Patient Preference And Adherence[JOURNAL]
Sun
200 papers
Situational Factors Associated with Dietary Behavior in Stroke Patients During Rehabilitation: A Qualitative Study Based on the COM-B Model.
Zhong W, Pan X, Li J … +5 more , Zhang Y, Chen L, Sun X, Wang Z, Xu L
Patient Prefer Adherence · 2026 · PMID 41836098 · Full text
OBJECTIVE: This study investigated situational factors associated with dietary behavior in stroke patients during rehabilitation using the Capability, Opportunity, Motivation - Behavior (COM-B) model, which explains beha...
OBJECTIVE: This study investigated situational factors associated with dietary behavior in stroke patients during rehabilitation using the Capability, Opportunity, Motivation - Behavior (COM-B) model, which explains behavior via three components: capability, opportunity, and motivation. METHODS: This study employed a qualitative and descriptive design. Using purposive sampling, 17 stroke patients during rehabilitation were recruited from a tertiary hospital in Jiangsu Province, China, between July and September 2024. Semi-structured interviews were conducted, and data were analyzed using directed content analysis. RESULTS: The following themes and (sub)themes were identified. Capability: (1) a lack of knowledge relating to dietary management; (2) difficulty managing negative emotions; (3) reduced self-regulatory ability; (4) distress caused by symptoms of functional impairment. Opportunity: (1) support from the physical environment; (2) using and adjusting assistive feeding devices; (3) influence of the social environment; (4) accessibility and quality of external help services. Motivation: (1) clarification of eating intentions; (2) lack of focus during eating; (3) differences in food assessment. CONCLUSION: The situational factors associated with dietary behavior in stroke patients during rehabilitation are influenced by a complex interplay of factors within the personal, social, and environmental domains. The application of the COM-B model in this research is a significant contribution. It not only helps to clearly categorize and understand the various situational factors but also provides a structured framework for developing targeted interventions. Interventions that promote healthy dietary behaviors for stroke patients during rehabilitation should incorporate strategies to enhance capability, optimize opportunity, and strengthen motivation.
Associated Factors of Different Cardiac Rehabilitation Adherence Profiles Post-PCI: A Latent Profile Analysis.
He X, Wang J, Ye L … +3 more , Zhao X, Xu L, Gao J
Patient Prefer Adherence · 2026 · PMID 41836097 · Full text
OBJECTIVE: This study aimed to identify distinct in-hospital cardiac rehabilitation (CR) adherence profiles and explore their associated clinical and sociodemographic factors among patients following percutaneous coronar...
OBJECTIVE: This study aimed to identify distinct in-hospital cardiac rehabilitation (CR) adherence profiles and explore their associated clinical and sociodemographic factors among patients following percutaneous coronary intervention (PCI). METHODS: A cross-sectional survey was conducted among patients undergoing Phase I cardiac rehabilitation following percutaneous coronary intervention (PCI) who were hospitalized in the cardiology department between June and July 2025 (n=384). Data were collected using a general information questionnaire and a treatment adherence questionnaire (Since the study population consisted of inpatients undergoing PCI followed by phase I cardiac rehabilitation, the dimension of follow-up compliance was excluded). LPA, a person-centered method that identifies unobserved subgroups (profiles) based on response patterns, was prespecified to classify CR adherence profiles. Multinomial logistic regression was performed to examine factors associated with profile membership. Clinical indicators (number of diseased vessels, LVEF, LDL-C, and serum creatinine) were included as candidate predictors; after LASSO selection, LDL-C and number of diseased vessels were retained and entered the final multinomial logistic regression model as continuous variables (original values). RESULTS: Three distinct CR adherence profiles were identified: Low CR Adherence (125/384, 32.55%), Medium CR Adherence (169/384, 44.01%), and High CR Adherence (90/384, 23.44%). Profile membership was significantly associated with gender, living situation, family monthly income, residential distance, smartphone use/proficiency and LDL-C ( < 0.05). CONCLUSION: CR adherence among post-PCI patients was overall moderate-to-low, with substantial heterogeneity across adherence patterns. The associated sociodemographic and contextual factors may help inform profile-based, tailored support to improve CR adherence after PCI. Given the cross-sectional design, these associations are non-causal and should be validated in future multicenter longitudinal and intervention studies.
Readiness for Hospital Discharge and Associated Factors Among Adult Ophthalmic Day Surgery Patients: A Cross-Sectional Study.
Li Y, Li X, Ren J … +1 more , Luo H
Patient Prefer Adherence · 2026 · PMID 41821764 · Full text
PURPOSE: This study evaluated readiness for hospital discharge (RHD) among ophthalmic day surgery patients and identified psychosocial factors associated with RHD to inform clinical practice. PATIENTS AND METHODS: A tota...
