Patient Perceptions Research Articles

Perception of Patients with High Blood Pressure in Haitian Hospital Regarding Traditional Medicine

In Haiti, high blood pressure (HBP) is a major public health problem. Many patients have uncontrolled blood pressure due to poor adherence to care, which in their case requires. In the North Department, particularly in the city of Cap-Haitian, this pathology continues to increase. The World Health Organization (WHO) recommends behavioral measures such as a healthy lifestyle, a balanced diet, and compliance with treatment in order to reduce this scourge. For sociocultural and economic reasons, some patients resort to traditional medicine/natural medicine. However, the effectiveness of the management of HBP by the latter remains to be proven. In the Haitian hospital environment, professionals are committed to a merciless fight to control this pathology. Irregular control of HBP, neglect, poverty, lack of psychological assistance both in hospital and at home favor the choice of traditional/natural medicine as a first resort to modify their blood pressure figure. The objective of this article is to understand the factors that influence the psychological care of hypertensive patients in the health zone of Cap-Haitian in order to improve psychological care. It also intends to review the prevalence of hypertensive patients using traditional medicine as a curative method to lower their HBP.

Impact of implementing primary care-based medication for opioid use disorder on provider and staff perceptions

Abstract Medication for opioid use disorder (MOUD) is the management of opioid use disorder (OUD) on an outpatient basis with buprenorphine or buprenorphine/naloxone (or methadone, which is limited to federally certified opioid treatment programs). Primary care practices are well poised to provide comprehensive care for patients with OUD, including provision of MOUD. The aim of this study was to assess provider and staff OUD attitudes and role perceptions before and after implementation of a MOUD clinical service line. A survey was distributed to evaluate attitudes and perceptions of patients with OUD and provision of MOUD among providers and staff in an academic family medicine clinic. Surveys were distributed in December 2020 (73% response rate), prior to a substance use disorder educational training and MOUD service line implementation, which provided patients with OUD both primary care services and management with buprenorphine/naloxone. A follow-up survey was distributed in February 2022 (69% response rate).Training and implementation of the MOUD service line demonstrated improvements in the domains of motivation (+0.63), attitudes (+0.32), satisfaction (+0.38), role support (+0.48), role adequacy (+0.39), and safety (+0.79) among surveyed participants. The change in satisfaction and safety domains was statistically significant (P < .05). There was no change in the role legitimacy domain.Implementation of a primary care-based MOUD service line positively affected provider and staff motivation, attitudes, satisfaction, sense of safety, role support, and adequacy when working with patients with OUD. This highlights the benefits of MOUD-specific clinical support to optimize care delivery within primary care.

From Filters to Scalpels-Understanding Perceptions of Facial Asymmetry: An AAFPRS Survey.

Facial asymmetries can significantly affect patient satisfaction post-surgery. Social media can impact a patient's perception of their asymmetries. To gather insights into the practices, perceptions, and approaches concerning facial asymmetry among facial plastic surgeons. The aim of this study was to understand the impact of social media on perceptions of facial asymmetry. This is an American Academy of Facial Plastic and Reconstructive Surgeons (AAFPRS) survey consisting of 46 questions that sought to understand facial plastic surgeons' perceptions of facial asymmetry, their consultation process, their patients' perspectives on their own facial asymmetries, and patient satisfaction. The survey was distributed to 1,269 members of AAFPRS across community hospitals, private practices, and academic hospitals. Sixty-seven members completed the survey. The survey revealed that 31% (21) of surgeons face challenges in managing patient expectations regarding facial asymmetry. In addition, 12% (8) of surgeons felt that patients did not initially recognize their own asymmetries. Eighty-seven percent (58) of surgeons emphasize the natural occurrence of asymmetry during consultations to set realistic expectations. This study emphasizes the need for thorough patient education during initial consultations to align expectations with achievable outcomes. Surgeons should explain the natural occurrence of asymmetry clearly and use digital imaging to show patients realistic previews of surgical results.

Patient Experiences and Perceptions with Infections Due to Multidrug-Resistant Organisms: A Systematic Review.

