Patient Attitudes Research Articles

Impact of Patient Personality on Adherence to Oral Anticancer Medications: An Opportunity?

Adherence to prescribed oral anticancer therapy is an important determinant of patient outcomes, including progression-free and overall survival. While many factors (eg, medication side effects and out-of-pocket costs, problems with insurance authorization, and timely medication refills) can affect adherence, one that is relatively unexplored is the impact of a patient's attitude and personality. Patient personality influences medication adherence and persistence in nonmalignant chronic conditions such as cardiovascular disease and diabetes. In breast cancer and chronic myeloid leukemia, studies suggest that personality also affects adherence to oral chemotherapy which can be targeted to improve adherence. In this viewpoint, we highlight the opportunity of incorporating patient personality as interventions to oral cancer therapy adherence and discuss current barriers to implementation.

Changes in patient sentiment on Reddit through periods of atopic dermatitis treatment.

To discover patient attitudes toward atopic dermatitis (AD) treatments, 573,788 posts and comments from eczema-associated Reddit communities were analyzed with the latest natural language processing techniques. Our study reveals that patient sentiment toward AD treatments has improved in the periods following the introductions of dupilumab and Janus kinase inhibitors. These insights not only highlight areas for potential improvement in patient care, but also underline the utility of AI in capturing and analyzing nuanced patient experiences in online forums.

Knowledge, attitude, and practice of dental patients toward dental defects and dental fillings in Jinan, Shandong Province, China: a mediation analysis

BackgroundDental filling is a prevalent method for treating dental defects. This study aimed to investigate the knowledge, attitude, and practice (KAP) toward dental defects and dental fillings among dental patients in Jinan, Shandong Province, China.MethodsThis cross-sectional study was conducted at the main campus and several branch campuses of Jinan Stomatological Hospital, and community locations within Jinan city between October 2023, and January 2024. Spearman correlation analysis and mediation analysis were used to assess the associations and interrelationships between KAP scores.ResultsIn this study, 2529 dental patients participated, with 69.1% being females. Of these, 1711 had no dental defects, 551 had defects and fillings, and 267 had defects without fillings. Their median knowledge, attitude, and practice (Questions 1–6) scores were 8.00 [5.00, 12.00] (possible range: 0–18), 27.00 [26.00, 29.00] (possible range: 10–50), and 19.00 [15.00, 24.00] (possible range: 9–45), respectively. Mediation analysis revealed that in patients without dental defects, knowledge had a direct effect on attitude (β = -0.983, 95% CI: -0.999, -0.966, P < 0.001). Additionally, attitude had a direct effect on practice (β = -0.797, 95% CI: -1.490, -0.103, P = 0.024), while knowledge had an indirect effect on practice through attitude (β = 0.783, 95% CI: 0.096, 1.470, P = 0.026). In patients with dental defects who had undergone dental fillings, significant direct effects were observed between knowledge and attitude (β = -0.736, 95% CI: -0.821, -0.650, P < 0.001), knowledge and practice (β = 0.396, 95% CI: 0.214, 0.577, P < 0.001), and attitude and practice (β = -0.499, 95% CI: -0.683, -0.315, P < 0.001). Moreover, knowledge had an indirect effect on practice (β = 0.367, 95 CI: 0.221, 0.513, P < 0.001). In patients with dental defects but without any fillings, direct effects were found between knowledge and attitude (β = -0.929, 95% CI: -1.028, -0.829, P < 0.001).ConclusionsDental patients had inadequate knowledge, attitude, and practices concerning dental defects and fillings. It is recommended that clinical interventions should focus on enhancing patient education and promoting positive engagement in dental care practices.