PURPOSE: This study evaluated readiness for hospital discharge (RHD) among ophthalmic day surgery patients and identified psychosocial factors associated with RHD to inform clinical practice. PATIENTS AND METHODS: A total of 281 adults undergoing elective ophthalmic day surgery at West China Hospital, Sichuan University (December 2024-March 2025), were recruited by convenience sampling. Data were collected using a demographic questionnaire, the Readiness for Hospital Discharge Scale (RHDS) to evaluate discharge readiness among ophthalmic day surgery patients under a rapid-turnover model, the All Aspects of Health Literacy Scale (AAHLS), and the Quality of Discharge Teaching Scale (QDTS). Univariate analysis and stepwise multiple linear regression were used to examine factors associated with RHD. RESULTS: The mean total RHDS score was 99.48 ± 13.35, with an average item score of 8.29 ± 1.11. Expected support had the highest mean dimension score was for expected support (8.76 ± 1.62), followed by personal status (8.42 ± 1.63) and coping ability (7.99 ± 1.11). Univariate analysis showed that sex, marital status, place of residence, comorbid chronic diseases, low vision at admission, type of surgery, and requirement for special postoperative positioning significantly affected RHDS scores (all < 0.05). RHDS was weakly correlated with health literacy (r = 0.218, < 0.01) and moderately correlated with quality of discharge teaching (r = 0.500, < 0.01). Quality of discharge teaching (skills and effectiveness), health literacy (ability to use written health information), rural residence, male sex, low vision at admission, and requirement for special postoperative positioning were identified as main factors associated with RHDS = 0.456, < 0.05). CONCLUSION: Adult ophthalmic day surgery patients demonstrated relatively high RHD, although coping ability was comparatively weaker and requires further attention. Clinicians should pay particular attention to rural residents, women, patients with low vision, and those requiring special postoperative positioning. Improving discharge teaching and health literacy may further enhance RHD.
Development and Validation of the Treatment Adherence Scale for Non-Dialysis Chronic Kidney Disease Patients in China: A Mixed-Methods Study.
Cui Y, Li X, Liu N … +8 more , Li J, Feng Y, Li S, Bai X, Li F, Liu H, Zhang Y, Lv H
Patient Prefer Adherence · 2026 · PMID 41809633 · Full text
PURPOSE: Chronic kidney disease (CKD) is a global public health priority. Adherence to complex therapeutic regimens is crucial for non-dialysis patients. However, the absence of multidimensional assessment instruments ha...
PURPOSE: Chronic kidney disease (CKD) is a global public health priority. Adherence to complex therapeutic regimens is crucial for non-dialysis patients. However, the absence of multidimensional assessment instruments has impeded precise adherence evaluation and targeted interventions. This study aimed to develop and validate a disease-specific Treatment Adherence Scale for Non-Dialysis CKD Patients (TAS-NCKD). METHODS: A cross-sectional mixed-methods study was conducted in China. Preliminary items were developed by a scoping review and two Delphi expert rounds. Three rounds of surveys (n=160, 350, and 370) were conducted for the construction and psychometric validation of the scale. Feasibility, reliability, validity, discrimination and difficulty, and optimal cutoff determination was verified. RESULTS: The third validation cohort consisted of 181 patients with CKD stage 1, 49 with stage 2, 59 with stage 3, 38 with stage 4, and 43 with stage 5. The final TAS-NCKD comprises 45 items across 5 dimensions. The scale demonstrated high feasibility with a completion rate of 92.5%, and a completion time within 18 minutes. The Cronbach's α, split-half reliability, test-retest reliability for the scale were 0.955, 0.968, and 0.836. The scale-level content validity index (CVI) and item-level CVI were 0.992 and 0.875-1. Confirmatory factor analysis showed a good model fit. Convergent and discriminant validity both met the standards. Item characteristic curves were ideal and the optimal cutoff was established at 179 points. CONCLUSION: The TAS-NCKD is a valid and reliable instrument for assessing treatment adherence in Chinese non-dialysis CKD patients. This study provides targeted insights for improving patient self-management and may help slow disease progression.
Assessment of Factors Associated with Treatment Adherence Among Elderly Patients with Multimorbid Type 2 Diabetes Mellitus Using Lasso-Logistic Regression.
Ma R, Zhou B, Liu T … +1 more , Wang Y
Patient Prefer Adherence · 2026 · PMID 41799783 · Full text
AIMS AND OBJECTIVES: This study aimed to investigate treatment adherence among elderly patients with multimorbid type 2 diabetes mellitus (T2DM), and analyze the influencing factors. DESIGN: A single-centre, cross-sectio...
