple constraints; interpersonal support and interaction; organization resource integration and driving; social environment constraints and demands; public policy support and promotion. CONCLUSION: The implementation of unaccompanied care in Chinese tertiary hospitals faces challenges such as economic burden, cultural expectations of family caregiving, and insurance policy gaps. Through targeted communication, joint development of infrastructure and staff capabilities, along with supportive payment and regulatory policies, this pilot model can be integrated into sustainable, high-quality care for elderly inpatients.
Factors Associated with Patient Treatment Satisfaction in Diabetes Mellitus Care Using the DTSQs: A Nationwide Cross-Sectional Study in Saudi Arabia.
Alqifari SF, Amirthalingam P, Prabahar K … +5 more , Qasem KA, Alanazi FE, Alrasheed T, Al-Ajlan NA, Aljabri A
Patient Prefer Adherence · 2026 · PMID 41858637 · Full text
INTRODUCTION: Patient satisfaction is crucial in managing chronic diseases like diabetes mellitus (DM). This study aims to identify the key factors associated with patient satisfaction with DM treatment in the Kingdom of...
INTRODUCTION: Patient satisfaction is crucial in managing chronic diseases like diabetes mellitus (DM). This study aims to identify the key factors associated with patient satisfaction with DM treatment in the Kingdom of Saudi Arabia. METHODS: This cross-sectional study collected data from 709 participants country-wide via an online survey. Participants included patients receiving care from public and private healthcare facilities offering primary or specialized diabetes care. Patient satisfaction was assessed using the Diabetes Treatment Satisfaction Questionnaire (DTSQs), with chi-square tests for HbA1c control and Mann-Whitney -tests for comparisons of means between groups. RESULTS: Governmental healthcare patients had higher satisfaction (Mean = 27.32, SD = 7.62) than private (Mean = 25.5, SD = 8.51) ( = 0.007). Patient treatment satisfaction was also greater in diabetes centers (Mean = 28.93, SD = 6.34), than in primary care (Mean = 25.45, SD = 8.51), (= <0.001). Although overall treatment satisfaction scores did not differ significantly between controlled and uncontrolled diabetes (= 0.784), patients with controlled diabetes experienced significantly fewer hyperglycemic and hypoglycemic episodes, (= <0.001), and higher satisfaction with treatment flexibility (= 0.006), diabetes understanding (= 0.013) and willingness to recommend their treatment to others (= <0.001). CONCLUSION: Mode of healthcare delivery (public or private hospitals) and choice between primary care or diabetes centers was significantly associated with treatment satisfaction with greater satisfaction in governmental healthcare and specialized diabetes centers. Glycemic control, measured by HbA1c, showed no significant association with overall treatment satisfaction but was associated with specific item scores (including satisfaction with understanding and treatment flexibility). This study is among the first in Saudi Arabia to compare DM treatment satisfaction across different healthcare settings using the DTSQs. Recognizing these associations can provide healthcare professionals with valuable insights for more successful treatment of diabetes patients and ultimately improve patient outcomes.
Preferences of Chinese Women for Perinatal Depression Screening: A Discrete Choice Experiment.
Quan J, Wen Y, Wu S … +3 more , Li X, Zuo X, Li S
Patient Prefer Adherence · 2026 · PMID 41858636 · Full text
INTRODUCTION: Perinatal depression affects 17.7% of women globally, with prevalence reaching 20-30% in China and higher in low-income regions. It poses severe risks, including adverse pregnancy outcomes, maternal suicide...