Development and validation of the Behavioral Determinants of Deprescribing Questionnaire (BDDQ)

Abstract Background Deprescribing is a strategy to optimize medication use. While health behaviour can successfully be predicted by health behavior theories, the literature on deprescribing relies almost exclusively on questionnaires that measure attitudes only, such as the Beliefs about Medicines Questionnaire and the Patients Attitudes Towards Deprescribing, resulting in poor predictive validity. The aim of this study was to develop a new tool to measure the psychological determinants of deprescribing among people aged over 60, based on concepts derived from health behaviour theories. Methods A draft self-report questionnaire was developed consisting of 64 questions measuring 11 dimensions representing determinants of deprescribing. As well as previous deprescribing experience, current deprescribing behaviour and willingness to deprescribe. Face validity was assessed by asking 10 health professionals and 13 of older people to complete the questionnaire and comment in a small group discussion, resulting in the removal of 18 items. Construct validity was assessed on a sample of 103 participants aged over 60, using exploratory factor analysis (EFA). Internal consistency was assessed via Cronbach’s alpha. Results The EFA could confirm 11 dimensions explaining 70,5% of the total variance, but revealed poor loadings for several items and inadequate alphas (&amp;lt;.50) for two factors. Removal of items and these two dimensions resulted in 26 items measuring 9 dimensions, all showing acceptable internal consistencies (between .52 and .77): perceived risk; relatives’ involvement; deprescribing concerns; attitudes; medication beliefs; healthcare support; perceived difficulties; motivation to comply; communication accessibility. Conclusions This study produced a conceptually based and psychometrically validated questionnaire to assess behavioural determinants of deprescribing. It provides for a more comprehensive investigation of deprescribing intentions and behaviour of older adults. Key messages • A conceptually sound, psychometrically validated questionnaire (BDDQ) was developed. • BDDQ can be used for a more comprehensive study of de-prescribing in older people.

Effectiveness of Educational Program for Nurses about Patient Safety Values, Attitudes and Competency

Effectiveness of Educational Program for Nurses about Patient Safety Values, Attitudes and Competency

Knowledge, attitude, and practice toward nonsteroidal anti-inflammatory drugs among osteoarthritis patients: a cross-sectional study

Background Nonsteroidal anti-inflammatory drugs (NSAIDs) are common drugs in patients with osteoarthritis (OA). NSAIDs are generally used at home by patients, without supervision, requiring proper knowledge and attitudes for correct practice. This study investigated the knowledge, attitude, and practice (KAP) of patients with OA toward NSAIDs. Methods This cross-sectional study enrolled patients with OA at the Qingpu Branch of Zhongshan Hospital of Fudan University between January and March 2024. The KAP scores and demographic information of respondents were collected through a self-designed questionnaire. Results There were 645 participants, with 579 (89.8%) over 45 years old and 394 (61.1%) females. The average scores for knowledge, attitude, and practice were 16.26 ± 3.79 (possible range: 0–24), 18.12 ± 1.99 (possible range: 5–35), and 29.20 ± 5.52 (possible range: 10–50), respectively. The structural equation model (SEM) found that for individuals currently using NSAIDs, the attitude had a direct effect on practice (β = 0.978, P < 0.001). For individuals not using NSAIDs, the attitude had a direct effect on practice (β = 0.936, P < 0.001). Conclusion This study suggested that adequate NSAID knowledge is the prerequisite for correct NSAID-related medical decisions, while attitude has a crucial intermediary effect. Healthcare professionals and society should strengthen education regarding the relevant knowledge of NSAIDs and guide the cultivation of positive attitudes toward NSAIDs.

Exploring the roles and influences of the modern general practice receptionist: a systematic review with narrative synthesis.

Modern general practice is characterised by increased demand and growing multi-disciplinarity, including ring-fenced funding for additional non-clinical roles. However, for practice receptionists training has remained unchanged for decades, yet primary care is under greater pressure than ever with receptionists becoming a growing focal point of abuse and unprecedented numbers leaving the role. To present the evidence of the range of tasks that receptionists continue to perform, describing their impact on primary care delivery and how the role might be better supported. We conducted a systematic review of evidence contained in the major medical databases (Medline/PubMed, CINAHL, ASSIA, Cochrane Library, and EMBASE) up until July 2023, including hand searches of the bibliographies of included studies. We identified 28 studies which we grouped into three themes: Service delivery, confirming the continuing role of receptionists in providing administrative support alongside clinical tasks of prioritising patients for consultations, facilitating repeat prescriptions, and communicating blood test results; Patient attitudes describing how patient's lacked trust in receptionists viewed as unqualified and unnecessarily obstructive; Finally, in considering Receptionist experience, the contrast between their confidence in performing administrative roles and the anxiety induced from the clinically related tasks was described, particularly the mounting pressure from patients to meet their preferences for clinician appointments. Though confident performing administrative tasks, receptionists described the uncertainty and anxiety when providing clinically oriented support or managing patients when their requests for appointments could not be met. More appropriate training or professionalisation might improve staff retainment.

