Ho Thi Quynh Anh Le

Background: Chronic diseases are the leading cause of death worldwide. Medication adherence is a critical factor in improving treatment efficacy and reducing patient costs. Objectives: (1) To survey the general characteristics of patients receiving treatment for chronic diseases at the Hue Family Medicine Clinic; (2) To assess home medication adherence among these patients using the GMAS scale. Materials and methods: A cross-sectional descriptive study was conducted on 127 patients with chronic diseases (diabetes, hypertension, dyslipidemia, other cardiovascular diseases) at the Family Medicine Clinic from July 2024 to September 2024. Medication adherence was evaluated using the GMAS scale. Results: The mean age of the patients was 63.48 ± 8.65years. On average, patients had 2.23 ± 0.88 primary/comorbid conditions and were prescribed 2.77 ± 1.31 medications. The rate of high medication adherence was 92.1%. However, approximately 30-50% of patients occasionally or frequently forgot their medication due to being busy, traveling, attending social events, or having difficulty remembering. About 20% of patients "frequently or occasionally" discontinued medication on their own, and 28.3% self-adjusted their daily medication regimen. Conclusion: Interventions are needed to minimize forgetfulness due to changes in routine and to address the self-adjustment of treatment regimens, which may stem from a lack of knowledge or ineffective communication with physicians. Future patient counseling and education programs should focus on these two specific aspects.

Background: Shared decision-making (SDM) is a core component of patient-centred chronic disease care, yet little is known about how to measure patient-perceived SDM in Vietnamese primary care. This study evaluated the psychometric properties of the Vietnamese version of the 9-item Shared Decision-Making Questionnaire (SDM‑Q‑9) among adults with chronic diseases. Methods: A cross-sectional survey was conducted among patients receiving ongoing care for chronic conditions at the Family Medicine Centre, Hue University of Medicine and Pharmacy, in 2025. The SDM‑Q‑9 was translated and culturally adapted using forward-backwards translation and cognitive debriefing. Internal consistency was assessed using Cronbach’s alpha and corrected item-total correlations. Structural validity was examined using confirmatory factor analysis (CFA). Construct validity was evaluated through known-group analyses based on clinical characteristics and patient-reported experiences of consultation. Results: The Vietnamese SDM‑Q‑9 showed good internal consistency (Cronbach’s alpha = 0.81); corrected item–total correlations ranged from 0.30 to 0.68, and removing any item did not improve alpha. Early-stage SDM items showed lower factor loadings (0.32) and floor effects, whereas later-stage items demonstrated higher loadings (≥0.63) and ceiling effects. The CFA showed a poor fit for the original one-factor model (χ²/df = 10.67, RMSEA = 0.22, CFI = 0.63), and alternative models showed partial improvement (with the highest CFI of 0.73), but did not meet the conventional criteria. SDM-Q-9 scores differed by consultation-related experiences (all p < 0.01) but not by disease duration, disease control, or medication adherence (all p > 0.05). Conclusions: The Vietnamese SDM‑Q‑9 demonstrates acceptable reliability and construct validity for assessing patient-perceived SDM in chronic disease management in primary care. The findings support retaining all nine items to preserve conceptual completeness and international comparability. Further validation in larger and more diverse samples is warranted to strengthen evidence for its broader application in research, education, and quality improvement.

Objectives Chronic diseases pose significant challenges to primary care, requiring patient-centred strategies to improve chronic care delivery. As telehealth emerges as a promising tool, this study aims to examine patient experiences with chronic care and their preferences for self-management support (SMS) through telehealth services in primary care settings. Design A multicentre, cross-sectional survey was conducted (June–August 2022) using the Patient Assessment of Chronic Illness Care (PACIC), the Patient Assessment of Self-Management Tasks (PAST) and a telehealth preferences questionnaire. Linear regression assessed the association between PACIC and PAST scores. Multivariate logistic regression identified factors associated with telehealth preferences, with variables selected according to Andersen’s model of healthcare utilisation. Settings Five diverse primary care settings in Central Vietnam, operating under Family Medicine principles. Participants 290 individuals with hypertension and/or diabetes managed at primary care for at least 6 months. Results The average PACIC score was 2.52 (SD 0.7); 25.5% rated their care as high quality (PACIC score ≥3). Among PACIC domains, goal-setting and follow-up/coordination domains received the lowest ratings. Participants perceived lifestyle changes as their priority self-management tasks, followed by medical management, communication with providers and coping with disease consequences. Higher PACIC scores were significantly associated with greater engagement across most PAST domains. Live video conferencing and mobile health were the most preferred formats for SMS. Participants strongly preferred remote patient monitoring for medical management (OR 8.8, 95% CI 2.0 to 38.1). Rural residents were more likely to prefer other telehealth modalities (ORs 3.8–4.6), particularly for coping with disease consequences (OR 4.1, 95% CI 1.8 to 9.4) and lifestyle changes (OR 5.8, 95% CI 1.1 to 28.9). Telehealth preferences were associated with factors across Andersen’s domains, including education (predisposing), resident area and digital access (enabling), and pill count, disease control, and perceived care quality (need-related). Conclusions Most elements of the chronic care model remained unmet. Patients’ care experiences and self-management priorities aligned with their telehealth preferences, underscoring the need for personalised telehealth strategies to enhance SMS in primary care. Given the cross-sectional design and absence of patient and public involvement, further studies should incorporate these stakeholders and confirm associations in more diverse and underserved populations.

