4.7 Article

Patient Trust in Physicians Matters-Understanding the Role of a Mobile Patient Education System and Patient-Physician Communication in Improving Patient Adherence Behavior: Field Study

Journal

JOURNAL OF MEDICAL INTERNET RESEARCH
Volume 24, Issue 12, Pages -

Publisher

JMIR PUBLICATIONS, INC
DOI: 10.2196/42941

Keywords

mobile health; mHealth; trust; patient adherence; mobile patient education system; MPES; patient-physician communication; theory of planned behavior; TPB; patient-centered care; mobile phone

Funding

  1. University of South Carolina (USC) , Columbia, South Carolina, United States [80002838]
  2. USC Big Data Health Science Center
  3. USC excellence initiative program [BDHSC-2021-14, BDHSC-2022]
  4. USC Advancing Chronic Care Outcome through Research and Innovation Center (ACORN-2022)
  5. Utah Science Technology and Research Initiative grant (USTAR-TCG)

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This study aimed to investigate the impact of a mobile patient education system (MPES) and patient trust on patient adherence to prescribed medical therapies. The results showed that patient-physician communication and the use of an MPES significantly increased patients' trust in their physicians. Patient trust had a prominent effect on patient attitude toward treatment adherence, which in turn influenced patients' behavioral intention and actual adherence behavior.
Background: The ultimate goal of any prescribed medical therapy is to achieve desired outcomes of patient care. However, patient nonadherence has long been a major problem detrimental to patient health, and thus is a concern for all health care providers. Moreover, nonadherence is extremely costly for global medical systems because of unnecessary complications and expenses. Traditional patient education programs often serve as an intervention tool to increase patients' self-care awareness, disease knowledge, and motivation to change patient behaviors for better adherence. Patient trust in physicians, patient-physician relationships, and quality of communication have also been identified as critical factors influencing patient adherence. However, little is known about how mobile patient education technologies help foster patient adherence.Objective: This study aimed to empirically investigate whether and how a mobile patient education system (MPES) juxtaposed with patient trust can increase patient adherence to prescribed medical therapies.Methods: This study was conducted based on a field survey of 125 patients in multiple states in the United States who have used an innovative mobile health care system for their health care education and information seeking. Partial least squares techniques were used to analyze the collected data.Results: The results revealed that patient-physician communication and the use of an MPES significantly increase patients' trust in their physicians. Furthermore, patient trust has a prominent effect on patient attitude toward treatment adherence, which in turn influences patients' behavioral intention and actual adherence behavior. Based on the theory of planned behavior, the results also indicated that behavioral intention, response efficacy, and self-efficacy positively influenced patients' actual treatment adherence behavior, whereas descriptive norms and subjective norms do not play a role in this process.Conclusions: Our study is one of the first that examines the relationship between patients who actively use an MPES and their trust in their physicians. This study contributes to this context by enriching the trust literature, addressing the call to identify key patient-centered technology determinants of trust, advancing the understanding of patient adherence mechanisms, adding a new explanation of the influence of education mechanisms delivered via mobile devices on patient adherence, and confirming that the theory of planned behavior holds in this patient adherence context.

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