INTRODUCTION: Perinatal depression affects 17.7% of women globally, with prevalence reaching 20-30% in China and higher in low-income regions. It poses severe risks, including adverse pregnancy outcomes, maternal suicide, and infanticide. Despite its high prevalence, many cases go undiagnosed due to low screening participation. Screening is cost-effective and reduces depression risk by 2.1-9.1%, yet current strategies often fail to align with patient preferences. In this study, a discrete choice experiment was utilized to assess women's preferences for postpartum depression screening characteristics, and to quantify trade-offs and preference heterogeneity, providing information for a more patient-centered approach. METHODS: We identified six key screening attributes through literature review, interviews, and focus groups. A D-efficiency design approach was implemented to create 36 choice sets and randomly divide them into 3 blocks. A mixed logit model was applied to analyze participants' preferences, assess the relative importance of attributes, and predict the choice probabilities of participants for screening situations. RESULTS: There are 291 respondents were included in analysis. Healthcare provider type emerged as the most important screening characteristic (27% relative importance), with strongest preference for doctor-led screenings. Women consistently preferred shorter screening duration (15 minutes). Younger women (18-34 years) preferred online screening, while Postpartum women showed stronger preferences for telephone screenings. The most preferred scenario-online by a physician, lasted 15 minutes, occurred every three months, and provided as a rouhad a 0.270 predicted choice probability. These findings highlight the need for tailored screening approaches based on age and pregnancy status. CONCLUSION: This study identified a preference for brief, physician-led screening with follow-up. To enhance implementation in primary care, particularly in resource-limited settings, we recommend integrating short screenings into routine visits and utilizing trained non-specialists with digital support. These strategies can improve screening accessibility and long-term management.
Qualitative Study of Learned Helplessness in Colorectal Cancer Patients with Colostomy: A Social-Ecological Perspective.
Wei X, Wu L, Chen X … +2 more , Ding J, Hua Q
Patient Prefer Adherence · 2026 · PMID 41858635 · Full text
PURPOSE: To explore the experience of learned helplessness among colorectal cancer ostomy patients within the theoretical framework of social ecosystems, and to provide a theoretical basis for developing targeted nursing...
PURPOSE: To explore the experience of learned helplessness among colorectal cancer ostomy patients within the theoretical framework of social ecosystems, and to provide a theoretical basis for developing targeted nursing interventions for this population. METHODS: Employing purposive sampling, semi-structured in-depth interviews were conducted with 16 colorectal cancer patients with ostomies at the First Affiliated Hospital of Anhui Medical University between March and June 2024. Data analysis was performed using Colaizzi's phenomenological methodology. RESULTS: A total of three main themes and nine sub-themes were identified, as follows: (1) Micro-level systems: fear and negative cognition, self-care barriers and dependency, and self-regulation fatigue and loss of control; (2) Meso-level systems: heavy economic burden, the importance of family support, and social avoidance and stigma; (3) Macro-level systems: insufficient medical information and services, social cognitive bias, and the importance of social security policies. CONCLUSION: Learned helplessness in colorectal-cancer patients is driven by synergistic systemic factors. Healthcare providers should implement multifaceted, individualized interventions that target psychological distress and mitigate helplessness across the entire care trajectory.
Knowledge, Attitudes, and Practices Toward Insomnia Among Insomnia Patients.
Fang Y, Wang S, Li G … +5 more , Deng J, Tian Y, Wan Z, Yang D, Wang Q
Patient Prefer Adherence · 2026 · PMID 41853640 · Full text
PURPOSE: This study aimed to investigate the knowledge, attitudes, and practices (KAP) toward insomnia among patients. PATIENTS AND METHODS: A cross-sectional survey was conducted from May 20, 2023, to March 25, 2024, in...
