Analysis of Factors Influencing Compliance of Antiviral Therapy in Patients with Chronic Hepatitis B in Sichuan Province_West China Medical Journal

Authors：

YANG Mei ¹ , YANG Yanjia ¹ , WANG Zhenling ² , LI Yaxin ¹ , TANG Yudong ³ ,  LIU Kai ^1,2 , TANG Hong ^1,2

1.Center of Infectious Diseases, West China Hospital; 2. State Key Laboratory of Biotherapy; 3. West China School of Pharmacy; Sichuan University, Chengdu, Sichuan 610041, P. R. China;

Corresponding author：

LIU Kai, Email: yangmei69@126.com

Keywords：

慢性乙型肝炎; 抗病毒治疗; 依从性

DOI：

10.7507/1002-0179.20130491

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目的　通过分析影响四川地区慢性乙型肝炎患者抗病毒治疗依从性的因素，探讨提高患者治疗依从性的策略。方法　选择2011年4月－2012年4月在四川大学华西医院接受核苷（酸）类似物抗病毒治疗的324例慢性乙型肝炎患者作为研究对象。采用问卷调查的方法，对患者一般情况、心理状态、文化程度、经济情况、疾病认知情况、抗病毒疗效、服药持续性等相关因素进行分析，评估这些因素对患者治疗依从性的影响。结果　324例患者中能够完全遵照医嘱者78例（24.07%），不能完全依从者246例（75.93%）。心理状态良好者132例（40.74%），其中依从性良好者54例；心理负担较重者192例（59.26%），其中依从性良好者24例。初中及以上学历204例（62.96%），依从性良好者72例；初中以下学历者120例（37.04%），依从性良好者仅6例。不同心理状态、文化程度的患者依从率差异有统计学意义。患者经济状况、年龄差异对于依从性也有一定影响。结论　慢性乙型肝炎患者对抗病毒治疗的依从性与心理状态、文化程度者及经济状况密切相关。改善患者医疗费用偿付能力，对患者进行疾病认知教育以及减少社会歧视等措施有助于提高患者治疗依从性。

Citation： YANG Mei,YANG Yanjia,WANG Zhenling,LI Yaxin,TANG Yudong,LIU Kai,TANG Hong,.. Analysis of Factors Influencing Compliance of Antiviral Therapy in Patients with Chronic Hepatitis B in Sichuan Province. West China Medical Journal, 2013, 28(10): 1555-1558. doi: 10.7507/1002-0179.20130491 Copy

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2.	Keeffe EB, Dieterich DT, Han SH, et al. A treatment algorithm for the management of chronic hepatitis B virus infection in the United States: 2008 update[J]. Clin Gastroenterol Hepatol, 2008, 6(12): 1315-1341.
3.	洪婉媚, 李剑妮, 彭秋燕. 护理干预对慢性乙型病毒性肝炎患者抗病毒治疗依从性的影响[J]. 齐鲁护理杂志, 2011, 17(31): 2011.
4.	Chotiyaputta W, Hongthanakorn C, Oberhelman K, et al. Adherence to nucleos(t)ide analogues for chronic hepatitis B in clinical practice and correlation with virological breakthroughs[J]. J Viral Hepat, 2012, 19(3): 205-212.
5.	McHutchison JG, Manns M, Patel K, et al. Adherence to combination therapy enhances sustained response in genotype-1-infected patients with chronic hepatitis C[J]. Gastroenterology, 2002, 123(4): 1061-1069.
6.	Pol S, Sogni P. Treatment of chronic hepatitis B: adherence and safety[J]. Gastroenterol Clin Biol, 2010, 34(Suppl 2): S142-S148.
7.	Lee M, Keeffe EB. Study of adherence comes to the treatment of chronic hepatitis B[J]. J Hepatol, 2011, 54(1): 6-8.
8.	Hilleret MN, Larrat S, Stanke-Labesque F, et al. Does adherence to hepatitis B antiviral treatment correlate with virological response and risk of breakthrough?[J]. J Hepatol, 2011, 55(6): 1468-1469.
9.	Martín-Mateos RM, Moreira-Vicente VF, Cuesta-López I, et al. Treatment adherence and persistence in patients with chronic hepatitis B virus infection[J]. Gastroenterol Hepatol, 2012, 35(4): 293-294.
10.	Ha NB, Ha NB, Garcia RT, et al. Medication nonadherence with long-term management of patients with hepatitis B e antigen-negative chronic hepatitis B[J]. Dig Dis Sci, 2011, 56(8): 2423-2431.
11.	张耀, 周吉军, 王宇明. 心理干预对国内慢性乙型肝炎患者焦虑抑郁情绪影响的荟萃分析[J]. 世界华人消化杂志, 2008, 16(1): 101-104.
12.	Lutgehetmann M, Meyer F, Volz T, et al. Knowledge about HBV, prevention behaviour and treatment adherence of patients with chronic hepatitis B in a large referral centre in Germany[J]. Z Gastroenterol, 2010, 48(9): 1126-1132.
13.	Chotiyaputta W, Peterson C, Ditah FA, et al. Persistence and adherence to nucleos(t)ide analogue treatment for chronic hepatitis B[J]. J Hepatol, 2011, 54(1): 12-18.
14.	黄丽芬, 陈禄彪, 张丽华. HBeAg阴性肝硬化患者抗病毒治疗的护理要点[J]. 中华实验和临床病毒学杂志, 2010, 24(3): 209-211.
15.	Yang JH. Development and evaluation of a program to promote self management in patients with chronic hepatitis B[J]. J Korean Acad Nurs, 2012, 42(2): 258-268.

