与不依从HBV抗病毒治疗有关的因素

StephenW

Antivir Ther. 2017 Jan 22. doi: 10.3851/IMP3219. [Epub ahead of print]
Factors associated with non-adherence to HBV antiviral therapy.Sheppard-Law S1,2,3, Zablotska-Manos I3, Kermeen M4, Holdaway S5, Lee A4, George J5,6, Zekry A7,8, Maher L3.
Author information
1University of Technology Sydney, Faculty of Health, Broadway, NSW, Australia.2Sydney Children's Hospital Randwick, Nursing Research Unit, Randwick, NSW, Australia.3The Kirby Institute, UNSW Australia, UNSW Australia Kensington, Sydney, NSW, Australia.4Concord Repatriation General Hospital, Gastroenterology and Liver Services.5Westmead Hospital, Westmead, NSW, Australia.6University of Sydney - Westmead Institute for Medical Research, Westmead, NSW, Australia.7St George Hospital, Kogarah, NSW, Australia.8UNSW Australia - St George Hospital Clinical Group School of Medicine, Kogarah, NSW, Australia.

AbstractBACKGROUND: Hepatitis B virus (HBV) anti-viral therapy has the potential to reduce the burden of HBV-related liver disease by suppressing HBV deoxyribonucleic acid (DNA) replication to undetectable levels, reducing the progression of liver fibrosis and reducing the risk of hepatocellular carcinoma (HCC) development. Treatment outcomes and long-term benefits require adherence to medication regimens. This study aimed to identify the prevalence and factors associated with non-adherence to anti-viral therapy.
METHODS: A cross-sectional survey of patients receiving HBV anti-viral therapies was conducted in three Sydney hospitals. Participants were asked to complete an online questionnaire. Logistic regression was used to assess the associations between non-adherence (defined as missing more than one day of medication in the last 30 days) and demographic, socio-economic, disease, treatment, health-care-system and individual-related factors.
RESULTS: Of the 277 participants, 66 (23.8%) were non-adherent, missing a mean 1.7 days of medication (SD 4.8) in the last 30 days. In multivariate analysis, non-adherent behaviour declined with age (OR 0.9 95% CI 0.97-0.99, p<0.013). Participants who reported having no established routine to take their medication (OR 5.0, 95%CI 1.4-17.4, p<0.012) and having inadequate health literacy (OR 2.7, 95%CI 1.3-5.5, p<0.007) were more likely to be non-adherent.
CONCLUSIONS: Almost a quarter of participants in the current study were non-adherent. Adherence is potentially modifiable through person-centred education, collaborative models of patient care and interventions designed to improve health literacy and establish medication routines. Findings have the potential to improve health service delivery to patients at risk of non-adherence to HBV anti-viral therapy.


PMID:29355830DOI:10.3851/IMP3219

StephenW

Antivir Ther。 2017年1月22日doi：10.3851 / IMP3219。 [电子版提前打印]
与不依从HBV抗病毒治疗有关的因素。
Sheppard-Law S1,2,3，Zablotska-Manos I3，Kermeen M4，Holdaway S5，Lee A4，George J5,6，Zekry A7,8，Maher L3。
作者信息

1
    悉尼科技大学澳大利亚新南威尔士州百老汇卫生学院。
2
    悉尼儿童医院兰德威克，护理研究单位，澳大利亚新南威尔士州兰德威克。
3
    柯比研究所，澳大利亚新南威尔士大学，澳大利亚新南威尔士大学，澳大利亚悉尼新南威尔士肯辛顿大学。
4
    康科德综合医院，消化内科和肝脏服务。
五
    Westmead医院，Westmead，NSW，澳大利亚。
6
    悉尼大学 - Westmead医学研究所，澳大利亚新南威尔士州Westmead。
7
    澳大利亚新南威尔士州Kogarah圣乔治医院。
8
    澳大利亚新南威尔士州圣乔治医院临床小组医学院，澳大利亚新南威尔士州Kogarah。

抽象
背景：

乙型肝炎病毒（HBV）抗病毒治疗有可能通过将HBV脱氧核糖核酸（DNA）复制抑制到无法检测的水平来减少HBV相关肝病的负担，减少肝纤维化的发展并降低肝细胞癌的风险HCC）的发展。治疗结果和长期利益需要坚持药物治疗方案。这项研究旨在确定与不遵守抗病毒治疗相关的流行率和因素。
方法：

在三所悉尼医院进行了一项对接受HBV抗病毒治疗的患者的横断面调查。参与者被要求完成在线调查问卷。 Logistic回归分析用于评估非依从性（定义为在过去30天内药物丢失超过一天的药物）与人口统计学，社会经济学，疾病，治疗，保健系统和个人相关因素之间的关系。
结果：

在277名受试者中，66名（23.8％）不依从，在过去30天内缺少平均1.7天的药物（SD 4.8）。在多变量分析中，非贴壁行为随着年龄增长而下降（OR = 0.995％CI 0.97-0.99，p <0.013）。报告没有确定常规服药的参与者（OR5.0,95％CI1.4-17.4，p <0.012）和健康素养不足（OR2.7,95％CI1.3-5.5，p <0.007）更可能不贴心。
结论：

目前的研究中，近四分之一的参与者是非依从的。依从性可以通过以人为本的教育，患者护理和干预措施的协作模式进行修改，以提高健康素养和建立药物治疗程序。调查结果有可能改善对不依从HBV抗病毒治疗风险的患者的卫生服务。

结论：
    29355830
DOI：
    10.3851 / IMP3219