The Role of Informal Social Support for Patients Undergoing Bariatric Surgery.

Bariatric surgery is underutilized as a treatment for metabolic disease and its associated comorbidities. While social support is known to play a crucial role in outcomes following bariatric surgery, little is known about the role of social support prior to surgery, which may impact preparedness for and willingness to undergo surgery. The study's objective was to examine the role of informal social support prior to bariatric surgery, the types of support received, and patient attitudes toward different demonstrations of support. We conducted semi-structured interviews with patients who had previously undergone bariatric surgery (n = 20) from two high-volume bariatric surgery centers. Interviews focused on patient engagement with and attitudes about social support during the preoperative process. Transcripts from each interview were iteratively analyzed through steps informed by deductive and inductive thematic analysis. Four major themes emerged characterizing social support among patients undergoing bariatric surgery: (1) emotional support, (2) instrumental support, (3) informational support, and (4) self-support. Examples of meaningful support participants received included "cheerleading" (i.e., unconditional encouragement), advice from role models who had previously undergone surgery (e.g., receiving information on the process), shared experiences with loved ones regarding dietary and activity modifications (e.g., exercising with friends), and self-support measures (e.g., seeking therapy). A comprehensive understanding of how patients receive informal social support can offer valuable insights for individuals considering surgery. Further, such knowledge may enable providers to effectively counsel patients through the decision-making process and to ensure the establishment of support systems both pre- and post-surgery.

Effectiveness of Educational Interventions to Develop Patient Safety Competencies in Undergraduate Nursing Students: A Systematic Review.

Nursing professionals are key to providing safe care that improves patient outcomes. Hence, it is essential to focus on developing nurses' patient safety competencies and principles. This review examined the effectiveness of educational interventions in developing patient safety knowledge, skills, behaviors, and attitudes in undergraduate nursing students. The search strategy aimed to identify published and unpublished studies in databases and grey literature. Studies were assessed using the Joanna Briggs Institute critical appraisal tools. A total of 36 studies met the inclusion criteria. The teaching methods employed single or combined interventions and the educational interventions suggested either improvements in outcomes or no impact. The effectiveness of educational interventions to develop patient safety competencies in undergraduate nursing students, either as a single or combined strategy, was mixed. Further research is needed to provide more robust evidence on which teaching method for patient safety is most effective.

Pattern and associated factors of COVID-19 knowledge, attitude and practice (KAP) among COVID-19-comorbid patients: a systematic review and meta-analysis

BackgroundThe COVID-19 comorbid population is at higher risk of developing severe health issues like acute respiratory distress syndrome, coagulation syndrome, metabolic acidosis, and septic shock, potentially leading to patient death. Patients’ knowledge, attitudes, and practices (KAP) significantly influence their response to the pandemic and aid in enhancing health policy implementation.ObjectiveTo identify and evaluate the pattern and associated factors to COVID-19 knowledge, attitude, and practice among individuals with comorbidities.MethodologyThe systematic review followed the PRISMA guidelines. Relevant studies assessing the KAP of comorbid patients were retrieved by carefully searching the PubMed and Google Scholar databases. The appraisal tool for cross-sectional studies was used to determine the quality of the included studies and the risk of biases.ResultsEighteen studies met the inclusion criteria and were included in the review. The pooled sample size of the included studies was 9,104. Different comorbidities reported in the studies include hypertension, diabetes, psychological disorders, and cancer. Pooled analysis showed that 65% of patients showed good knowledge, 57% of patients showed a positive attitude and 51% of patients followed good practices to manage the COVID-19 in presence of their comorbid condition. Significant factors impacting knowledge, attitude and practice in COVID-19 comorbid patients were ethnicity OR 1.78 [95% CI 1.35–2.32]; educational status 3.2 [2.79–3.58]; urban residence 2.43 [1.65–3.02]; employment Status 1.67[1.34–2.12]; financial Status 4.02[3.66–4.38]; occupation 3.65[3.31–4.25]; information Source 2.64[2.19–3.26]; comorbidity 3.28[2.78–3.61]; and duration of chronic illness 1.59[1.31–2.04].ConclusionComorbid COVID-19 patients showed good knowledge, positive attitude and good practice towards the management of the disease.