1. 　中华医学会肝病学分会、感染病学分会. 慢性乙型肝炎防治指南(2010年版)[J]. 中华肝脏病杂志, 2011, 19(1): 13-24.
2. 　Keeffe EB, Dieterich DT, Han SH, et al. A treatment algorithm for the management of chronic hepatitis B virus infection in the United States: 2008 update[J]. Clin Gastroenterol Hepatol, 2008, 6(12): 1315-1341.
3. 　洪婉媚, 李剑妮, 彭秋燕. 护理干预对慢性乙型病毒性肝炎患者抗病毒治疗依从性的影响[J]. 齐鲁护理杂志, 2011, 17(31): 2011.
4. 　Chotiyaputta W, Hongthanakorn C, Oberhelman K, et al. Adherence to nucleos(t)ide analogues for chronic hepatitis B in clinical practice and correlation with virological breakthroughs[J]. J Viral Hepat, 2012, 19(3): 205-212.
5. 　McHutchison JG, Manns M, Patel K, et al. Adherence to combination therapy enhances sustained response in genotype-1-infected patients with chronic hepatitis C[J]. Gastroenterology, 2002, 123(4): 1061-1069.
6. 　Pol S, Sogni P. Treatment of chronic hepatitis B: adherence and safety[J]. Gastroenterol Clin Biol, 2010, 34(Suppl 2): S142-S148.
7. 　Lee M, Keeffe EB. Study of adherence comes to the treatment of chronic hepatitis B[J]. J Hepatol, 2011, 54(1): 6-8.
8. 　Hilleret MN, Larrat S, Stanke-Labesque F, et al. Does adherence to hepatitis B antiviral treatment correlate with virological response and risk of breakthrough?[J]. J Hepatol, 2011, 55(6): 1468-1469.
9. 　Martín-Mateos RM, Moreira-Vicente VF, Cuesta-López I, et al. Treatment adherence and persistence in patients with chronic hepatitis B virus infection[J]. Gastroenterol Hepatol, 2012, 35(4): 293-294.
10. 　Ha NB, Ha NB, Garcia RT, et al. Medication nonadherence with long-term management of patients with hepatitis B e antigen-negative chronic hepatitis B[J]. Dig Dis Sci, 2011, 56(8): 2423-2431.
11. 　张耀, 周吉军, 王宇明. 心理干预对国内慢性乙型肝炎患者焦虑抑郁情绪影响的荟萃分析[J]. 世界华人消化杂志, 2008, 16(1): 101-104.
12. 　Lutgehetmann M, Meyer F, Volz T, et al. Knowledge about HBV, prevention behaviour and treatment adherence of patients with chronic hepatitis B in a large referral centre in Germany[J]. Z Gastroenterol, 2010, 48(9): 1126-1132.
13. 　Chotiyaputta W, Peterson C, Ditah FA, et al. Persistence and adherence to nucleos(t)ide analogue treatment for chronic hepatitis B[J]. J Hepatol, 2011, 54(1): 12-18.
14. 　黄丽芬, 陈禄彪, 张丽华. HBeAg阴性肝硬化患者抗病毒治疗的护理要点[J]. 中华实验和临床病毒学杂志, 2010, 24(3): 209-211.
15. 　Yang JH. Development and evaluation of a program to promote self management in patients with chronic hepatitis B[J]. J Korean Acad Nurs, 2012, 42(2): 258-268.

West China Medical Journal

Analysis of Factors Influencing Compliance of Antiviral Therapy in Patients with Chronic Hepatitis B in Sichuan Province

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