Infections by multidrug-resistant organisms (MDROs) pose significant public health challenges, including increased mortality rates, healthcare costs, and significant impacts on the quality of life for patients. Utilizing a systematic review methodology adhering to PRISMA guidelines, we performed a comprehensive search across three databases, identifying 20 relevant studies that investigated the psychological effects of infections due to MDROs on hospitalized adults. The primary outcomes examined included depression, anxiety, and other psychosocial impacts, while secondary outcomes included patient and caregiver understanding of the infection. Findings revealed consistent associations between contact isolation due to MDRO infections and heightened levels of depression and anxiety among patients, although evidence regarding the impact on anger was mixed. Other psychological aspects, such as feelings of stigmatization and reduced healthcare provider interactions, were also recorded. The current systematic review highlights the importance of addressing these psychological effects through holistic, patient-centered care approaches, emphasizing the need for better communication and comprehensive education for both patients and healthcare providers. Our findings suggest that mitigating the psychological burden of MDROs can enhance overall patient care and outcomes and call for further research to optimize care strategies for patients hospitalized for infections due to MDROs.

Abstract C130: Evaluation of key performance indicators of a community-focused patient navigation program in an outpatient cancer center

Abstract Background: In 2021, Dana-Farber Cancer Institute’s (DFCI) Cancer Care Equity Program (CCEP) implemented a Community-Focused Patient Navigation (CFPN) program to support adult medical oncology patients from historically marginalized groups by proactively identifying and addressing patients’ barriers to cancer treatment. The program has been sequentially implemented in five cancer treatment centers, gastrointestinal, breast, thoracic, and gynecologic oncology and hematologic malignancies with plans to expand further. The purpose of this analysis is to evaluate CFPN against key performance indicators (KPIs) in gastrointestinal oncology, where the program was implemented first. Methods: Patients included in the analysis met CFPN eligibility criteria: adult medical oncology patients from zip codes in the Greater Boston area with significant socio-economic disparities and who agreed to receive support from the patient navigator. Program KPIs included in the analysis were appointment no show rate, New Patient Intake Questionnaire (NPIQ) response rate, and social work encounter rate. A pre- post analysis was used to identify trends in the KPIs of interest among navigated patients from the start of the program in October 2021 through May 2024 compared to similar groups of patients seen one year prior to the launch of the program who would have met CFPN eligibility criteria if the program had existed at that time. The data were taken from the cancer center’s electronic medical record system and visualized in a dashboard. Results: Preliminary findings show a significant decrease in appointment no show rate from 4.07% to 2.29% (p<0.05) and an increase in NPIQ response rate from 20.97% to 34.74% (p<0.05) among all navigated patients after the program was implemented compared to one year prior to the program launch. While not statistically significant, there was an increase from 28.23% to 43.16% in the social work encounter rate for patients engaged with the patient navigator. Conclusion: Preliminary analysis of CFPN demonstrates a positive trend toward meeting KPIs in gastrointestinal oncology and reveals outcomes that will guide further quantitative and qualitative analysis to identify areas of programmatic success and improvement. Next steps include conducting a more in-depth quantitative analysis on additional KPIs, including patient retention rate, stratified by demographics. CCEP also plans to conduct a qualitative analysis to identify patient and care team perceptions of CFPN through focus groups and/or structured interviews. An abstract describing CFPN program design was accepted for online publication at ASCO. This project was undertaken as a Quality Improvement Initiative at DFCI, and as such was not formally supervised by the Institutional Review Board per policy. Citation Format: Sarah Pohl, Emma Green, Katherine Miller, Ludmila Svoboda, Magnolia Contreras, Christopher Lathan. Evaluation of key performance indicators of a community-focused patient navigation program in an outpatient cancer center [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr C130.

Patients' experience of telehealth clinics during the COVID-19 pandemic: Cross-sectional study.