Treatment preference archetypes in eosinophilic esophagitis and their implications for therapy.

Little is known about how patients make decisions about and prioritize, therapies and disease management in eosinophilic esophagitis (EoE). We aimed to systematically identify and characterize patient perspectives and attitudes that influence decision making for EoE management. To understand the diverse attitudes and values of EoE patients, we designed a study using the Q-method. We iteratively developed 31 statements related to EoE disease management. Participants sorted statements by ranking from +4 (most agree) to -4 (most disagree). By-person factor analysis, using 2- and 3- factor rotation, revealed distinct preference archetypes. Thirty-four adults with EoE (mean age 40.9, 51.4% male, 82.9% White) were recruited from gastroenterology and allergy clinics from a single center. We identified two treatment-centered archetypes: Medication preference, driven by symptoms and the desire to minimize risk of complications, and Natural treatment preference, focusing on identifying trigger foods and diet adherence. Three-factor analysis revealed an additional archetype: Treatment ambivalent, a view of EoE as a mild and episodic (not chronic) disease with low priority to treat. Comparison by factor revealed 54% of those in the natural preference archetype were recategorized as treatment ambivalent, suggesting that they see natural treatment as a less complicated or milder strategy and may be at risk of nonadherence and reduced treatment uptake. We identified three distinct treatment preference archetypes among individuals with EoE, underscoring the need for personalized treatment strategies, especially for those favoring natural approaches but masking ambivalence, and may be at risk for nonadherence or loss to follow-up.

Just another tool in their repertoire: uncovering insights into public and patient perspectives on clinicians' use of machine learning in perioperative care.

Successful implementation of machine learning-augmented clinical decision support systems (ML-CDSS) in perioperative care requires the prioritization of patient-centric approaches to ensure alignment with societal expectations. We assessed general public and surgical patient attitudes and perspectives on ML-CDSS use in perioperative care. A sequential explanatory study was conducted. Stage 1 collected public opinions through a survey. Stage 2 ascertained surgical patients' experiences and attitudes via focus groups and interviews. For Stage 1, a total of 281 respondents' (140 males [49.8%]) data were considered. Among participants without ML awareness, males were almost three times more likely than females to report more acceptance (OR = 2.97; 95% CI, 1.36-6.49) and embrace (OR = 2.74; 95% CI, 1.23-6.09) of ML-CDSS use by perioperative teams. Males were almost twice as likely as females to report more acceptance across all perioperative phases with ORs ranging from 1.71 to 2.07. In Stage 2, insights from 10 surgical patients revealed unanimous agreement that ML-CDSS should primarily serve a supportive function. The pre- and post-operative phases were identified explicitly as forums where ML-CDSS can enhance care delivery. Patients requested for education on ML-CDSS's role in their care to be disseminated by surgeons across multiple platforms. The general public and surgical patients are receptive to ML-CDSS use throughout their perioperative care provided its role is auxiliary to perioperative teams. However, the integration of ML-CDSS into perioperative workflows presents unique challenges for healthcare settings. Insights from this study can inform strategies to support large-scale implementation and adoption of ML-CDSS by patients in all perioperative phases. Key strategies to promote the feasibility and acceptability of ML-CDSS include clinician-led discussions about ML-CDSS's role in perioperative care, established metrics to evaluate the clinical utility of ML-CDSS, and patient education.