PURPOSE: This study aimed to investigate the knowledge, attitudes, and practices (KAP) toward insomnia among patients. PATIENTS AND METHODS: A cross-sectional survey was conducted from May 20, 2023, to March 25, 2024, in the Neurology Outpatient Department at the Affiliated Hospital of Chengdu University of Traditional Chinese Medicine. Data were collected through the distribution of questionnaires. RESULTS: A total of 568 valid questionnaires were analyzed. Of these respondents, 368 (64.79%) were female. Notably, 156 (27.46%) exhibited symptoms of anxiety, and 103 (18.13%) were found to be experiencing depressive symptoms. The mean knowledge, attitude, and practice scores were 5.50±2.20 (possible range: 0-9), 24.53±3.21 (possible range: 8-40), and 28.55±4.28 (possible range: 8-40), respectively. The results of pathway analysis showed that knowledge was directly associated with both attitude (β=0.240, P=0.010) and practice (β=-0.128, P=0.013), and attitude was associated with practice (β=0.179, P=0.010). Furthermore, an indirect association was observed between knowledge and practice through attitude (β=0.043, P=0.010). CONCLUSION: The study found patients' insomnia knowledge and attitudes are poor, yet their practices are proactive. Since knowledge and attitudes were associated with practice, clinical programs should consider implementing educational interventions to improve understanding and foster positive attitudes toward insomnia management.
Smart Blister System with and without Mobile App Support: A Randomized Controlled Usability Trial.
Eikholt AA, Chan AHY, Van Boven JFM
Patient Prefer Adherence · 2026 · PMID 41847246 · Full text
PURPOSE: Medication non-adherence remains a major barrier to effective long-term disease management. Smart packaging technologies offer digital solutions to monitor and support adherence. This study evaluated the usabili...
PURPOSE: Medication non-adherence remains a major barrier to effective long-term disease management. Smart packaging technologies offer digital solutions to monitor and support adherence. This study evaluated the usability and feasibility of a smart blister pack (Cerepak) for monitoring medication adherence, both with and without a mobile adherence app (MEMS Mobile), in healthy adult participants. METHODS: In this randomized controlled trial, 36 participants were assigned to use the smart blister pack either with the mobile adherence app (intervention) or without the app (control) over eight weeks, simulating twice-daily medication intake. Usability was assessed using the System Usability Scale (SUS) and user experience surveys. Semi-structured interviews explored user satisfaction, barriers, and suggestions for improvement. Adherence was measured electronically and via pill counts. RESULTS: Usability scores were significantly higher in the intervention group (median SUS: 80.0) compared to the control group (67.5; p = 0.0007). Participants appreciated the packaging's visual layout and the app's reminder and tracking features. Qualitative findings highlighted improved structure, motivation, and ease of use with the app, alongside technical and packaging challenges. Electronic adherence was 91.7% in the app group and 86.2% in the non-app group. Pill count adherence was 96.4% and 88.0%, respectively. No statistically significant differences were observed. Intermittent data capture issues associated with the smart blister pack led to minor performance inconsistencies in 10.4% of packages, which were accounted for in the analysis, ensuring data integrity. CONCLUSION: The smart blister pack is usable and feasible for daily medication taking and tracking, particularly when supported by a mobile app. These findings support further research into clinical populations and long-term implementation studies.
Factors Influencing Acceptance of Biologics and Small Molecule Targeted Drugs Among Patients with Chronic Spontaneous Urticaria: A Cross-Sectional Study.
Yang Y, Gao C, Fei X … +2 more , Wang R, Jiang W
Patient Prefer Adherence · 2026 · PMID 41847245 · Full text
OBJECTIVE: This study aimed to investigate CSU patients' awareness, attitudes, and acceptance of biologics and small-molecule targeted drugs (SMTD). MATERIALS AND METHODS: We conducted a single-center cross-sectional sur...