Globally, the Coronavirus disease (COVID-19) pandemic in 2019 has accelerated the adoption of telehealth technologies. The implementation of the Saudi Telemedicine Network (STN) and other digital health initiatives, such as the telehealth clinic (THC) at King Abdullah bin Abdulaziz University Hospital (KAAUH), exemplifies this trend in Saudi Arabia. The aim of this study was to explore the patients' experience of THC in KAAUH during the COVID-19 pandemic and their' beliefs about their readiness to replace the traditional onsite clinical visits with THC from March to September 2020. A cross-sectional study targeted all 1398 patients who utilized THC at KAAUH. A self-administrated, validated survey collected the data. The survey used a Likert scale and included questions on satisfaction with THC services and the perceived effectiveness of telehealth as a substitute for in-person visits. The collected data was analyzed using frequency and percentage. A total of 252 patients responded to the THC postvisit survey. Overall, 217 patients (86%) were satisfied, 32 patients (13%) were dissatisfied, and only 3 patients (1%) were neutral about THC. Most patients (65.5%) agree that THC provided enough information about their health conditions, which can substitute for clinical visits. About 18.3% of patients were neutral, while 16.3% disagreed with the effectiveness of THC services and believed that they could not replace onsite visits. During the COVID-19 pandemic, most patients were satisfied at KAAUH-THC in Saudi Arabia and believed that it could replace the onsite visit to a physician's clinic. The 2 main causes of the patient's belief that THC could not replace an onsite clinical visit were: First, nonadherence to appointments led to missed calls and a complete medical service. Second, the patient's perception is that a physical examination and lab investigation cannot be completed through THC.

Influence of the Quality of Pharmacy Services and Non-Pharmacy on the Decision to Redeem the Prescription and Its Impact on Retreatment of General Outpatient at Pasar Minggu Hospital

The study examines the influence of pharmaceutical and non-pharmaceutical service quality on prescription redemption decisions and subsequent re-treatment decisions among general outpatients at Pasar Minggu Regional Hospital. The hospital has faced challenges, including a decline in outpatient visits and filled prescriptions, affecting its revenue during the 2022-2023 period. Patient perceptions of the pharmacy services significantly impact their decision to return for further medical care. The research aims to assess both direct and indirect effects of service quality on prescription redemption and re-treatment decisions. The study employs a verification approach with a cross-sectional design, using accidental sampling to survey 342 general outpatients between October 2023 and February 2024. Data were analyzed descriptively and inferentially using SEM PLS 3.0, encompassing both outer and inner model analyses through PLS Algorithm, Bootstrapping, and Blindfolding techniques. The findings reveal that the quality of pharmaceutical and non-pharmaceutical services significantly influences the decision to redeem a prescription (P = 0.000). Moreover, non-pharmaceutical service quality and the decision to redeem a prescription significantly affect the decision to re-medicate (P = 0.002 and 0.000, respectively). However, pharmaceutical service quality alone does not positively impact repeat treatment (P = 0.041). Both service variables have a significant indirect effect on re-treatment decisions through the mediating role of prescription redemption (P = 0.000).

Follow-up care experience of patients with invasive meningococcal disease and their family caregivers: a qualitative study

BackgroundClinical guidelines recommend systematic follow-up of patients surviving invasive meningococcal disease (IMD) to assess sequelae. However, little is known about survivors and family caregivers’ experiences of the follow-up care. Study sought to explore IMD survivors’ and their family caregivers’ experiences after hospitalization for IMD and to identify unmet needs.MethodsSemi-structured interviews were conducted with patients and family caregivers, identified through hospitals database. Interviews were audiotaped, transcribed and subject to a thematic analysis. NVivo software was used for data management and analysis.ResultsEight IMD survivors and 14 family caregivers were interviewed. Three themes were identified from the data: (1) perception of patient and family caregiver on follow-up after IMD and role of healthcare professionals; (2) access to care and support; (3) relationship with healthcare professionals. Although most were satisfied with follow-up care after IMD, suggestions for improving the healthcare pathway were made relating information on potential sequelae and follow-up care, coordination, and access to psychological support.ConclusionsThis study confirms the need for more structured follow-up care for patients suffering from IMD and their families which is currently limited and focused on physical recovery. Optimal follow-up should aim to provide sufficient information, emotional support and logistical support for patient and family caregivers.Trial registrationEthics Committee of University of Lyon, France (ref: 2022-06-23-002).

Assessment of laparoscopic surgery practice, knowledge, and training goals in Liberia: A mixed-methods study among Liberian surgeons.

