From AI-Enabled Glaucoma Care to Follow-Up Adherence: The Sequential Mediating Roles of Patient Trust and Patient Engagement at Bharatpur Eye Hospital, Nepal

2026-10-28T18:00:43+00:00

The study explores the socio-technical process involved in connecting AI-enabled glaucoma care experience to the follow-up adherence in a developing country setting, focusing on patient trust and patient engagement as mediating variables in a sequence of mediations. This quantitative cross-sectional study drew data from N = 423 glaucoma patients at Bharatpur Eye Hospital in Nepal based on the Technology Acceptance Model, Information-Motivation-Behavioral Skills model and Social Cognitive Theory. Partial Least Squares Structural Equation Modeling (PLS-SEM) and Importance-Performance Map Analysis (IPMA) was used for testing the hypotheses of direct effect, simple mediation and serial mediation. Results: The results indicate significant direct positive effects of AI-enabled glaucoma care experience on follow-up adherence, patient engagement and patient trust. More importantly, both patient trust and patient engagement play vital roles as mediators. In addition, the serial mediation path, which connects digital experience to behavior in the form of AI care experience to patient trust to patient engagement to follow-up adherence, is also statistically significant, indicating a robust psychological pathway from digital experience to behavioral compliance. This paper fills an important empirical lacuna in ophthalmology literature through developing an innovative socio-technical framework of multiple phases, which will show how artificial intelligence can be used in LMICs to build trust and engage patients to reduce avoidable blindness from glaucoma.

THE DETERMINANTS OF DELAY IN DOOR-TO-NEEDLE TIME FOR TISSUE PLASMINOGEN ACTIVATOR IN PATIENTS ATTENDING CARDIAC EMERGENCY

2026-10-28T12:56:54+00:00

OBJECTIVE:

To identify and analyse the factors contributing to delays in door-to-needle time for administering tissue plasminogen activator (tPA) in patients presenting with cardiac emergencies.

METHODS:

A cross-sectional study was done on 178 participants (selected via non-probability purposive sampling technique) who presented to the ED of Civil Hospital Mirpurkhas within 6 months of duration. All patients aged 18 years or above, with a confirmed diagnosis of cardiac emergency and who received intravenous tPA as part of emergency treatment, were included in the study. Data were collected via a self-structured questionnaire and analysed in SPSS version 28.

RESULTS:

Most of the participants (80.34%) recognised their symptoms as cardiac in nature, and the time from symptom onset to hospital arrival was more than 3 to 6 hours in 74.16% by private transport (60.68%). The time from arrival to ECG and the time taken to make a diagnosis after ECG were less than 10 minutes, reported as 68.54% and 65.73%, respectively. The reported time from ECG to tPA administration was less than 30 minutes, and availability of tPA at time of need was immediately available in 94.94% of cases. The recorded total door-to-needle time was delayed, i.e., more than 30 minutes, in 88.76% of participants.

CONCLUSION:

The study concluded that delayed DTNT was more frequent regardless of prompt ECG evaluation, diagnosis and immediate availability of tPA. Prehospital delay was more commonly found. Prompt intervention could potentially be improved by bolstering ED procedures and encouraging early healthcare-seeking behaviour.

KEYWORDS:

Door to Needle Time, Tissue Plasminogen Activator, Cardiac Emergency, Thrombolytic Therapy

Asia Pacific Journal of Health Management

From AI-Enabled Glaucoma Care to Follow-Up Adherence: The Sequential Mediating Roles of Patient Trust and Patient Engagement at Bharatpur Eye Hospital, Nepal

THE DETERMINANTS OF DELAY IN DOOR-TO-NEEDLE TIME FOR TISSUE PLASMINOGEN ACTIVATOR IN PATIENTS ATTENDING CARDIAC EMERGENCY