AIMS AND OBJECTIVES: This study aimed to investigate treatment adherence among elderly patients with multimorbid type 2 diabetes mellitus (T2DM), and analyze the influencing factors. DESIGN: A single-centre, cross-sectional study design. METHODS: In this study, convenience sampling was used to examine elderly patients with multimorbid T2DM seeking treatment at six community health service centers within the Jinqiao Medical Alliance in the Pudong New Area of Shanghai between May and July 2024. Demographic and disease-related data were collected including treatment adherence, self-care activities, social support, cognitive function, and depression. Factors influencing treatment adherence were investigated through three machine learning approaches: random forest algorithm for detecting non-linear patterns, multiple linear regression for linear relationship analysis, and Lasso-Logistic regression with L1 regularization to optimize feature selection while controlling multicollinearity. This tripartite methodology synergistically combines ensemble learning, parametric modeling, and sparse logistic regression to ensure robust predictor identification. RESULTS: This study found that the average treatment adherence score for elderly patients with multimorbid T2DM was 45.30 (SD = 5.99). Integrated machine learning (random forest, Lasso-Logistic regression, and linear regression) identified four key determinants: elevated HbA1c ( = -4.417, < 0.01) and depression ( = -1.207, < 0.01) significantly reduced adherence, whereas improved self-care ( = 0.081, < 0.01) and higher income ( = 0.589, < 0.01) enhanced compliance. This multi-method approach validated predictors through both linear and non-linear modeling frameworks. CONCLUSION: This study quantifies adherence in elderly T2DM patients (Mean=45.30) and identifies four modifiable predictors through advanced modeling. Prioritized interventions should focus on enhancing glycemic control through intensified HbA1c monitoring for upward trends and integrating depression management into diabetes care plans, while leveraging self-care capacity and economic support as foundational enhancers through tailored guidance and support programs to improve treatment adherence, optimize health outcomes, and minimize morbidity in this population.
Exploring Changes in Family Functioning: A Qualitative Study of Patients with Rheumatoid Arthritis.
Sadeghnezhad H, Sabeghi H, Vagharseyyedin SA
Patient Prefer Adherence · 2026 · PMID 41783123 · Full text
PURPOSE: Rheumatoid arthritis (RA) is a chronic inflammatory disease that affects not only patients' physical and psychological health but also their families' functioning. Despite the central role of families in providi...
PURPOSE: Rheumatoid arthritis (RA) is a chronic inflammatory disease that affects not only patients' physical and psychological health but also their families' functioning. Despite the central role of families in providing care, particularly in cultures with strong family bonds, little is known about the specific changes that RA causes in family functioning. This study aimed to explore patients' experiences and perceptions of changes in family functioning associated with with RA. PATIENTS AND METHODS: This conventional content analysis study was performed on 19 participants who were purposively selected from Birjand and Kashmar cities in Iran from February 2025 to July 2025. Face-to-face, semi-structured, in-depth interviews were conducted to collect data. The interviews continued until no new experiential meanings emerged, indicating data saturation. The data were analyzed using the conventional content analysis approach of Graneheim and Lundman using MAXQDA version 2020. RESULTS: Six main categories emerged, reflecting extensive changes in family functioning: 1) reduced functional independence in daily life activities, 2) compromised marital affairs, 3) limitations in parenting, 4) Imposing additional financial burden on the family, 5) restrictions in social activities, and 6) deprivation of psychological comfort within the family. CONCLUSION: Patients reported that RA disrupts their family functioning. In contexts such as Iran, where families are deeply involved in caregiving, these challenges are intensified. The findings highlight the need for family centered interventions, psychosocial support, and health policies that address patient care and family well-being.
The Information Needs of Breast Cancer Patients at All Stages of Their Journey: A Scoping Review.
Priambodo AP, Trisyani Y, Nuraeni A … +2 more , Anna A, Sugiharto F
Patient Prefer Adherence · 2026 · PMID 41783122 · Full text
BACKGROUND: Breast cancer is the most commonly diagnosed cancer and the leading cause of cancer-related mortality among women worldwide. Adequate and timely information is essential to reduce anxiety, uncertainty, and ps...
BACKGROUND: Breast cancer is the most commonly diagnosed cancer and the leading cause of cancer-related mortality among women worldwide. Adequate and timely information is essential to reduce anxiety, uncertainty, and psychological distress among breast cancer patients. However, many women report dissatisfaction with the information they receive, and evidence addressing patients' information needs across the entire disease continuum remains limited. PURPOSE: This scoping review aimed to synthesize evidence of the information needs among breast cancer patients across different phases of the cancer continuum, from diagnosis to post-treatment survivorship. METHODS: A scoping review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). Studies were identified through systematic searches of EBSCOhost, PubMed, Scopus, ScienceDirect, and Taylor & Francis, supplemented by Google Scholar searches, reference list screening, and expert network recommendations. Study selection followed the Population-Concept-Context (PCC) framework, focusing on women with breast cancer, information needs, and stages of the cancer continuum. RESULTS: Forty eligible studies were included. Four major themes of informational needs were identified across the disease trajectory. In the diagnostic phase, patients primarily sought information on disease characteristics, prognosis, treatment options, and emotional support. During treatment, information needs focused on treatment management, self-care, lifestyle modification, and psychosocial support. In the post-treatment and survivorship phase, patients emphasized long-term follow-up, recurrence prevention, and quality-of-life issues. Across all phases, patients preferred trusted healthcare professionals and multimodal information delivery formats. CONCLUSION: Breast cancer patients have diverse and evolving information needs throughout the cancer continuum. Addressing these needs through structured, culturally sensitive, and patient-centered information strategies is essential to reduce anxiety, support informed decision-making, and improve quality of care.
Development of a Complex Biofeedback-Based Intervention to Improve Methotrexate Adherence in Rheumatoid Arthritis: A COM-B Model Informed Qualitative Study.