Laparoscopy training remains inaccessible in many low- and middle-income countries, including Liberia. We assessed the availability of laparoscopy and feasibility of implementing a laparoscopic program among Liberian surgeons and trainees. This mixed-methods study utilized a 32-item survey and semi-structured interviews on laparoscopic experience, knowledge, desires, barriers, patient perceptions, and training opportunities among surgeons and trainees at Liberia's two main teaching hospitals in March 2023. Data analysis utilized summed knowledge and desirability scores, descriptive statistics, and qualitative content analysis. 31 interns, residents, and consultants participated, comprising 60% of Liberia's surgeons. Laparoscopic training (32%) and experience (16%) was low, with exposure limited to those training outside Liberia (p=0.001). While laparoscopy knowledge varied (29% low, 55% medium, 16% high), participants expressed high interest in training (100%) and willingness to pay (52%). Interviews revealed four themes: desires for training, patient acceptability, feasibility of technology-based training, and barriers including limited equipment and expert trainers. At the time of survey, the only minimally invasive surgeries ever performed in Liberia were two diagnostic laparoscopies. This is the first mixed-methods study assessing laparoscopy in Liberia. Our sample, though small, comprised approximately 60% of Liberian surgeons in both rural and urban hospitals. Findings demonstrated limited experience, variable knowledge, and high desires for training, showing feasibility for laparoscopy implementation in Liberia.

Perception of Efficiency in Care: A Study of Time Management and Discharge Planning from Nurses and Patients in Hospital Medical Units

Background: Effective time management and efficient discharge planning are crucial for high-quality hospital patient care. This study aimed to understand the perceptions of nurses and patients regarding these aspects to identify areas for improvement. Method: A survey was conducted with 45 nurses and 60 patients in a hospital setting. The nurses’ surveys focused on their experiences with call bell responsiveness, medication administration, and discharge planning. Patient surveys evaluated their perception of nurses’ responsiveness and involvement in the discharge process. Statistical analysis, including ANOVA and correlation tests, was used to assess the data. Results: Nurses reported mixed experiences with call bell response times and varied capabilities for timely medication administration. Challenges included disruptions from call bells, delays in medication delivery, and constraints in discharge discussions and planning. In contrast, patients generally viewed nurses as prompt and attentive, with satisfactory timeliness of care. However, patients expressed dissatisfaction with discharge education. No significant correlations were found between the demographics and perceptions of either group. Conclusion: This study highlights the disparity between nurses' experiences and patients' perceptions of hospital time management and discharge planning. It underscores the need for improved processes and communication strategies to align nurses’ capabilities with patients’ expectations, thereby enhancing overall patient care and satisfaction.

Evaluation of patients' perception of a blockchain system for prescription management

The management of medical prescriptions without computational system can result in errors and security issues. This study, conducted in Monclova, Coahuila, evaluates the perception and disposition of patients from public and private health services towards implementing a secure computational system to improve prescription and medical record management. A survey of 68 adults, using a mixed research methodology. The results indicate that a secure and low-cost computational system would have positive acceptance among the population, thereby validating the researcher's hypothesis. In conclusion, it was determined that a secure computational system is a feasible solution to improve the management of medical prescriptions, would be accepted by most of the patients, and could serve as a basis for future developments in other areas of the healthcare sector. The literature on blockchain in prescription management supports the system’s benefits. A 10% margin of error was used to maintain validity with a smaller sample size.

Analysis of patient experiences regarding JAK inhibitors for atopic dermatitis, psoriasis, alopecia areata, and vitiligo.

The use of medications which target the JAK-STAT signaling pathway, also known as janus kinase (JAK) inhibitors, has rapidly increased in recent years. Patient perceptions, opinions, and concerns regarding the use of JAK inhibitors are largely uninvestigated. Our objective is to better understand patient concerns, reported side effects, and sentiments regarding the use of JAK inhibitors for dermatologic disease. The authors performed a cross-sectional analysis of the most frequented subreddits for dermatologic disease in which JAK inhibitors have obtained FDA approval (r/atopic dermatitis, r/psoriasis, r/alopecia areata, r/vitiligo, and r/eczeJAKS). The sentiment, central theme, and engagement level of each post was evaluated using previously utilized methods. Nine hundred twenty-three posts were analyzed, with the majority focusing on efficacy (433, 47%) and medication-related side effects (150, 16%). Other themes of interest to patients were Payment/Insurance (84, 9%), Study Results/News (69, 7%), Administration/Dosage (33, 4%), and Medication Interactions (31, 3%). The most frequently reported side effects were acne/folliculitis (24, 22%), nausea/gastrointestinal disturbance (11,10%), and fatigue/muscle aches (10, 9%). At the same time, the medication interactions garnering the most concern were sunscreens/facial moisturizers (5, 16%), topical calcineurin inhibitors (4, 13%), and Marijuana/THC (3, 9.%). This analysis highlights that patients are most concerned about the efficacy and side effects of JAK inhibitors in addition to issues regarding access to JAK inhibitors. Providers can use the insights gained from this study to address hesitancy better and guide comprehensive, patient-centered discussions with patients regarding JAK inhibitor use.

