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; 抗病毒治療; 依從性

DOI：

10.7507/1002-0179.20130491

Video：

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目的　通過分析影響四川地區慢性乙型肝炎患者抗病毒治療依從性的因素，探討提高患者治療依從性的策略。方法　選擇2011年4月－2012年4月在四川大學華西醫院接受核苷（酸）類似物抗病毒治療的324例慢性乙型肝炎患者作為研究對象。采用問卷調查的方法，對患者一般情況、心理狀態、文化程度、經濟情況、疾病認知情況、抗病毒療效、服藥持續性等相關因素進行分析，評估這些因素對患者治療依從性的影響。結果　324例患者中能夠完全遵照醫囑者78例（24.07%），不能完全依從者246例（75.93%）。心理狀態良好者132例（40.74%），其中依從性良好者54例；心理負擔較重者192例（59.26%），其中依從性良好者24例。初中及以上學歷204例（62.96%），依從性良好者72例；初中以下學歷者120例（37.04%），依從性良好者僅6例。不同心理狀態、文化程度的患者依從率差異有統計學意義。患者經濟狀況、年齡差異對于依從性也有一定影響。結論　慢性乙型肝炎患者對抗病毒治療的依從性與心理狀態、文化程度者及經濟狀況密切相關。改善患者醫療費用償付能力，對患者進行疾病認知教育以及減少社會歧視等措施有助于提高患者治療依從性。

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

1.	中華醫學會肝病學分會、感染病學分會. 慢性乙型肝炎防治指南(2010年版)[J]. 中華肝臟病雜志, 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, 李劍妮, 彭秋燕. 護理干預對慢性乙型病毒性肝炎患者抗病毒治療依從性的影響[J]. 齊魯護理雜志, 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.	張耀, 周吉軍, 王宇明. 心理干預對國內慢性乙型肝炎患者焦慮抑郁情緒影響的薈萃分析[J]. 世界華人消化雜志, 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.	黃麗芬, 陳祿彪, 張麗華. HBeAg陰性肝硬化患者抗病毒治療的護理要點[J]. 中華實驗和臨床病毒學雜志, 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. 　中華醫學會肝病學分會、感染病學分會. 慢性乙型肝炎防治指南(2010年版)[J]. 中華肝臟病雜志, 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, 李劍妮, 彭秋燕. 護理干預對慢性乙型病毒性肝炎患者抗病毒治療依從性的影響[J]. 齊魯護理雜志, 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. 　張耀, 周吉軍, 王宇明. 心理干預對國內慢性乙型肝炎患者焦慮抑郁情緒影響的薈萃分析[J]. 世界華人消化雜志, 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. 　黃麗芬, 陳祿彪, 張麗華. HBeAg陰性肝硬化患者抗病毒治療的護理要點[J]. 中華實驗和臨床病毒學雜志, 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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