Brief Article
Copyright ©2012 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Hepatol. Feb 27, 2012; 4(2): 43-49
Published online Feb 27, 2012. doi: 10.4254/wjh.v4.i2.43
Evaluation of adherence to oral antiviral hepatitis B treatment using structured questionnaires
Leesa Giang, Christian P Selinger, Alice Unah Lee
Leesa Giang, Christian P Selinger, Alice Unah Lee, Department of Gastroenterology and Liver Services, Hospital Road, Concord NSW 2139, Australia
Author contributions: Giang L and Lee AU designed the study; Giang L collected the data; all authors analysed and interpreted the data; Giang L wrote the draft manuscript; Selinger CP and Lee AU critically reviewed the manuscript; all authors approved the final version.
Correspondence to: Alice Unah Lee, Professor, Department of Gastroenterology and Liver Services, Hospital Road, Concord NSW 2139, Australia.
Telephone: +61-2-96766111 Fax: +61-2-97676767
Received: September 23, 2011
Revised: December 29, 2011
Accepted: February 24, 2012
Published online: February 27, 2012

AIM: To assess adherence rates to nucleos(t)ide analogues (NUCs) therapy in patients with chronic hepatitis B virus infection and determine factors associated with adherence.

METHODS: The questionnaire study was conducted in the liver clinics at Concord Repatriation General Hospital. All patients who were currently taking one or more NUCs were asked to complete a structured, self-administered 32-item questionnaire. Adherence was measured using visual analogue scales. The patient’s treating clinician was also asked to assess their patient’s adherence via a structured questionnaire.

RESULTS: A total of 80 patients completed the questionnaire. Sixty six percent of the patients (n = 49) reported optimal adherence whilst 25 (33.8%) graded their adherence to NUCs as suboptimal. Thirty four (43%) patients reported to have omitted taking their NUCs sometime in the past. Recent non-adherence was uncommon. Amongst the patients who reported skipping medications, the most common reason cited was ”forgetfulness“ (n = 27, 56.25%). Other common reasons included: ran out of medications (n = 5, 10.42%), being too busy (n = 4, 8.33%) and due to a change in daily routine (n = 5, 10.42%). Patients who reported low adherence to other prescription pills were also more likely to miss taking NUCs (P = 0.04). Patients who were under the care of a language-discordant clinician were also more likely to report suboptimal adherence to NUCs (P = 0.04).

CONCLUSION: Adherence rates were much less than that expected by the physician and has potential adverse affect on long term outcome. Communication and education appear central and strategies need to be implemented to improve ongoing adherence.

Keywords: Patient compliance, Patient adherence, Antiviral agents, Hepatitis B, Chronic