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Persistence and adherence to nucleos(t)ide analogues in chronic hepatitis B: a multicenter cohort study. | LitMetric

AI Article Synopsis

  • This study examined adherence and persistence rates of chronic hepatitis B patients taking nucleos(t)ides analogues, analyzing prescription data from 400 patients across four liver centers in Greece from 2011 to 2016.
  • Results showed a high median adherence rate of 99%, with over 89% of patients maintaining over 80% adherence, but only 57% persisted with the treatment over 12 months, especially during the first 3 months.
  • The findings suggest that while many patients follow their medication regime, there's a significant difference between adherence and persistence, indicating a need for targeted educational programs to improve long-term medication adherence.

Article Abstract

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.

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Source
http://dx.doi.org/10.1097/MEG.0000000000001558DOI Listing

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