Prediction of Illness Attitude Based on Early Maladaptive Schemas and Intolerance of Uncertainty in Patients with Multiple Sclerosis

Background: The present study was conducted to predict attitudes towards illness based on early maladaptive schemas and intolerance of uncertainty in individuals with Multiple Sclerosis (MS). Methods: This was a cross-sectional study conducted on 62 patients with MS (72% of them were female). They were selected based on availability and voluntary participation. Data were collected through three questionnaires: the Illness Attitudes Scale, the Intolerance of Uncertainty scale, and the Yang Schema Questionnaire. Results: The mean age (±SD) of the participants and duration of diagnosis was 36.10±7.05 yr, and 4.21±3.78 yr, respectively. The results showed that 18 early maladaptive schemas, together with intolerance of uncertainty, can predict up to 8.9% of illness attitude in patients with MS. Among the early maladaptive schemas, schemas of emotional deprivation, social isolation-alienation, abandonment-instability, failure, dependence-underdeveloped self, vulnerability, trapped-victim, emotional inhibition, stubborn/fault-finding standards, self-control disciplinary, seeking attention-seeking approval, and negativity/pessimism had a significant relationship with attitudes towards illness (p&lt;0.05). Additionally, there was a significant relationship between intolerance of uncertainty and all its dimensions with attitudes towards illness (p&lt;0.05). Conclusion: Early maladaptive schemas and intolerance of uncertainty can predict illness attitudes in patients with MS. Patients with MS who have high intolerance of uncertainty are more likely to interpret ambiguous information as threatening. Therefore, effective interventions in the field of uncertainty intolerance for these patients can likely be effective in improving their attitudes towards illness and preventing the exacerbation of their symptoms.

Digital therapeutic for hypertension improves physician-patient communication and clinical inertia: a survey of physicians who implemented CureApp HT in clinical practice.

In the 2019 Guidelines for the Management of Hypertension by the Japanese Society for Hypertension, lifestyle modification is recommended for all individuals except those with normal blood pressure. However, no detailed methods have been established to achieve the target blood pressure and resolve clinical inertia. CureApp HT, a digital therapeutic for hypertension that contributes to blood pressure reduction through lifestyle modification, was approved as software as a medical device for reimbursement by Japanese national health insurance in September 2022. This study aimed to survey physicians who implemented CureApp HT to assess how it changes physician-patient communication and contributes to clinical inertia resolution. A questionnaire survey was conducted at three time points: before the first prescription (first survey), 3 months (second survey), and 6 months (third survey) after the first prescription for physicians who had implemented CureApp HT. The primary outcome was the total score of five items on a Likert scale related to physician-patient communication, and it was analyzed based on the 47 physicians who responded to all three questionnaires. The total score of physician-patient communication significantly improved after 6 months of the introduction of CureApp HT, reflecting that physicians observed positive changes in patients' knowledge and attitudes regarding hypertension treatment. Furthermore, the number of physicians who set a target home blood pressure of 125/75 mmHg for their patients significantly increased. CureApp HT allows physicians to recognize changes in patients' disease knowledge and treatment attitudes, enabling them to set more stringent blood pressure targets and addressing clinical inertia. Physicians who implemented CureApp HT recognized changes in the patients' stages of behavioral change through improvements in patients' knowledge of the disease and their attitudes towards treatment, and by experiencing more effective communication, they set stricter blood pressure targets.

Patient perceptions of an electronic-health-record-based rheumatoid arthritis outcomes dashboard: a mixed-methods study

BackgroundOutcome measures are crucial to support a treat-to-target approach to rheumatoid arthritis (RA) care, yet their integration into clinical practice remains inconsistent. We developed an Electronic Heath Record-integrated, patient-facing side-car application to display RA outcomes (disease activity, functional status, pain scores), medications, and lab results during clinical visits (“RA PRO Dashboard”). The study aimed to evaluate patient perceptions and attitudes towards the implementation of a novel patient-facing dashboard during clinical visits using a mixed-methods approach.MethodsRA patients whose clinicians used the dashboard at least once during their clinical visit were invited to complete a survey regarding its usefulness in care. We also conducted semi-structured interviews with a subset of patients to assess their perceptions of the dashboard. The interviews were transcribed verbatim and analyzed thematically using deductive and inductive techniques. Emerging themes and subthemes were organized into four domains of the Ecological Model of Health.ResultsOut of 173 survey respondents, 79% were interested in seeing the dashboard again at a future visit, 71% felt it improved their understanding of their disease, and 65% believed it helped with decision-making about their RA care. Many patients reported that the dashboard helped them discuss their RA symptoms (76%) and medications (72%) with their clinician. Interviews with 29 RA patients revealed 10 key themes: the dashboard was perceived as a valuable visual tool that improved patients’ understanding of RA outcome measures, enhanced their involvement in care, and increased their trust in clinicians and the clinic. Common reported limitations included concerns about reliability of RA outcome questionnaires for some RA patients and inconsistent collection and explanation of these measures by clinicians.ConclusionsIn both the quantitative and qualitative components of the study, patients reported that the dashboard improved their understanding of their RA, enhanced patient-clinician communication, supported shared decision-making, and increased patient engagement in care. These findings support the use of dashboards or similar data visualization tools in RA care and can be used in future interventions to address challenges in data collection and patient education.