Objectives: Our study aimed to identify the complex interplay between self-efficacy, self-care practice, and glycaemic control among people with type 2 diabetes mellitus (PWDs) to inform the design of more targeted and effective behavioural interventions in primary care. Methods: A cross-sectional descriptive study was performed with 294 PWDs managed in primary care. The Diabetes Management Self-Efficacy Scale (DMSES) and Summary of Diabetes Self-Care Activities (SDSCA) questionnaire measured patients’ self-efficacy and self-care practice. Multivariate logistic regression models were developed to explore how SDSCA, DMSES, and their combined effect relate to glycaemic control, adjusting for patient characteristics. Network analysis in R software examined relationships between self-efficacy and self-care dimensions across glycaemic control subgroups using a Gaussian graphical model with the extended Bayesian information criterion. Results: Half the PWDs (50.7%) had suboptimal glycaemic control. Better glycaemic control was consistently associated with higher self-efficacy (odds ratio (OR) = 0.76, 95% confidence (CI) (0.60, 0.97), p = 0.03), shorter duration of diabetes (OR = 1.89, 95% CI (1.08, 3.31), p = 0.03), normal waist circumference (OR = 1.76, 95% CI (1.02, 3.05), p = 0.04), absence of diabetes complications (OR = 2.09, 95% CI (1.10, 3.98), p = 0.02), and treatment with oral hypoglycaemic agents (OR = 3.05, 95% CI (1.53, 6.09), p < 0.01). Network analysis among people with well-controlled HbA1c revealed that diet adherence and self-efficacy had the most robust connection, with diet self-efficacy strongly associated with most self-efficacy dimensions. Self-efficacy in exercise, blood glucose monitoring, and foot care are the most central factors in the network structures for PWDs with suboptimal glycaemic control. Conclusions: Our study highlights the critical role of self-efficacy in diabetes primary care. For people with optimal glycaemic control, prioritising self-efficacy in diet adherence is crucial for sustaining glycaemic outcomes and supporting other self-care behaviours. Among those with suboptimal glycaemic control, enhancing self-efficacy in exercise, blood glucose monitoring, and foot care is essential. Targeted education programs, personalised counselling, and E-health tools can further empower patients to manage their diabetes more effectively.

Background: Vietnam is undergoing a rapid epidemiological transition with a considerable burden of non-communicable diseases (NCDs), especially hypertension and diabetes (T2DM). Continuity of care (COC) is widely acknowledged as a benchmark for an efficient health system. This study aimed to determine the COC level for hypertension and T2DM within and across care levels and to investigate its associations with health outcomes and disease control.Methods: A cross-sectional study was conducted on 602 people with T2DM and/or hypertension managed in primary care settings. We utilized both the Nijmegen continuity of care questionnaire (NCQ) and the Bice - Boxerman continuity of care index (COCI) to comprehensively measure three domains of COC: interpersonal, informational, and management continuity. ANOVA, paired-sample t-test, and bivariate and multivariable logistic regression analysis were performed to examine the predictors of COC.Results: Mean values of COC indices were: NCQ: 3.59 and COCI: 0.77. The proportion of people with low NCQ levels was 68.8%, and that with low COCI levels was 47.3%. Primary care offered higher informational continuity than specialists (p < 0.01); management continuity was higher within the primary care team than between primary and specialist care (p < 0.001). Gender, living areas, hospital admission and emergency department encounters, frequency of health visits, disease duration, blood pressure and blood glucose levels, and disease control were demonstrated to be statistically associated with higher levels of COC.Conclusions: Continuity of primary care is not sufficiently achieved for hypertension and diabetes mellitus in Vietnam. Strengthening robust primary care services, improving the collaboration between healthcare providers through multidisciplinary team-based care and integrated care approach, and promoting patient education programs and shared decision-making interventions are priorities to improve COC for chronic care.