OBJECTIVE: This study aimed to investigate CSU patients' awareness, attitudes, and acceptance of biologics and small-molecule targeted drugs (SMTD). MATERIALS AND METHODS: We conducted a single-center cross-sectional survey using a structured questionnaire to collect clinical and demographic data from 711 patients with CSU, along with information on their knowledge of and attitudes toward biologics and SMTD. Multivariable logistic regression analysis was performed to estimate odds ratios (OR) and 95% confidence intervals (CI) to identify factors associated with patients' acceptance of biologics and SMTD. RESULTS: Among all participants, 53.02% were aware of biologics and SMTD, and 47.81% expressed willingness to use these therapies. Higher education level (college and above; OR = 5.44, 95% CI: 1.09-27.08), marital status (married; OR = 3.79, 95% CI: 1.29-11.17), and family history (OR = 5.97, 95% CI: 2.75-12.95) were positively associated with acceptance. Conversely, alcohol consumption showed an independent negative association (OR = 0.37, 95% CI: 0.15-0.88). Patients' awareness of biologics and SMTD (OR = 3.66, 95% CI: 1.85-7.24), perceived safety (OR = 3.70, 95% CI: 2.16-6.34) and perceived efficacy (OR = 11.86, 95% CI: 6.79-20.72) were also strongly associated with willingness to adopt these therapies. CONCLUSION: This study found that higher educational attainment, marital status, abstinence from alcohol, and a family history of CSU were associated with greater willingness to accept biologics and SMTD, while awareness of these therapies and perceptions of their safety and efficacy were the most influential determinants of treatment acceptance. These findings highlight the importance of improving patient awareness and providing clear, culturally tailored communication to support informed decision-making and facilitate the integration of biologics and SMTD into CSU management in China.
Medication Sharing Among Older Adults in South Korea: A Qualitative Study.
Song S, Lee EE
Patient Prefer Adherence · 2026 · PMID 41847244 · Full text
PURPOSE: Medication sharing has been reported in many countries, with prevalence rates of 6-42% for lending and 5-54% for borrowing. This can cause serious harm, particularly in older adults. Therefore, this study aimed...
PURPOSE: Medication sharing has been reported in many countries, with prevalence rates of 6-42% for lending and 5-54% for borrowing. This can cause serious harm, particularly in older adults. Therefore, this study aimed to investigate older adults' perceptions and experiences of medication sharing. PATIENTS AND METHODS: For this qualitative study, semi-structured interview study, data were collected in person from older adults aged 65-90 years, who were recruited using snowball sampling. The study was conducted between May and November 2020. Descriptive analysis was conducted to summarize participants' demographic characteristics. The interview responses were analyzed using content analysis with deductive and inductive methods. RESULTS: A total of 20 participants were included in the study. Among them, 18 participants (90%) reported medication-sharing experiences with prescription or over-the-counter medications, and 16 (80%) reported sharing medications with family or relatives. The shared medications ranged from oral tablets for chronic disease management to topical patches for acute pain. The participants primarily described the following reasons for medication sharing: lenders having unused (leftover) medications available, borrowers' financial difficulties, and lenders having drug coverage provided through their health insurance. Eleven participants (55%) identified leftover medications as one of the reasons for medication sharing, and five participants (25%) identified financial difficulties. The lenders reported that the medication-sharing behavior negatively affected their medication therapy adherence. CONCLUSION: In this study's sample, most older adults (90%) reported engaging in medication sharing within close relationships, which was described as a socially situated practice with implications for medication management. Addressing this behavior may require privacy-assured, non-judgmental communication strategies that are culturally tailored. Future quantitative or mixed-methods studies are needed to better understand the behavior and inform the development of effective interventions.
Assessment of Participant Satisfaction and Overall Experience: A Cross-Sectional Survey to Inform Trial Conduct.
Al-Maqbali JS, Al Alawi AM, Al-Zakwani I … +1 more , Al Za'abi M
Patient Prefer Adherence · 2026 · PMID 41847243 · Full text
PURPOSE: This study assessed participants' experience with their clinical trial and explored perceived health improvements to support quality improvement initiatives. PATIENTS AND METHODS: A cross-sectional survey was co...