Dissecting implicit food-related behaviors in Binge Eating Disorder and obesity: insights from a mobile approach-avoidance framework.

Bulimic episodes experienced by patients with Binge Eating Disorder (BED) might be sustained by an enhanced behavioral propensity to approach food stimuli. To test this hypothesis, automatic approach avoidance tendencies toward high-calorie foods (HCF), low-calorie foods (LCF), and neutral objects were assessed in a group of 23 patients with BED, and their performance was compared to the one of 17 patients with obesity without BED and a group of 32 normal weight participants. All participants performed a mobile approach-avoidance task in which they were required to approach and avoid different stimuli by respectively pulling their phone toward themselves or pushing it away. Reaction times were analyzed. Results showed a significant three-way interaction between group, type of movement and stimulus. Post-hoc analyses revealed that all the groups displayed an approach bias toward HCF. Patients with BED and healthy controls also displayed an approach bias toward LCF, a bias that was absent in obese individuals without BED. Moreover, patients with BED were faster in approaching food stimuli, both HCF and LCF, compared to healthy controls. These behavioral tendencies are quite consistent with the real-life attitudes of both BED patients and patients with obesity and might contribute to the maintenance of unhealthy eating habits such as binging in patients with BED and high-calorie diets in patients with obesity.

Acceptability of artificial intelligence in dental radiology among patients in India: are we ready for this revolution?

In recent times, artificial Intelligence (AI) has gained popularity in medical as well as dental radiology. Studies have been conducted among medical and dental students and professionals about the knowledge and understanding towards AI. The aim of this study was to investigate the perceptions and acceptability of AI in dental radiology among a group of Indian patients seeking dental treatment. A cross-sectional research was planned with a validated questionnaire, containing ten close ended questions amongst 1562 patients. Their sociodemographic characters, opinions and attitudes regarding AI and feasibility of acceptance of AI-based dental radiological diagnosis among patients was evaluated. The study sample was divided in various groups on the basis of their age; group-1(16-30years), group-2(31-45years) and group-3(>45years), educational status and urban/rural background. Statistical analysis was done by Chi-square test with significance value set at p< 0.005. The participants possessed impressive knowledge about AI. Patients' awareness, attitudes and acceptability towards AI for dental radiographic diagnosis were substantially influenced by age, education level and residential background. Although many of them, especially the urban and more educated participants believed that AI could be more accurate, they preferred the human judgement. Overall, a negative attitude in terms of acceptability of AI in dental radiology was observed in this study. Participants opined that AI should only be used as an auxiliary tool and valued clinical judgment over AI in ambiguous situations. It is recommended that this promising technological advancement can be used for initial screening in dental radiology.

Gender identity in Klinefelter Syndrome: a patient-centered approach to treatment

Introduction There is increasing evidence that gender dysphoria (GD) is more prevalent in the Klinefelter Syndrome (KS) population than in males in the general population; however, the exact incidence is uncertain. The aim of this study was to further explore the prevalence of gender-related issues, the role that physical characteristics play in gender identity, and the issues surrounding Hormone Replacement Therapy (HRT) in KS. Methods As part of a registered Quality Improvement Project (QIP), one online 23-point questionnaire on KS patient attitudes toward gender identity was shared with members of the Klinefelter Syndrome Association (KSA). In total, 139 anonymous responses were collected between December 2021 and January 2023. The questionnaire was developed with the guidance of multiple clinicians (including gender psychiatrists, urologists, psychosexual medicine specialists, and endocrinologists) and patient Delphi rounds. Data was reviewed and analyzed by 4 independent researchers within the QIP team. Results Only 53% of KS patients responding to this survey fully identified as male and 19% stated that they did not enjoy living as the sex on their birth certificate, with 43% considering changing aspects of their physical appearance to better match their gender. Regarding HRT, 67% of respondents were receiving Testosterone Replacement Therapy (TRT). 63% wanted TRT and 17% wanted estrogen, including 6% of TRT users who would prefer estrogen instead. 36% that were currently receiving TRT did not identify as male, and 3 participants stated that they have GD. Conclusion These results indicate that a significant proportion of KS patients do not fully identify with the male gender and are unhappy living as the sex on their birth certificate. Although TRT worked for most, its use should be discussed carefully with those with gender identity concerns.