Shafi H, Armitage CJ, Verstappen SMM … +3 more , Barton A, Lee RR, Bluett J
Patient Prefer Adherence · 2026 · PMID 41783121 · Full text
INTRODUCTION: Methotrexate (MTX) is one of the first-line treatments for Rheumatoid arthritis (RA) but sub-optimal adherence to MTX is common. Adherence can be challenging to detect in the clinic but can be assessed obje...
INTRODUCTION: Methotrexate (MTX) is one of the first-line treatments for Rheumatoid arthritis (RA) but sub-optimal adherence to MTX is common. Adherence can be challenging to detect in the clinic but can be assessed objectively using a MTX biochemical adherence test measuring levels of MTX in the blood. However, it remains unknown how to use the results of MTX biochemical adherence tests to improve adherence. COMMIT (development of a COMplex Methotrexate adherence IntervenTion utilising biofeedback) is a qualitative study designed to explore adherence to MTX in RA patients and aid the development of a behaviour change intervention that can be delivered alongside MTX biochemical adherence testing. METHODS: Potential participants were identified from the Rheumatoid Arthritis Medications Study (RAMS), a large national study of patients with RA commencing MTX. An interview topic guide was developed using the Capability, Opportunity and Motivation to Behaviour (COM-B) model and the Theoretical Domains Framework (TDF). Consenting participants took part in a 1:1 semi-structured telephone interview. Transcripts were inductively analysed and mapped to themes. RESULTS: Seventeen participants treated with MTX for a mean 3 years (range 3-20) took part in the semi-structured interviews. Five overarching themes were identified and mapped to behaviour change techniques. Themes included 1. Knowledge of MTX and its impact, 2. Motivators versus barriers for continuation of MTX, 3. The healthcare approach in shaping patient adherence, 4. Creating habits and routines 5. MTX biochemical adherence blood tests and external monitoring of behaviour. CONCLUSION: This study has identified many of the key facilitators and barriers that influence adherence to methotrexate in RA patients. Through identifying the capabilities, opportunities, and motivations that shape engagement with MTX biochemical adherence testing, we can select targeted behaviour change techniques to address these factors. This theory-driven approach offers a novel pathway to improving uptake of MTX adherence testing.
A Multidimensional Framework for Pharmaceutical Care to Enhance Medication Adherence and Patient Engagement: The CMO-MAPEX Model.
Morillo-Verdugo R, Ibarra-Barrueta O, Martin Conde MT … +2 more , Vicente-Escrig E, Contreras Macias E
Patient Prefer Adherence · 2026 · PMID 41783120 · Full text
PURPOSE: This study aimed to develop Capacity-Motivation-Opportunity MAPEX (CMO-MAPEX), a multidimensional, patient-centred and operational framework to guide medication-adherence support in outpatient pharmaceutical car...
PURPOSE: This study aimed to develop Capacity-Motivation-Opportunity MAPEX (CMO-MAPEX), a multidimensional, patient-centred and operational framework to guide medication-adherence support in outpatient pharmaceutical care. METHODS: A six-stage framework-development process was undertaken. First, a narrative scoping synthesis identified behavioural, experiential and organisational determinants of medication adherence relevant to outpatient pharmaceutical care. Second, key constructs were extracted and coded into a shared analytic matrix. Third, framework analysis was applied to cluster constructs into higher-order domains. Fourth, an integrative synthesis aligned the emergent CMO structure with evidence on adherence, treatment burden, patient experience and hybrid-care models. Fifth, the conceptual architecture was translated into a structured clinical workflow incorporating CMO-based assessment, a three-level complexity stratification system, domain-specific intervention families and hybrid follow-up rules. Finally, a multidisciplinary expert panel reviewed and refined the framework to ensure ecological validity and feasibility in routine practice. RESULTS: The analysis yielded a stable three-domain structure-Capacity, Motivation and Opportunity-capturing patients' ability to manage treatment, their beliefs and emotional readiness, and the contextual conditions enabling or hindering adherence. These domains were operationalised through assessment indicators, complexity-based stratification, targeted intervention mapping and longitudinal hybrid-care pathways. Patient-reported outcome and experience measures were embedded as core components to monitor treatment burden, preferences and experience, and to support dynamic re-stratification and adjustment of follow-up intensity over time. CONCLUSION: CMO-MAPEX provides a pragmatic and scalable framework that translates adherence theory into patient-centred pharmaceutical care. By integrating behavioural determinants, patient experience and hybrid-care organisation within a single operational structure, it offers a reproducible approach to tailoring adherence support according to patient preferences and complexity in outpatient settings.
The Effectiveness of Guiding Questions Integrated Into Pulmonary Rehabilitation Health Education Videos for Chronic Obstructive Pulmonary Disease Patients: A Quasi-Experimental Controlled Study.
Lin BY, Weng C
Patient Prefer Adherence · 2026 · PMID 41783119 · Full text
PURPOSE: Chronic Obstructive Pulmonary Disease (COPD) is a major global health concern that substantially affects patients' quality of life. Pulmonary rehabilitation exercises are effective in alleviating symptoms and re...
