University of Technology Sydney, Faculty of Health, Broadway, NSW, Australia.
Sydney Children's Hospital Randwick, Nursing Research Unit, Randwick, NSW, Australia.
The Kirby Institute, UNSW Australia, UNSW Australia Kensington, Sydney, NSW, Australia.
Concord Repatriation General Hospital, Gastroenterology and Liver Services.
Westmead Hospital, Westmead, NSW, Australia.
University of Sydney - Westmead Institute for Medical Research, Westmead, NSW, Australia.
St George Hospital, Kogarah, NSW, Australia.
UNSW Australia - St George Hospital Clinical Group School of Medicine, Kogarah, NSW, Australia.
Hepatitis B virus (HBV) anti-viral therapy has the potential to reduce the burden of HBV-related liver disease by suppressing HBV deoxyribonucleic acid (DNA) replication to undetectable levels, reducing the progression of liver fibrosis and reducing the risk of hepatocellular carcinoma (HCC) development. Treatment outcomes and long-term benefits require adherence to medication regimens. This study aimed to identify the prevalence and factors associated with non-adherence to anti-viral therapy.
A cross-sectional survey of patients receiving HBV anti-viral therapies was conducted in three Sydney hospitals. Participants were asked to complete an online questionnaire. Logistic regression was used to assess the associations between non-adherence (defined as missing more than one day of medication in the last 30 days) and demographic, socio-economic, disease, treatment, health-care-system and individual-related factors.
Of the 277 participants, 66 (23.8%) were non-adherent, missing a mean 1.7 days of medication (SD 4.8) in the last 30 days. In multivariate analysis, non-adherent behaviour declined with age (OR 0.9 95% CI 0.97-0.99, p<0.013). Participants who reported having no established routine to take their medication (OR 5.0, 95%CI 1.4-17.4, p<0.012) and having inadequate health literacy (OR 2.7, 95%CI 1.3-5.5, p<0.007) were more likely to be non-adherent.
Almost a quarter of participants in the current study were non-adherent. Adherence is potentially modifiable through person-centred education, collaborative models of patient care and interventions designed to improve health literacy and establish medication routines. Findings have the potential to improve health service delivery to patients at risk of non-adherence to HBV anti-viral therapy.