PURPOSE: This study assessed participants' experience with their clinical trial and explored perceived health improvements to support quality improvement initiatives. PATIENTS AND METHODS: A cross-sectional survey was conducted among participants of a randomized, double-blind clinical trial on magnesium supplementation in type 2 diabetes. All participants were invited to complete a 25-item survey after providing informed consent. The survey covered general information, core trial experience (Five-Point-Likert-Scale), symptom improvement, overall satisfaction, and open-ended questions. The tool was bilingually developed, culturally adapted, and psychometrically tested for consistency and validity. Both quantitative and qualitative thematic analysis were performed. RESULTS: The survey demonstrated a high internal consistency (Cronbach's alpha=0.93), and a strong construct validity characterized by a predominant unidimensional structure (Kaiser-Meyer-Olkin value=0.897). Of 227 contacted participants, 132 completed the survey (response rate: 58.15%). Satisfaction scores were consistently positive, especially for staff professionalism, respect for time, and informed consent clarity. Most respondents (75%) were willing to join future trials, and 87.88% would recommend participation. Over half reported symptom improvements, particularly in muscle cramps, energy, and sleep quality. No significant association was found between satisfaction and symptom improvement. Satisfaction was high across all educational levels. Open-ended responses emphasized staff professionalism, clear communication, and perceived health benefits as key factors to the overall reported satisfaction. CONCLUSION: Respondents reported a consistently high satisfaction level, with perceived symptom improvements and strong willingness to future participation. This internally reliable and structurally valid survey captured meaningful feedback and may serve as a valuable quality improvement initiative to enhance patient engagement and optimize trial conduct, however, within the study's limitations.
Barriers and Enablers of Electronic Health Literacy in Colorectal Cancer Patients: A Phenomenological Study.
Xu Y, Chen Q, Wang M … +1 more , Lu Y
Patient Prefer Adherence · 2026 · PMID 41847242 · Full text
PURPOSE: The real experience of patients with colorectal cancer in their electronic health (eHealth) practice was investigated to provide recommendations for the formulation of eHealth literacy improvement-oriented inter...
PURPOSE: The real experience of patients with colorectal cancer in their electronic health (eHealth) practice was investigated to provide recommendations for the formulation of eHealth literacy improvement-oriented interventions in clinical settings. PATIENTS AND METHODS: A descriptive phenomenological study using Colaizzi's analysis was conducted. Through purposive maximum variation sampling until data saturation, semi-structured interviews were performed with 14 colorectal cancer patients at a tertiary hospital in Taizhou, China. Data were analyzed following Colaizzi's seven-step method with NVivo 12 qualitative data analysis software (NVivo 12.0). Trustworthiness was ensured via member checking, peer debriefing, and an audit trail. RESULTS: The following three themes and eight sub-themes were identified: patient personal factors (education level and age, patient illness denial, and willingness to search online for health information), social support factors (double-edged family support and positive effect of support from healthcare professionals), and information carriers and information quality (insufficient knowledge of available helpful information carriers, acceptance and evaluation of information carriers, and questionable information content quality). CONCLUSION: Patients with colorectal cancer's eHealth literacy is hindered by low willingness and ability to seek information. Healthcare professionals should motivate patients with colorectal cancer to actively seek information related to their disease; develop a healthcare provider-family-patient coordinated support system; and develop an information platform specifically focusing on patients with colorectal cancer. These integrated interventions at the individual, family, clinical, and systemic levels can collectively improve eHealth literacy and health outcomes.
Cross-Cultural Adaptation and Psychometric Validation of a Diabetes-Specific Health Literacy Scale in Mainland China.
Ma R, Yu X, Zhang L … +6 more , Hu Z, Zhang Y, Luo Q, Huang J, Li C, Li J
Patient Prefer Adherence · 2026 · PMID 41836100 · Full text
PURPOSE: The study aimed to cross-culturally adapt and psychometrically test the Mandarin version of the Chinese Health Literacy Scale for Diabetes (M-CHLSD). PATIENTS AND METHODS: A cross-sectional study was conducted i...