PURPOSE: Chronic Obstructive Pulmonary Disease (COPD) is a major global health concern that substantially affects patients' quality of life. Pulmonary rehabilitation exercises are effective in alleviating symptoms and reducing hospitalization rates; however, patients' learning effectiveness and motivation remain critical challenges in rehabilitation education. Given the need for accessible and sustainable patient education strategies, this study aimed to examine whether integrating guiding questions into pulmonary rehabilitation health education videos could enhance learning effectiveness and learning motivation among patients with COPD. PATIENTS AND METHODS: This study employed a prospective controlled trial with quasi-random allocation. The research was conducted in 2024 at a hospital in Taiwan, involving 60 patients with chronic obstructive pulmonary disease. Participants were divided into an experimental group (receiving guiding questions instructional strategy videos) and a control group (receiving traditional videos). Baseline and post-intervention data were collected through a learning assessment form and the learning motivation scores. RESULTS: Both groups showed significant improvements in learning assessment scores and motivation after the intervention (p < 0.05). Further comparison revealed that the experimental group had higher adjusted mean scores than the control group in both learning assessment (65.00 vs 52.00) and learning motivation (156.67 vs 137.27), with statistically significant differences. CONCLUSION: The high cost of certain equipment and technological solutions often limits their widespread adoption in clinical education settings. Therefore, identifying cost-effective yet high-impact instructional strategies is essential to enhance accessibility and support the sustainable implementation of patient education. Integrating guiding questions into pulmonary rehabilitation health education videos significantly enhances patients' learning effectiveness and learning motivation. As a low-cost and scalable instructional strategy, this approach offers a practical means of strengthening educational outcomes in pulmonary rehabilitation programs for patients with COPD.
Comparing a Conceptual Framework and Factor Analysis to Achieve Survey Item Reduction in Predicting Medication Non-Persistence.
Umeaghadi CF, Taylor JG, Yao S … +1 more , Blackburn DF
Patient Prefer Adherence · 2026 · PMID 41783118 · Full text
Adherence surveys can be lengthy due to the high number of potential risk factors to be analyzed. As a result, researchers often reduce items into conceptual domains (eg, beliefs, economic factors) to overcome power cons...
Adherence surveys can be lengthy due to the high number of potential risk factors to be analyzed. As a result, researchers often reduce items into conceptual domains (eg, beliefs, economic factors) to overcome power constraints or focus testing on a specific theme. However, item reduction can also be guided by factor analysis (FA), a process that identifies domains without regard to conceptual frameworks. Although both approaches achieve the same objective, their outputs can be drastically different. It was unclear how the process used to create domains could impact downstream performance of an adherence prediction model. We compared two logistic regression models on the outcome of non-persistence from the same survey data; variables for the models were reduced using a conceptual approach or factor analysis (FA). Both approaches identified three domains from 51 survey items. While domains from the conceptual approach were based on the WHO framework, items contained in FA-guided domains crossed conceptual boundaries. Both models demonstrated good predictive performance with c-statistics of 0.84 (subjective model) and 0.82 (FA model) (p=0.060). The conceptual approach organizes data in a highly relevant structure that aligns with contemporary research and can more readily impact future practice. We found no evidence for a trade-off with respect to model prediction performance.
Patient Attitudes and Awareness of Anesthesia Risks and Perioperative Instructions in Preoperative Anesthesia Clinics: A Multicenter Cross-Sectional Survey in Digestive Endoscopic Patients.
Ma M, Gong Y, Dai R … +6 more , Du Y, Song D, Du X, Zhang Y, Ma H, Shen L
Patient Prefer Adherence · 2026 · PMID 41777296 · Full text
PURPOSE: To meet the rapidly growing demand for digestive endoscopies and daytime surgeries, the setup of preoperative assessment clinics is increasing explosively in China. This study aims to explore patient attitudes t...
PURPOSE: To meet the rapidly growing demand for digestive endoscopies and daytime surgeries, the setup of preoperative assessment clinics is increasing explosively in China. This study aims to explore patient attitudes to patient education and to assess patient awareness scores regarding informed consent and perioperative instructions in preoperative anesthesia clinic, as well as to evaluate the preference of current patient education tools. PATIENTS AND METHODS: A cross-sectional study was conducted across five hospitals. A 37-item digital questionnaire was administered to patients who attended preoperative anesthesia assessment clinics and underwent digestive endoscopies between September 1 and September 20, 2024. Awareness scores were calculated as the sum of correct responses to 15 questions assessing perioperative knowledge, with a total score ranging from 0 to 15, and higher scores indicating greater awareness. RESULTS: A total of 1300 participants were included in the study. Over 97% of the patients reported a positive attitude to the preoperative assessment clinic. Approximately 20% of patients reported poor recall of the information provided by anesthesiologists. Mean awareness rates were 51.2% for preoperative precautions, 62.7% for anesthesia-related risks, and 56.7% for postoperative precautions, with an overall awareness score of 8.37 ± 4.2 points. Higher awareness scores correlated with higher education levels (p < 0.05), shorter intervals (≤1 week) between clinic visits and procedures (p < 0.05), and the use of multimedia and interactive educational methods (p < 0.05). CONCLUSION: Sole reliance on preoperative anesthesia assessment clinics for patient education on informed consent and perioperative instructions is inadequate. We recommend a multimodal, patient-centered approach that accounts for educational background, integrates periodic reinforcement, and employs diverse educational tools, including multimedia and interactive strategies, to optimize information comprehension and retention.
