Adherence to Treatment with Oral Nucleoside/Nucleotide Analogs in Patients with Chronic Hepatitis B

Objectives: Adherence to antiviral treatment is important for treatment success and prevention of resistance. It was aimed to determine treatment adherence to nucleoside/nucleotide analogs and factors influencing on adherence.
Methods: The study included 168 patients who received oral nucleoside/nucleotide analog with diagnosis of chronic hepatitis for at least 1 year. Data regarding demographic characteristics and missed drug were collected using a survey, while list of medication within prior year were extracted from pharmacy registry and Medication Possession Rate (MPR) was calculated.
Results: There were 60 women (35.7%) and 108 men (64.3%) in the study. Mean age was calculated as 43.61±10.35 years. It was found that 29.2% of patients were non-adherent based on MPR (MPR<0.90). It was observed that adherence was improved on middle age. Treatment adherence was found to be higher in patients receiving medication due to disorders other than hepatitis B. It was found that there was no significant difference in adherence according to age, gender, occupation status, marital status, smoking or alcohol consumption habits, type of antiviral treatment, time and mode of drug intake, and biopsy finding at time of drug prescription. The most common cause was identified as forgetfulness for missed drug. Other common causes were inoccupation and alteration in daily routine.
Conclusion: In our study, the treatment adherence determined by MPR was 70.8%. This rate was lower than those reported for chronic hepatitis B in the literature. It is important to monitor and encourage treatment adherence in patients with chronic hepatitis B by clinicians.

Kronik hepatit b ile yaþayan hastalarda oral nükleozid /nükleotid analoglarý ile tedavi uyumu

Amaç: Antiviral tedaviye uyum tedavi baþarýsý ve direncin önlenmesi için önemlidir. Nükleoz(t)id analoglarý ile tedavi alan hastalarda tedaviye uyum oraný ve bunu etkileyen faktörlerin saptanmasý amaçlanmýþtýr.
Yöntem: En az bir yýldýr kronik hepatit B tanýsý ile oral nükleoz(t)id analogu(NA) alan 168 hasta çalýþmaya dahil edildi. Hastalarýn demografik verileri ile ilaç atlama durumlarý uygulanan geri bildirim anketinden elde edilirken, eczane kayýt sisteminden son 1 yýllýk ilaçlarýn dökümü yapýlarak Medication Possesion Ratio(MPR) hesaplandý.
Bulgular: Hastalarýn 60’ý (%35,7) kadýn, 108’i (% 64,3) erkek idi. Yaþ ortalamasý 43,61±10,35 olarak hesaplandý. MPR ye göre %29.2 hasta nonadherence- uyumsuz (MPR deðeri < 0,90) saptandý. Orta yaþlardan itibaren tedavi uyumunun arttýðý görüldü. Hepatit B dýþýndaki hastalýklar nedeni ile ilaç kullanýmý olan hastalarda tedavi uyumu daha yüksek bulundu. Cinsiyet, eðitim- çalýþma durumu, medeni hali, sigara- alkol gibi alýþkanlýklarý, kullanmakta olduðu antiviral tedavinin türü, ilaç alma zaman ve þekli, tedavi baþlangýcýndaki biopsi bulgularý arasýnda tedavi uyumu açýsýndan anlamlý fark saptanmadý. Hastalarýn en sýk ilaç atlama nedenleri unutkanlýk olarak saptandý. Sýk görülen diðer nedenler baþka iþlerle meþgul olma, günlük rutinde deðiþiklik olmasýydý.
Sonuç: Çalýþmamýzda MPR ile hesaplanan tedavi uyumu %70.8 olarak saptanmýþtýr. Bu uyum düzeyi literatürdeki KHB ile yapýlan çalýþmalara göre daha düþük düzeydedir. KHB hastalarýnda uyumun hekim tarafýndan takip edilmesi ve desteklenmesi önemlidir. (SETB-2021-09-282)