Τίτλος:
Persistence and adherence to nucleos(t)ide analogues in chronic hepatitis B: A multicenter cohort study
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
Background Adherence and persistence to long-term therapy with nucleos(t)ides analogues are crucial to the outcome of treatment in chronic hepatitis B. Our aim was to determine the persistence and adherence rates to nucleos(t)ides analogues in chronic hepatitis B patients under maintenance therapy and to identify relative to prediction of adherence factors. Methods We retrospectively analyzed electronic prescription data of patients (2011-2016; n = 400) with chronic hepatitis B treated with nucleos(t)ides analogues at 4 tertiary liver centers in Greece. Results Two hundred ninety-six of 400 patients were under or initiated treatment in 2011-2012 (existing patients), while the remainder initiated or switched medication from January 2013 and onward (new patients). The median adherence rate was 99%, with 89.7% achieving adherence >80% during a mean follow-up of 28 ± 14 months. The overall 12-month persistence rate was 57%, with no difference between patients receiving tenofovir, entecavir or double therapy (57.8%, 52.8% and 68.4%, respectively, P = 0.399). The decline in persistence was more pronounced during the first 3 months of follow-up and in existing patients (P = 0.057). Overall, 80% and 55.1% of nonpersistent patients succeeded adherence to nucleos(t)ides analogues >80% and >90%, respectively. Multivariate analyses showed that existing (vs. new) patients were less likely to have >80% adherence (odds ratio: 0.324, P = 0.44) and persistence (odds ratio: 0.562, P = 0.057) to nucleos(t)ides analogues therapy. Conclusion In this real-world cohort of chronic hepatitis B patients, high adherence to nucleos(t)ides analogues was coupled with suboptimal persistence with prescribing the medication. Our data indicate that persistence and adherence are distinct measures that should be approached separately in educational programs targeting to improve medication-taking behavior in chronic hepatitis B. © 2020 Lippincott Williams and Wilkins. All rights reserved.
Συγγραφείς:
Manolakopoulos, S.
Striki, A.
Papastergiou, V.
Perlepe, N.
Zisimopoulos, K.
Papazoglou, A.
Deutsch, M.
Papadopoulos, N.
Triantos, C.
Goulis, J.
Papatheodoridis, G.
Περιοδικό:
European Journal of Gastroenterology and Hepatology
Εκδότης:
Lippincott Williams and Wilkins
Λέξεις-κλειδιά:
antidepressant agent; entecavir; nucleoside derivative; nucleotide derivative; prescription drug; sedative agent; tenofovir; antivirus agent; nucleoside, adult; antiviral therapy; Article; chronic hepatitis B; cohort analysis; combination drug therapy; comparative study; drug substitution; drug withdrawal; electronic prescribing; female; follow up; Greece; help seeking behavior; human; maintenance therapy; major clinical study; male; medication compliance; middle aged; monotherapy; negligence; patient attitude; patient compliance; prediction; priority journal; retrospective study; survival analysis; tertiary care center; treatment switching; aged; chronic hepatitis B; clinical trial; medication compliance; multicenter study; treatment outcome; virology, Adult; Aged; Antiviral Agents; Female; Greece; Hepatitis B, Chronic; Humans; Male; Medication Adherence; Middle Aged; Nucleosides; Retrospective Studies; Treatment Outcome
DOI:
10.1097/MEG.0000000000001558