The Developmental Trajectory of Learned Helplessness in Breast Cancer Chemotherapy Patients: A Longitudinal Study Based on Latent Growth Models.
Li X, Guo Z, Jiao Y … +5 more , Lu Y, Ding S, Li X, Yang R, Chen C
Patient Prefer Adherence · 2026 · PMID 41777295 · Full text
OBJECTIVE: This study aimed to examine the trajectory of learned helplessness in breast cancer chemotherapy patients using latent growth curve models. It also analyzed how chemotherapy regimen, age, education, and social...
OBJECTIVE: This study aimed to examine the trajectory of learned helplessness in breast cancer chemotherapy patients using latent growth curve models. It also analyzed how chemotherapy regimen, age, education, and social support influence changes in helplessness. METHODS: From October 2024 to June 2025, a total of 206 breast cancer patients undergoing chemotherapy at two tertiary hospitals in Henan Province, China, were enrolled as study participants using the convenience sampling method. Participants were assessed at four time points: prior to chemotherapy and after the 2nd, 4th, and 6th cycles, using the Learned Helplessness Scale and the Social Support Rating Scale. Latent growth models were employed for analysis. RESULTS: Learned helplessness increased linearly among patients, with individuals starting at lower levels showing faster growth. Significant individual differences were found in both baseline levels and rates of change. Patients receiving anthracycline-based chemotherapy showed a faster rate of helplessness increase compared to those on non-anthracycline regimens, although there was no significant difference in their initial levels. Younger patients had higher initial helplessness levels than older patients, but age did not affect the rate of change. Lower educational levels were associated with higher initial helplessness, but education did not influence the rate of change. Higher social support significantly reduced helplessness. CONCLUSION: Learned helplessness in breast cancer chemotherapy patients increases linearly with notable individual differences. These findings suggest that healthcare providers should develop targeted interventions based on patients' trajectories and influencing factors to reduce helplessness.
Medication Regimen Complexity and Patient-Reported Adherence: A Cross-Sectional Study in Internal Medicine Outpatients.
Ertuna E, Guray I, Inci V … +4 more , Sirmatel Bucuk P, Sozen Gencer N, Arun MZ, Kilavuz A
Patient Prefer Adherence · 2026 · PMID 41777294 · Full text
PURPOSE: Medication non-adherence and regimen complexity are significant barriers to achieving therapeutic goals. This study aimed to determine the impact of medication regimen complexity, and clinical characteristics of...
PURPOSE: Medication non-adherence and regimen complexity are significant barriers to achieving therapeutic goals. This study aimed to determine the impact of medication regimen complexity, and clinical characteristics of patients on medication adherence in internal medicine outpatients. PATIENTS AND METHODS: This prospective cross-sectional study was conducted in the internal medicine and geriatric outpatient clinics of a tertiary university hospital. Adherence was assessed with Medication Adherence Report Scale (MARS-5), and regimen complexity was quantified using the Medication Regimen Complexity Index (MRCI) in 150 patients. RESULTS: The mean age of the participants was 57.53±1.26 years. Only 44% of the participants demonstrated perfect adherence to therapy. The MRCI scores of geriatric patients (median: 11 (3-44) vs 19 (5-65)) and those hospitalized within the last six months (median: 12.75 (3-47) vs 20 (6-65.5)) were significantly higher. Complexity scores related to dosing schedule and instructions for use were especially higher in patients with hypertension or diabetes. No statistically significant correlation was found between the total MRCI score and patient-reported adherence scores (=0.32). However, geriatric patients and recently hospitalized patients were less likely to fully adhere to therapy (χ (1, N=150) = 4.71, =0.030 and 4.23, =0.040, respectively). CONCLUSION: Although a direct correlation between total regimen complexity and self-reported adherence was not observed, complexity poses a significant challenge for specific high-risk groups, including geriatric patients and those with recent hospitalizations. These findings may suggest that providing targeted medication counseling and medication regimen review, particularly in the early post-discharge period, might be crucial for optimizing adherence and clinical outcomes.
Supporting Medication Adherence and Patient-Centered Care for Attention-Deficit Hyperactivity Disorder in Taiwan: A Pharmacist-Oriented Perspective Informed by Targeted Evidence.
Chiu YJ, Huang YM
Patient Prefer Adherence · 2026 · PMID 41773095 · Full text
Despite the broad coverage offered by Taiwan's National Health Insurance system, attention-deficit/hyperactivity disorder (ADHD) care continues to face a critical "leaky pipeline" problem. There is a clear gap between di...
