Background: Poor medication adherence results in negative health outcomes and increased healthcare costs. Several healthcare professionals provide interventions to improve medication adherence, with the effectiveness of nurse-led interventions in people with chronic diseases remaining unclear. Objective: This study sought to evaluate the effectiveness of nurse-led interventions for improving medication adherence in adults with chronic conditions. Methods: Five databases (MEDLINE, CINAHL, EMBASE, Cochrane Library, SCOPUS) were searched without applying a temporal limit. Studies evaluating the effects of nurse-led interventions on medication adherence in adults with one or multiple chronic conditions were included. Interventions only targeting a single acute disease were excluded. Results: A total of twenty-two studies with 5975 participants were included. Statistically significant improvements in adherence were reported in five out of seven studies involving face-to-face visits to patients with heart failure (n = 2), chronic myeloid leukemia (n = 1), hypertension (n = 1) and multimorbidity (n = 1) and in four out of nine studies adopting a mixed method involving face-to-face visits and telephone follow-up for patients with heart failure (n = 1), hypertension (n = 1), coronary disease (n = 1) and multimorbidity (n = 1). Remote interventions were effective in improving medication adherence in one out of six studies. No statistically significant differences were found between tablet computer-based patient education and nurse-led educational sessions. The motivational approach was found to be one of the most common strategies used to promote patient medication adherence. Conclusions: Nurse-led face-to-face visits may be effective in improving medication adherence in people with chronic diseases. However, further research is needed because current methods for measuring medication adherence may not accurately capture patient behaviour and medication consumption patterns.

To assess whether the use of the revised Cochrane risk of bias tool for randomized trials (RoB2) in systematic reviews (SRs) adheres to RoB2 guidance. We searched MEDLINE, Embase, Cochrane Library from 2019 to May 2021 to identify SRs using RoB2. We analyzed methods and results sections to see whether risk of bias was assessed at outcome measure level and applied to primary outcomes of the SR as per RoB2 guidance. The relation between SR characteristics and adequacy of RoB2 use was examined by logistic regression analysis. Two hundred-eight SRs were included. We could assess adherence in 137 SRs as 12 declared using RoB2 but actually used RoB1 and 59 did not report the number of primary outcomes. The tool usage was adherent in 69.3% SRs. Considering SRs with multiple primary outcomes, adherence dropped to 28.8%. We found a positive association between RoB2 guidance adherence and the methodological quality of the reviews assessed by AMSTAR2 (p-for-trend 0.007). Multivariable regression analysis suggested journal impact factor [first quartile vs. other quartiles] was associated with RoB2 adherence (OR 0.34; 95% CI: 0.16-0.72). Many SRs did not adhere to RoB2 guidance as they applied the tool at the study level rather than at the outcome measure level. Lack of adherence was more likely among low and very low quality reviews.

Background: Myeloproliferative neoplasms (MPNs) are chronic haematological disorders with a significant symptom burden and implications for quality of life. Traditional physician-led outpatient models often lack sufficient time for in-depth symptom monitoring and patient engagement. This quality improvement project aimed to implement (1) a structured nurse-led visit within a haematology outpatient clinic in northern Italy, (2) routine symptom monitoring and (3) evaluation of patient-related experience. Methods: The nurse-led visit was integrated into routine 1-day hospital activities and focused on a structured comprehensive symptom assessment, health education and self-management support. Patient-reported outcomes to assess physical, psychological, nutritional and functional aspects and patient satisfaction as patient-reported experience measures were collected using validated tools and recorded on a patient symptom diary with patients’ self-care recommendations. The Plan–Do–Study–Act cycle and the person-centred care framework guided the intervention design and iterative improvement. Results: Over the first 6 months, 102 patients underwent nurse-led visits with a high adherence rate and follow-up compliance. Patients reported high satisfaction with the nurse-led visit, with a mean score of 9.6±0.75 points on a 0–10 points visual scale. The intervention optimised waiting times, promoted patient activation and strengthened nurse-physician collaboration. No adverse events occurred. Conclusions: The implementation of nurse-led visits was feasible, sustainable and highly accepted by patients. This approach aims to enhance symptom management, patient engagement and care coordination for individuals with MPNs and may prove to be a promising model for broader implementation in chronic disease management.

Aim: To investigate the symptom burden associated with MPNs and its impact on patients' psychophysical well‐being and quality of life through a structured PROM‐based nurse‐led visit. Design: Observational study. Methods: We included MPN patients followed at the haematology outpatient clinic of a large university‐affiliated hospital in Italy. Data were collected from September 2024 to March 2025 on 102 patients who underwent a structured PROM‐based nurse‐led visit supported by a dedicated symptom diary. Results: Symptom burden was substantial (85% were symptomatic) across all disease subtypes, with fatigue emerging as the most prominent symptom, affecting 72% of patients and accompanied by marked psychological distress (42% and 44% with anxious and depressive symptoms, respectively). Overall health‐related quality of life was predominantly moderate (mean score: 70.7 ± 21.3). Nearly all moderate‐to‐severe symptoms, including fatigue, inactivity, pain, itching, and abdominal discomfort, were strongly associated with impaired global health. 43% of patients need support in becoming more proactive in managing their disease, and satisfaction with the visit was very high (mean score 9.3 ± 1.3/10). Conclusion: The impact of MPNs was significant and multifaceted, affecting patients' physical, emotional, and social well‐being. Structured PROM‐based nurse‐led visits play a key role in detecting patients' needs and supporting symptom management across all domains of well‐being, fostering motivated engagement. Implications for the Profession and Patient Care: Integrating structured PROM‐based nurse‐led visits into routine haematology care may improve symptom monitoring, support patient engagement, and guide timely and tailored supportive interventions. Impact: Patients with MPNs experience a substantial physical and psychosocial symptom burden. Symptom clusters are associated with anxiety, depression, and reduced quality of life. Structured PROM‐based nurse‐led visits may facilitate the early identification of unmet supportive care needs. Reporting Method: Guidelines for reporting observational studies (STROBE): Patient Contribution: Patients actively participated during the nurse‐led visit and in data collection.

This study aims to investigate the lived experiences of patients with MPNs, including daily challenges, disease-related burden, and suggestions for improving care. Sixteen patients with essential thrombocythemia, polycythemia vera, or myelofibrosis participated in three focus groups in an Italian hematology outpatient clinic of an academic hospital. Data were analyzed using interpretative phenomenological analysis (IPA), and findings were mapped against the person-centered care (PCC) framework to identify implications for care delivery and improvement. Three superordinate themes emerged: (1) A silent start, a lasting impact, describing the shock of incidental diagnosis and the pervasive physical and psychological burden; (2) Adjusting to the disease, reflecting identity changes, emotional distress, and coping strategies; and (3) Need for a multilayered approach, encompassing family and community support, clinical information needs, and a patient-centered healthcare system. Patients highlighted the need for improved communication, tailored education, and supportive services, with the possibility of a remote contact. MPNs profoundly affect patients' physical, psychological, and social well-being. Structured symptom monitoring, tailored education, and flexible healthcare delivery could address patient's disease-related burden, enhance self-management, and empower patients. Nurses are well positioned to provide structured symptom assessment, proactive education, and ongoing psycho physical support. Implementing nurse-led services, either in person or through remote systems, can enhance continuity of care, improve patients' understanding of their disease, and promote self-management skills.