PURPOSE: The study aimed to cross-culturally adapt and psychometrically test the Mandarin version of the Chinese Health Literacy Scale for Diabetes (M-CHLSD). PATIENTS AND METHODS: A cross-sectional study was conducted in Beijing with 221 adults diagnosed with type 2 diabetes. The adaptation followed a rigorous five-step process: forward translation, synthesis, back translation, expert review (utilizing a two-round Delphi method), and cognitive interviews using the Questionnaire Appraisal System. Psychometric properties of the M-CHLSD were evaluated using reliability, content validity, and construct validity. Criterion validity was assessed by correlating the scale with glycemic measures and conducting group comparisons using the Mann-Whitney -test. RESULTS: The Delphi review highlighted the need for linguistic refinement, clinical accuracy, and contextual adaptation, leading to revisions aligned with Mainland China's healthcare system. Pilot testing with 15 patients confirmed comprehensibility. Confirmatory Factor Analysis indicated a good model fit (Comparative Fit Index = 0.93, Tucker-Lewis Index = 0.91, Root Mean Square Error of Approximation = 0.064). The scale demonstrated excellent internal consistency (Cronbach's α=0.884) and test-retest reliability (Intraclass Correlation Coefficient=0.82-0.91). The M-CHLSD showed moderate correlations with fasting plasma glucose ( = -0.36) and 2-hour postprandial glucose ( = -0.39). The scale successfully distinguished between individuals with good versus poor glycemic control (Cohen's d = 0.54-0.56). A mild ceiling effect (15.1%) was observed. CONCLUSION: The M-CHLSD is a robust, reliable, and clinically relevant tool for assessing health literacy in Mandarin-speakers with diabetes. Its rigorous methodology, including Delphi, cognitive interviews, and comprehensive psychometric testing, makes it superior to other adapted tools. The scale's strong clinical correlations and ability to stratify patients based on glycemic control ensure its utility in personalized education and follow-up care pathways.
Evaluation of Treatment Modalities for Radiation Therapy-Induced Trismus, Considering the Timing and Adherence to Progress in Mouth Opening and Oral Health-Related Quality of Life: A Systematic Review.
Meidarlina I, Rikmasari R, Wicaksono S … +2 more , Maskoen Snr AM, Kusumadjati A
Patient Prefer Adherence · 2026 · PMID 41836099 · Full text
PURPOSE: To assess the effectiveness of treatment modalities for radiation-induced trismus in improving mouth opening (MO) and oral health-related quality of life (OHRQoL), with considering of treatment timing and patien...
PURPOSE: To assess the effectiveness of treatment modalities for radiation-induced trismus in improving mouth opening (MO) and oral health-related quality of life (OHRQoL), with considering of treatment timing and patient adherence. METHODS: Electronic databases (PubMed, Google Scholar, Scopus, EBSCOhost, and ScienceDirect) were searched for studies published between 2015 and 2025 using relevant Medical Subject Headings (MeSH) combined with Boolean operators, including "Treatment OR therapy AND trismus OR limited mouth opening AND radiation therapy OR radiotherapy AND head and neck neoplasm OR head and neck cancer" and "Timing OR starting time AND treatment OR exercise AND trismus OR limited mouth opening OR restricted mouth opening." After duplicate removal, titles, abstracts, and full texts were screened for eligibility. RESULTS: The initial search identified 472,480 articles, of which 18 met the inclusion criteria after screening titles, abstracts, and full texts. Kruskal-Wallis analysis demonstrated significantly greater improvement in mouth opening when trismus treatment was initiated during or after radiotherapy compared to before radiotherapy (p = 0.020). The greatest improvement was observed with combined laser therapy and Therabite exercises, initiated concurrently with radiotherapy for 3 months with high adherence, resulting in a mean increase of 26.95 mm in MO and an improvement in OHRQoL. The second most effective modality was threaded tapered screw appliance (TTSA) therapy combined with low-level laser therapy (LLLT) administered post-radiotherapy for 6 weeks, yielding a 15 mm improvement with high adherence. CONCLUSION: The effectiveness of treatment for radiation-induced trismus is influenced by the therapeutic modality, timing of therapy initiation, and patient adherence, all of which contribute to improvements in MO and OHRQoL. Combination therapy modalities, particularly laser therapy combined with jaw movement devices, initiated during or after radiotherapy and supported by high patient adherence, optimize mouth opening and enhance OHR-QoL.
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