Despite the broad coverage offered by Taiwan's National Health Insurance system, attention-deficit/hyperactivity disorder (ADHD) care continues to face a critical "leaky pipeline" problem. There is a clear gap between diagnostic prevalence and long-term treatment retention. This perspective article applies the SPIDER (Sample, Phenomenon of Interest, Design, Evaluation, Research type) framework to synthesize evidence on the multidimensional factors that contribute to medication non-adherence among Taiwanese children and adolescents. The barriers are grouped into five domains. These domains include medication-related issues such as dosing complexity, child-level developmental challenges related to growing autonomy, family dynamics that reveal a distinctive "socioeconomic status paradox", stigma within school environments, and vulnerabilities at the healthcare system level. Together, these factors demonstrate that existing hospital-centered care models alone may not sufficient to support sustained treatment engagement. To address this gap, we propose a pharmacist-driven precision approach to improving adherence in ADHD. This approach redefines the pharmacist's role and emphasizes proactive involvement in ADHD management rather than passive medication dispensing. The proposed approach includes regimen optimization, digital tools that support adolescent self-management, and shared decision-making strategies that respond to family-specific concerns. Because community pharmacists are highly accessible, they can serve as continuity anchors across care settings and developmental stages and help strengthen treatment persistence and therapeutic outcomes.
The Mediating Role of Treatment Adherence in the Relationship Between Health Literacy and Health Maintenance Efficacy Among Adults with Type 1 Diabetes.
Yeşildal M, Tetik A, Siyar A
Patient Prefer Adherence · 2026 · PMID 41773094 · Full text
INTRODUCTION: Health literacy is a key determinant of diabetes self-management; however, the behavioral mechanisms linking health literacy to health maintenance efficacy in adults with type 1 diabetes mellitus (T1DM) rem...
INTRODUCTION: Health literacy is a key determinant of diabetes self-management; however, the behavioral mechanisms linking health literacy to health maintenance efficacy in adults with type 1 diabetes mellitus (T1DM) remain insufficiently explored. Health maintenance efficacy refers to individuals' perceived ability to sustain long-term diabetes care behaviors. METHODS: This cross-sectional analytical study was conducted with 368 adults diagnosed with T1DM in Turkey. Data were collected online using the European Health Literacy Survey Questionnaire (HLS-EU-Q6) and the treatment adherence and health maintenance efficacy subscales of the Chronic Illness Self-Management Scale. Descriptive statistics, Pearson correlation analysis, and mediation analysis were performed using Hayes' PROCESS Model 4 with 5000 bootstrap resamples. RESULTS: Health literacy was positively associated with both treatment adherence and health maintenance efficacy. Treatment adherence played a partial mediating role in the association between health literacy and health maintenance efficacy (indirect effect = 0.11; 95% CI: 0.06-0.17). The final model explained 38% of the variance in health maintenance efficacy. CONCLUSION: Health literacy was strongly associated with health maintenance efficacy in adults with T1DM, both directly and indirectly through its association with treatment adherence. By conceptualizing health maintenance efficacy as a distinct construct reflecting the sustainability of diabetes care behaviors, the findings provide clearer insight into how health literacy relates to long-term self-management capacity. Given the cross-sectional design, these relationships should be interpreted as associative rather than causal.
Quantifying the Tolerability of Dopamine Agonist Antiparkinsonian Medication Side Effects: A Best-Worst Scaling Survey.
Richards K, Avanceña ALV, Johnsrud M … +6 more , Collier H, Mantri S, Yarbrough D, Subasinghe A, Sasané R, Arcona S
Patient Prefer Adherence · 2026 · PMID 41773093 · Full text
PURPOSE: To identify dopamine agonist (DA) medication side effects that people with Parkinson's (PwP) disease view as most and least tolerable and how this impacts their decisions to initiate and remain on treatment. PAT...
PURPOSE: To identify dopamine agonist (DA) medication side effects that people with Parkinson's (PwP) disease view as most and least tolerable and how this impacts their decisions to initiate and remain on treatment. PATIENTS AND METHODS: An online survey was conducted with PwP and care partner proxies for patients with more advanced Parkinson's disease (PD) who were recruited from Michael J. Fox Foundation patient networks and online PD community. The survey contained a best-worst scaling (BWS) component to assess patient tolerability of 10 DA medication side effects identified through literature and qualitative research. Descriptive and statistical analyses were conducted to address the study objectives. RESULTS: According to the 102 survey respondents, the three least tolerable side effects were sudden/overwhelming sleepiness, hallucinations, and compulsive behaviors. Lightheadedness, headache, and nausea were the three most tolerable side effects. Results were similar between those who were diagnosed ≤5 years and >5 years prior. The least tolerable side effects were associated with an unwillingness to start or continue taking DA medications. CONCLUSION: Findings demonstrate that patients' tolerance of potential adverse effects can potentially impact treatment initiation and continuation. Thus, healthcare providers for PwP should discuss medication side effect profiles with their patients prior to treatment initiation and as medication therapy is reviewed and evaluated to promote treatment adherence and positive health outcomes.
Family Resilience and Fear of Disease Recurrence in Elderly OVCF Patients and Spouses: A Cross-Lagged Actor-Partner Interdependence Model Analysis.