Comparative assessment of attitudes and expectations: Iranian patients versus urologists in the management of benign prostatic hyperplasia.

Benign prostatic hyperplasia (BPH) is common and presents as lower urinary tract symptoms (LUTS). Understanding patient concerns and treatment preferences is essential for effective management. This study aimed to investigate the attitudes, preferences, and expectations of Iranian patients with BPH, and compare them with those of urologists in addressing this condition. A cohort of patients diagnosed with BPH underwent assessment during their initial visit. Before any counseling, their attitudes, concerns, and expectations regarding benign prostate enlargement were evaluated using semi-structured interviews. Patient responses were analyzed based on educational levels and age. Additionally, correspondence was initiated with thirty urologists who graduated within the past twelve years to assess their attitudes toward BPH, concerns, and treatment approaches. Interview questions were constructed using the Delphi method, and their validity was confirmed. Responses from both groups were analyzed and compared. Descriptive statistics, independent t-test, Chi-squared test, Mann-Whitney U, and principal component analysis (PCA) with varimax rotation were used for statistical analysis. The study comprised 261 patients and 30 urologists. Findings revealed that 86.2% of patients and 86.7% of urologists perceived a lack of sufficient patient knowledge about BPH. Patients across all educational levels and age groups expressed a desire for more information about their condition. Primary concerns among patients included exacerbation of urinary symptoms, potential malignancy, and sexual dysfunction. While patients generally preferred pharmacological treatments, those older than 75 years showed a significantly higher preference for surgical options. Conversely, urologists exhibited greater concern for long-term clinical complications associated with BPH. Results indicated significant parallels between the attitudes of urologists and patients in assessing the multifaceted impact of BPH on patient well-being. This study enhances our understanding of patient attitudes and concerns regarding BPH, thereby facilitating more effective treatment strategies. Our findings encourage urologists to enhance patient perspectives by delivering comprehensive information. Furthermore, the comparison between patient and urologist attitudes towards BPH underscores the importance of tailored care and patient-centered approaches in optimizing outcomes for individuals with BPH.

Exploring GP and patient attitudes towards the use and deprescribing of dietary supplements: a survey study in Switzerland

BackgroundDietary supplements are commonly used by older adults, but their inappropriate use may lead to adverse events. To optimise medication use, general practitioners (GPs) ideally are aware of all substances that patients use, including supplements. This cross-sectional study explored the use of dietary supplements by older patients with polypharmacy, the rate at which they disclosed this use to their GPs, and compared patients’ and GPs’ attitudes towards discontinuing dietary supplements.MethodsTen GPs in Swiss primary care recruited five to ten of their older patients taking ≥ 5 regular medications. Both GPs and their patients completed a survey on patients’ use of dietary supplements and attitudes towards deprescribing those. We described and compared their responses. We assessed the association of supplement disclosure with patient characteristics using multilevel logistic regression analysis.ResultsThree out of ten GPs (30%) were female, and GPs’ average age was 52 years (SD = 8). 45% of patients were female (29/65). Most patients (n = 45, 70%) were taking ≥ 1 supplement. On average, patients reported to be using three supplements (SD = 2). In 60% (n = 39) of patients, GPs were unaware of ≥ 1 supplement used. We did not find evidence for an association between supplement disclosure to GPs and patient characteristics. Only 8% (n = 5) of patients and 60% (n = 6) of GPs reported ≥ 1 supplement they would be willing to deprescribe and none of the supplements reported by GPs and patients to deprescribe matched.ConclusionSwiss GPs were unaware of many dietary supplements used by their older patients, which may affect medication optimisation efforts.