Understanding the Perspectives and Experiences of Patients with Acute Severe Ulcerative Colitis in the Hospital: A Qualitative Analysis.

Acute severe ulcerative colitis (ASUC) is a life-treating presentation of ulcerative colitis (UC) that requires prompt initiation of treatment to avoid complication. Unfortunately, outcomes for ASUC are suboptimal, with as many as 20-30% of patients requiring colectomy. This can be challenging for patients and highlights the need to understand patient experiences and perspectives navigating ASUC. A qualitative descriptive study utilizing semi-structured interviews was conducted to understand perspectives and experiences of patients navigating ASUC. Adult patients hospitalized for ASUC between January 2017 and March 2024 were eligible. Interviews were conducted both retrospectively among patients with a recent hospitalization and prospectively among patients within 24h of hospitalization for ASUC. Interviews were analyzed using a well-established hybrid inductive-deductive approach. Thirty-four patients (44.2% response rate) hospitalized for ASUC were interviewed. Hybrid thematic analysis uncovered five major themes: (1) the pervasive impact of UC on QoL and mental health, (2) challenges associated with navigating uncertainty, (3) prioritizing colon preservation, (4) bridging the divide between outpatient expectations and inpatient realities, and (5) balancing rapid symptom improvement with steroid safety. Our findings advocate for transparent approach to care, emphasizing the need for effective communication, education, and better alignment with patient values and expectations. Five key themes were identified, each with significant implications for developing a more patient-centered approach to ASUC care. These themes captured meaningful insight into patient perceptions and experiences, identifying multiple areas for actionable interventions to improve care.

A Patient-Centered Perspective on Changes in Personal Characteristics After Deep Brain Stimulation

Deep brain stimulation (DBS) results in improvements in motor function and quality of life in patients with Parkinson disease (PD), which might impact a patient's perception of valued personal characteristics. Prior studies investigating whether DBS causes unwanted changes to oneself or one's personality have methodological limitations that should be addressed. To determine whether DBS is associated with changes in characteristics that patients with PD identify as personally meaningful. This cohort study assessed changes in visual analog scale (VAS) ratings reflecting the extent to which patients with PD manifested individually identified personal characteristics before and 6 and 12 months after DBS at a large academic medical center from February 21, 2018, to December 9, 2021. The VAS findings were tailored to reflect the top 3 individually identified personal characteristics the patient most feared losing. The VASs were scored from 0 to 10, with 0 representing the least and 10 the most extreme manifestation of the trait. Change scores were examined at the individual level. Content analysis was used to code the qualitative data. Qualitative and quantitative analyses were performed from January 12, 2019 (initial qualitative coding), to December 15, 2023. Deep brain stimulation. The primary outcome variable was the mean VAS score for the top 3 personal characteristics. The secondary outcome was the incidence of meaningful changes on the patients' top 3 characteristics at the individual level. Fifty-two of 54 dyads of patients with PD and their care partners (96.3%) were recruited from a consecutive series approved for DBS (36 patients [69.2%] were male and 45 care partners [86.5%] were female; mean [SD] age of patients, 61.98 [8.55] years). Two patients and 1 care partner were lost to follow-up. Increases in the mean VAS score (indicative of greater manifestation of [ie, positive changes in] specific characteristics) were apparent following DBS for ratings of both the patients (Wald χ2 = 16.104; P < .001) and care partners (Wald χ2 = 6.746; P < .001) over time. The slopes of the changes for both the patient and care partners were correlated, indicating agreement in observed changes over time. The individual level analyses indicated that scores for most patients and care partners remained the same or increased. In this cohort study, participants reported greater (more positive) manifestations of individually identified, valued characteristics after DBS. These findings may be relevant to informing decision-making for patients with advanced PD who are considering DBS.