Background: Medical students play important frontline roles in the prevention, early detection, and treatment of hepatitis C. This study investigated knowledge and attitudes toward hepatitis C among 5th- and 6th-year medical students and possible associated factors. Methods: A cross-sectional survey was conducted among 2000 students from eight medical universities using a self-administered structured questionnaire. Results: The mean knowledge and attitude scores for hepatitis C were 20.1 ± 4.0 (out of 26) and 10.6 ± 2.9 (out of 20), respectively. Approximately, three-quarters (74.4%) of the participants had a good knowledge score, but only a small proportion (3.1%) obtained a good attitude score. Although the participants had fairly high knowledge about the causes, consequences, and transmission routes of hepatitis C, there were important gaps in their knowledge about hepatitis C screening and treatment. In multivariate analysis, female students, 5th-year students, and students from the central provinces had significantly higher knowledge and attitude scores. There was a low positive correlation between knowledge and attitude scores. Conclusion: This study points out the need to update the medical training curriculum to improve the knowledge and attitude of students about hepatitis C infection.

Background: Building capacity in hepatitis B virus prevention and management for medical students and health professionals is one of the pillars of the national viral hepatitis control strategy. Methods: A cross-sectional study was conducted at eight medical universities from the northern, central and southern regions of the country between May and November 2020 using a systematic random sampling technique. Results: Among 2000 participants, 84.2% reported they had been tested for hepatitis B and 83.9% had received the hepatitis B vaccine. The mean knowledge, attitude, practice score was 40.2 out of 54 (74.4%) with only 19.9% of the study participants obtaining a good score. In multivariate analysis, fifth year students, students from central universities, students who had tested positive for hepatitis B and students who had received hepatitis B vaccine or had encountered patients with chronic hepatitis B had significantly higher knowledge score (p < 0.05). The study showed lack of trust in the hepatitis B vaccine safety and lack of confidence in providing counselling, testing and management of patients with chronic hepatitis B. Conclusion: Findings from our research emphasized an immediate need to improve the medical schools’ training curriculum in Vietnam to enable students’ readiness in hepatitis B prevention and management.

Introduction: Cardiovascular diseases (CVDs) take the lives of 17.9 million people every year, 31% of all global deaths. Most patients with CVDs can be diagnosed, treated and managed by health-care practitioners at the primary health care system. Strengthening CVDs patients management and continuity of care in Commune health centres (CHCs) play an important, sustainable and cost-effective solutions. Objectives: To describe the current situation of CVDs management at commune health centers in Thua Thien Hue province. Methods: A cross-sectional study was conducted in the total 152 CHCs in Thua Thien Hue province. Service availability and readiness assessment (SARA-WHO) instrument was used to assess CVDs management of CHCs. Results: CVDs diagnosis and/or treatment were available at 97.4% of CHCs surveyed. Most CHCs were fully builted in equipments for screening and early detection of CVDs (>99%). Most CHCs delivered prevention services regarding risk factors of CVDs. More than 85% of CHCs weren’t equipped with adequate medicines for CVDs management prescribed by the Ministry of Health. Calcium channel blockers (90,8%) and angiotensin converting enzyme inhibitor (77%) were offered at the CHCs. Conclusion: CVDs prevention and management services at grassroots level have been fully and widely deployed throughout the province. It’s strongly recommended to enhance the availability of medication for CVDs, especially in mountainous area. The service readiness indicator of CVDs management in Thua Thien Hue Province is 67.9 points. Key words: Cardiovascular diseases management, commune health center, primary care, SARA

Diabetes and its consequences have become serious public health problems in many countries. Enhancing continuity of care and diabetes management at primary care plays a crucial, sustainable and cost-effective role in health care. Objectives: To describe the current situation of diabetes management at commune health centers (CHCs) in Thua Thien Hue province. Methods: A cross-sectional study was conducted in the total 152 CHCs in Thua Thien Hue province. Service availability and readiness assessment (SARA-WHO) instrument was used to assess diabetes management of CHCs. Results: Diabetes diagnosis and/or treatment were available at 40.8% of CHCs surveyed. There was a low percentage of CHCs fully equipped for screening and early detection of diabetes (18.4%). Most of CHCs delivered prevention services regarding risk factors of diabetes. All CHCs weren’t equipped with adequate medication for diabetes management prescribed by the Ministry of Health. Metformin (33.6%) and gliclazide (28.3%) were offered at the CHCs. Conclusion: Diabetes prevention and management services at grassroots level have not been fully and widely deployed throughout the province. It’s strongly recommended to enhance the availability and readiness of diabetes management services and to invest the essential supplies and medication for diabetes screening, early detection and treatment at primary care, particularly for CHCs in the rural and mountainous areas. Key words: Diabetes management, commune health center, primary care, SARA