Adherence to nucleos(t)ide analogues for chronic hepatitis B in clinical practic

StephenW

J Viral Hepat. 2012 Mar;19(3):205-12. doi: 10.1111/j.1365-2893.2011.01494.x. Epub  2011 Jul 14.
Adherence to nucleos(t)ide analogues for chronic hepatitis B in clinical practice and correlation with virological breakthroughs.Chotiyaputta W, Hongthanakorn C, Oberhelman K, Fontana RJ, Licari T, Lok AS.
SourceDivision of Gastroenterology and Hepatology, Department of Internal Medicine, University of Michigan Health System, Ann Arbor, MI, USA.

AbstractSummary.  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.
© 2011 Blackwell Publishing Ltd.





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StephenW

J病毒Hepat。 2012 03 19（3）:205-12。 DOI：10.1111/j.1365-2893.2011.01494.x。 EPUB 2011七月14。
坚持核苷（酸）类似物治疗慢性乙型肝炎 临床实践和相关的病毒学突破。
丰塔纳的RJ chotiyaputta瓦，HongthanakornÇ，Oberhelman，利卡里ţ，乐的AS。
源

胃肠病学和肝病，内科，安阿伯，MI，美国密歇根大学健康系统大学部。

摘要

综述。坚持服药是重要的核苷​​（酸）类似物 治疗慢性乙型肝炎的成功，这项研究的目的是确定坚持NUCs遵守相关的因素发生关联与坚持病毒学突破患者与慢性乙型肝炎例慢性乙型肝炎患者接受NUCs会被要求完成的一项调查显示，每3个月。还坚持在诊所的医疗保健机构进行评估。遵守率被定义为患者参加了在过去30天里他们的B型肝炎病毒药物的天数的百分之。一共有111名患者进行了研究。平均年龄为47.7岁，73.9％为男性，57.7％是亚裔，42.3％和80％的研究生教育有私人保险。 63个病人（74.1％）100％坚持在调查中，78例（83.9％）100％遵守他们的医疗保健供应商。根据调查坚持100％的患者年龄较大（P值0.02），更可能是男性（p = 0.006），并有较高的家庭年收入比那些与<坚持100％（p = 0.04）。在80例患者完成了三项调查，发现病毒突破100％遵守所有三次调查，1/18（5.6％）<100％坚持的一项调查显示，3/16（1/46（2.2％） 18.8％）≥2调查坚持<100％（P = 0.06）。总之，坚持NUC与慢性乙型肝炎患者的治疗是高，但坚持医疗服务提供者的自我报告可能被夸大。更好地遵守NUC治疗慢性乙型肝炎患者有朝着病毒的突破率较低的趋势。

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