The association of compassion with dignity and symptoms in end-of-life cancer patients.

Compassion is essential in palliative care; however, there is a lack of evidence of the association between this construct and patients' dignity-related distress. The present study aimed to investigate the association between end-of-life cancer patients' sense of dignity, the level of compassion of the healthcare professionals (HCPs) noticed and perceived by the patients, and levels of compassion that HCPs felt they had toward patients, investigating through specific attitudes and behaviors. Furthermore, the relationship between compassion and patients' physical and psychological symptoms, such as levels of anxiety and depression, was also investigated. The study was cross-sectional. The sample consisted of 105 end-of-life cancer patients and 40 HCPs. Patients had a Karnofsky Performance Status of 50 or lower and a life expectancy of less than 4 months. For each patient, sociodemographic data were collected, and a set of rating scales assessing compassion, dignity as well as physical and psychological symptoms were administered. The results showed significant negative associations between patients' perception of compassion and dignity-related distress as well as significant negative associations between patients' perception of compassion and patients' symptoms. Compassion seems to be involved in diminishing dignity-related distress and alleviating physical and psychological symptoms. Other studies are needed to understand whether patients' symptoms or whether specific HCPs' conditions influence compassion. Exploring compassion and at the end-of-life could encourage a dignity-conserving care.

Categorising Subjective Perceptions of Middle-Aged Breast Cancer Patients Using Q Methodology.

This study explores the characteristics of different perception types in middle-aged female breast cancer patients and proposes psychological counselling interventions tailored to each type. The study used the Q methodology, starting with the construction of 40 Q samples and 39 P samples. We categorised middle-aged female patients' subjective perceptions of battling breast cancer into five types along a spectrum: Type 1, 'Embracing a New Life'; Type 2, 'Finally Focusing on Myself'; Type 3, 'Struggling Amidst Confusion'; Type 4, 'Withdrawing in Despair'; and Type 5, 'Pushed to the Edge of Fear'. This study revealed that the subjective experiences of middle-aged female breast cancer patients range on a spectrum from post-traumatic growth to post-traumatic stress disorder (PTSD). Based on these findings, this study discusses the characteristics and significance of each subjectivity type and suggests implications and directions for future research.

Understanding patient and health care provider perceptions of barriers and facilitators to diabetes care in immigrant and refugee populations

BackgroundThere is a lack of literature which assesses both patient and health care provider (HCP) perceptions of barriers and facilitators to diabetes health care in immigrant and refugee populations within the United States. This study uniquely incorporates both cohorts’ perceptions on the same topic to assess for congruency and discrepancies in perspectives.MethodsSurveys were deployed to patients with diabetes and HCPs to solicit perceptions of barriers and facilitators to diabetes care, with the intention to determine similarities and differences between cohorts. A literature review was conducted to explore barriers and facilitators to diabetes care in immigrant/refugee populations in the US to aid in development of the survey used in this study, as no validated survey existed. Broad recruitment strategies were used, including snowball sampling. Descriptive statistics were calculated and reported p-values were derived from a chi-squared or Fisher’s exact test and used for categorical data and a Wilcoxon rank sum or Kruskal–Wallis rank sum test was used for continuous data. Qualitive analysis was completed using the inductive analysis method.ResultsAmong 19 immigrant and refugee patients and 35 HCPs, almost all facilitators to diabetes care were endorsed by patients and HCPs as helpful. The highest ranked facilitator among patients and HCPs was having access to health insurance. Patients rated stress, while HCPs rated lack of health insurance as the biggest barriers to diabetes care for immigrants and refugees. Patients and HCPs differed in perspective on who held primary responsibility for diabetes management. Patients wanted more diabetes education and nutrition support, while HCPs thought understanding patients’ cultural context/sensitivity, providing more education, and having language/translation services were the most important things HCPs can do to care for patients’ diabetes.ConclusionsImmigrant/refugee patients and HCPs largely agree about what factors are most helpful in managing diabetes, with access to health insurance as the greatest facilitator. However, while HCPs identified lack of health insurance as the greatest barrier to care, immigrant and refugee patients cited the role of stress as the greatest challenge in managing their diabetes. There was a striking difference in perception of responsibility for diabetes management, with 89% of patient participants responding that the patient is responsible, while only 17% of HCPs responded that the patient was responsible. Future work should include surveys translated into languages other than English to further elicit the perspective of diabetes care in immigrant/refugee populations. Clinical recommendations based on this study include assessing and supporting patient stressors, assuring patients understand that diabetes management is a partnership, providing culturally tailored diabetes education, and increasing access to health insurance.