Li R, Wu Y, Wang Y … +2 more , Li Y, Song H
Patient Prefer Adherence · 2026 · PMID 41767770 · Full text
AIM: This study examines the longitudinal interplay of family resilience and fear of disease recurrence between elderly osteoporotic vertebral compression fracture (OVCF) patients and their spouses using the APIM. METHOD...
AIM: This study examines the longitudinal interplay of family resilience and fear of disease recurrence between elderly osteoporotic vertebral compression fracture (OVCF) patients and their spouses using the APIM. METHODS: This study employed convenience sampling to recruit 223 elderly OVCF patients with adjacent vertebral fractures and their spouses. Participants were assessed with the Shortened Chinese version of the Family Resilience Assessment Scale and the Fear of Disease Progression Questionnaire-Short Form at three time points (T1: during surgery, T2: before discharge, T3: one month post-discharge). Data were analyzed using equivalence tests and cross-lagged analysis within the Actor-Partner Interdependence Model (APIM) framework. RESULTS: Specifically, patients' family resilience can negatively predict their fear of disease recurrence in subsequent stages (T1→T2: β=-0.14, T2→T3: β=-0.13, both <0.01), and spouses' family resilience can negatively predict their fear of disease recurrence in subsequent stages (T1→T2: β=-0.12, T2→T3: β=-0.13, both <0.01). Additionally, the main effect of fear of disease recurrence on family resilience in patients and their spouses was significant. The fear of disease recurrence in patients negatively predicted their family resilience in subsequent stages (T1→T2: β=-0.18, T2→T3: β=-0.17, <0.001), and the spouse's fear of disease recurrence negatively predicted their family resilience in the first stage (T1→T2: β=-0.15, <0.001, T2→T3: β=-0.13, <0.01). The partner effect of fear of disease recurrence was also significant, indicating that the patient's fear of disease recurrence could positively predict the spouse's fear of disease recurrence in subsequent stages (T1→T2: β=0.16, T2→T3: β=0.15, all <0.001), whereas the spouse's fear of disease recurrence could positively predict the patient's fear of disease recurrence in subsequent stages (T1→T2: β=0.15, <0.001, T2→T3: β=0.12, 0.01). CONCLUSION: Healthcare providers should strategically assess and manage family resilience and fear of disease recurrence in elderly OVCF patients and their spouses, leveraging their dyadic interactions to mitigate these fears.
Adherence to Pediatric Ophthalmology Follow-Up After Completion of Retinopathy of Prematurity: A Retrospective Review.
Xing SX, Hyman N, Kim DK … +5 more , Horowitz JD, Hark LA, Rosenberg SE, Yeager LB, Talsania SD
Patient Prefer Adherence · 2026 · PMID 41767769 · Full text
PURPOSE: Retinopathy of prematurity is a leading cause of preventable childhood vision loss, and infants remain at risk of long-term ocular complications even after ROP screening concludes. However, adherence to recommen...
PURPOSE: Retinopathy of prematurity is a leading cause of preventable childhood vision loss, and infants remain at risk of long-term ocular complications even after ROP screening concludes. However, adherence to recommended pediatric ophthalmology follow-up after ROP screening completion is not well characterized. This study aimed to evaluate adherence to pediatric ophthalmology follow-up visits after completion of ROP screening and identify factors associated with loss to follow-up in a tertiary care setting. PATIENTS AND METHODS: We performed a retrospective chart review of premature infants eligible for ROP screening at a single urban academic center between January 2018 and December 2021. All infants were screened by a single vitreoretinal specialist, with pediatric ophthalmology follow-up recommended at the time of ROP clearance within 4 to 6 months. The primary outcome was a documented follow-up visit with pediatric ophthalmology. Demographic, perinatal, and ROP-related factors were compared between those who did and did not follow up, using univariate and multivariate logistic regression analyses. RESULTS: Of 475 eligible infants, 223 (46.9%) completed at least one pediatric ophthalmology follow-up appointment. In multivariate analysis, outpatient discharge from ROP care (OR 0.66, 95% CI 0.45-0.97, p = 0.035) and higher gestational age (OR 0.92, 95% CI 0.84-1.00, p = 0.041) were significantly associated with lower adherence to follow-up. Timing of follow-up (pre-COVID-19 vs COVID-19 era), insurance status, race, ethnicity, number of comorbidities, and distance to the clinic were not significantly associated with follow-up adherence. CONCLUSION: Fewer than half of infants completed their recommended pediatric ophthalmology follow-up appointments after ROP screening completion. Lower adherence among infants discharged from outpatient ROP care and those born at higher gestational ages highlights a critical care transition from ROP screening to pediatric ophthalmology. Interventions such as scheduling follow-up appointments prior to discharge and improving caregiver education may enhance continuity of care and reduce preventable vision loss in this vulnerable population.
Factors Influencing the Implementation of Unaccompanied Care for Older Inpatients in Chinese Tertiary Hospitals: A Qualitative Study [Response to Letter].
He Y, Li R, Jiao T … +3 more , Liu C, Chen Y, Li L
Patient Prefer Adherence · 2026 · PMID 41767768 · Full text
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