Journal of Viral Hepatitis
Early View (Online Version of Record published before inclusion in an
issue)
Summary. Medication adherence is important for the success of
nucleos(t)ide analogue (NUC) treatment for chronic hepatitis B. The aims of
this study were to determine adherence to NUCs and factors associated with
NUC adherence and to correlate NUC adherence with the occurrence of
virological breakthroughs in patients with chronic hepatitis B. Consecutive
patients with chronic hepatitis B receiving NUC were asked to complete a
survey every 3 months. Adherence was also assessed by healthcare providers
in the clinic. Adherence rate was defined as the per cent of days the
patients took their hepatitis B virus medications during the last 30 days.
A total of 111 patients were studied. The mean age was 47.7 years, 73.9%
were men, 57.7% were Asian, 42.3% had postgraduate education and 80% had
private insurance. Sixty-nine (74.1%) patients reported 100% adherence in
the survey, while 78 (83.9%) reported 100% adherence to their healthcare
providers. Patients with 100% adherence based on the survey were older (P =
0.02), more likely to be men (P = 0.006), and had higher annual household
income (P = 0.04) than those with <100% adherence. In the 80 patients who
completed three surveys, viral breakthrough was observed in 1/46 (2.2%)
with 100% adherence on all three surveys, 1/18 (5.6%) with <100% adherence
on one survey and 3/16 (18.8%) with <100% adherence on ≥2 surveys, (P =
0.06). In conclusion, adherence to NUC therapy in our patients with chronic
hepatitis B was high but self-reporting of adherence to healthcare
providers may be inflated. Patients with chronic hepatitis B with better
adherence to NUC therapy had a trend towards a lower rate of viral
breakthroughs.作者: StephenW 时间: 2011-7-20 21:00