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12-10-2016 | HBV | News | Article

Factors linked to poor anti-HBV therapy adherence pinpointed

medwireNews: Young age and variable consistency of clinical care are key parameters associated with poor adherence in individuals receiving antiviral treatment for chronic hepatitis B virus (HBV) infection, finds an Australian research team.

By contrast, other factors, such as language discordance and distance to hospital, did not adversely affect adherence in this review of pharmacy records of patients treated at four Melbourne hospitals.

Of 1026 chronic HBV patients included in this analysis, nearly three-quarters of whom were of Asian ethnicity, 20% had poor adherence to antiviral therapy, as defined by a medication possession ratio lower than 0.90.

Multivariate analysis showed that age and consistency of care were significant factors affecting adherence. Specifically, patients younger than 35 years were significantly more likely to be poorly adherent compared with their counterparts aged at least 35 years (p=0.012).

This was also the case for individuals treated by the same doctor for less than 3 months relative to those with the same doctor for 3–6, 6–12 and more than 12 months, with poor adherence rates of 52.59% versus 21.54%, 12.54% and 11.48%, respectively (p<0.001).

Researcher Nicole Allard (Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria) and colleagues highlight the importance of recognising “the challenges faced by a younger person regularly taking medication at a time in their lives when they feel well”.

And they continue: “Reinforcement of adherence at each consultation, providing more flexible and convenient care arrangements, reminder systems and working with the individual to maximize medication adherence should be a routine part of clinical practice.”

The researchers also emphasize that “[c]onsistency of clinician should be considered in outpatient settings to reduce nonadherence.”

“Mutual trust and communication has been reported in other studies across different chronic diseases including HIV treatment as a factor promoting more consistent medication taking and better chronic disease management”, they write in the Journal of Viral Hepatitis.

Allard et al conclude: “Interventions piloted in other chronic diseases including involvement of pharmacists, family members and nurses, health messaging on mobile phones and other technology-based interventions to improve adherence could be incorporated in the management of [chronic HBV] but will need to be evaluated in this population for both acceptability and efficacy.”

By Shreeya Nanda

medwireNews is an independent medical news service provided by Springer Healthcare Limited. © Springer Healthcare Ltd; 2016

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