Evaluation of adherence to oral antiviral hepatitis B treatment using structured questionnaires
Evaluation of adherence to oral antiviral hepatitis B treatment using structured questionnaires
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DOI：
10.4254/wjh.v4.i2.43
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发表时间：
2012-02-27
影响因子：
2.4
通讯作者：
Lee, Alice Unah
中科院分区：
文献类型：
--
作者：
Giang, Leesa;Selinger, Christian P.;Lee, Alice Unah
目的：评估慢性乙型肝炎患者对核糖核酸类似物(Nucs)治疗的依从率，并确定与Nucs依从性相关的因素。方法：问卷研究在协和遣返综合医院的肝脏诊所进行，所有正在服用一种或多种Nucs的患者被要求完成一份结构化的自填式32项问卷。使用视觉模拟标尺测量粘附性。患者的治疗临床医生还被要求通过结构化问卷评估患者的依从性。结果：共有80名患者完成了问卷调查。66%的患者(n=49)报告了最好的依从性，而25(33.8%)的患者将他们对Nucs的依从性评定为次佳。据报道，34名患者(43%)在过去的某个时候遗漏了服用核素。最近不遵守规定的情况并不常见。在报告不服药的患者中，最常见的原因是“健忘”(n=27，56.25%)。其他常见原因包括：用药不足(n=5，10.42%)、工作太忙(n=4，8.33%)和改变日常生活(n=5，10.42%)。报告对其他处方药依从性低的患者也更有可能错过Nucs的服用(P=0.04)。在语言不一致的临床医生的护理下，患者也更有可能报告对Nucs的依从性不佳(P=0.04)。结论：依从率远低于医生的预期，并对长期结果有潜在的不利影响。传播和教育似乎是核心，需要实施战略，以改善持续的遵守情况。(C)2012年白石登。版权所有。
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. (C) 2012 Baishideng. All rights reserved.