Patients perception and coronary artery bypass surgery

Patients perception and coronary artery bypass surgery

Enhancing Tuberculosis Treatment Adherence: Evaluating the Efficacy of the Support for Treatment Adherence and Medication Protocols (STAMP) Device for Automatic Dispensing and Real-Time Medication Monitoring.

Tuberculosis (TB) remains a significant global health challenge, necessitating strict adherence to medication for successful treatment and prevention of drug resistance. Adherence to a regular medication regimen is crucial in TB management, yet achieving high adherence rates among patients proves challenging due to various factors including forgetfulness, complexity of treatment schedules, and socioeconomic barriers. This study explores the potential of an automatic medicine dispenser (AMD) anchored system to improve medication adherence among TB patients and evaluates its impact through monitoring and feedback mechanisms. The AMD integrates advanced technology to dispense medications at scheduled times, thereby reducing reliance on patient memory and manual adherence tracking. This device is complemented by a monitoring system where healthcare mentors oversee adherence data in real-time via a web-linked dashboard. Such real-time monitoring enables mentors to promptly intervene in cases of non-adherence, offering personalized support and guidance tailored to individual patient needs. The study employs a mixed-methods approach, combining quantitative analysis of adherence rates derived from the AMD anchored system with qualitative data from patient surveys. These surveys gather insights into patient experiences and perceptions regarding the use of the AMD anchored system, including feedback on the accuracy of medication intake recorded by the device. Data obtained from the surveys are analyzed alongside adherence metrics from the dashboard to elucidate factors influencing adherence behavior and the device's effectiveness in fostering sustained treatment adherence. Preliminary findings indicate promising outcomes associated with the AMD anchored system intervention. High rates of adherence are observed among patients utilizing the device, attributed to the device's automated dispensing mechanism and the supportive role of healthcare mentors. Challenges such as technical malfunctions and patient acceptance are also identified, prompting continuous refinement of the AMD and mentorship strategies. In conclusion, the integration of an AMD coupled with real-time monitoring through a web-linked dashboard represents a significant advancement in TB treatment adherence management. Future research should focus on the scalability and sustainability of this technology-augmented, holistic approach across diverse healthcare settings to maximize its impact on global TB management strategies.

Perspectives of People Living With Chronic Hepatitis D: Impact of Disease and Unmet Needs Along the Care Cascade.

Hepatitis D virus leads to a severe form of viral hepatitis and affects nearly 5% of people living with chronic hepatitis B. Chronic infection with hepatitis D virus leads to more rapid progression to cirrhosis, hepatocellular carcinoma and ultimately liver disease-related death compared with hepatitis B monoinfection. Health outcomes and treatment adherence can be affected by patient perception of, engagement in, and satisfaction with care. Our objective was to better understand the experiences of people with chronic hepatitis D, identify their preferred sources of information, and recognise unmet needs from their perspectives. Sixty-seven participants from the United States and the European Union took part in monthly, online, self-guided surveys for a minimum of 3 months with an optional extension. Participants reported feeling anxious and scared at the time of diagnosis but over time came to accept living with chronic hepatitis D. They voiced a need for access to information from trusted sources, fewer barriers to care, and shorter wait times for provider visits and test results after diagnosis. Participants experienced both physical and psychological strain living with chronic hepatitis D. Although most participants reported the ability to continue their regular activities and employment, some stated such activities were done at a reduced pace. Self-reported overall health appeared to be closely linked with emotional support. Understanding patient perspectives, with concurrent clinician perspectives, is crucial when working toward developing solutions to fulfil unmet patient needs associated with chronic hepatitis D management and advancing health equity.