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慢性乙型肝炎患者对核苷(酸)类似物药物依从性的轨迹及预测因素

Trajectory and predictors of adherence to Nucleos(t)ide analogues medication among patients with chronic hepatitis B.

作者信息

Zhang Lin, Tian Jinping, Xu Di, Liu Yunyue, Zhang Zhenjiang

机构信息

Department of Infectious Diseases, The Affiliated Suqian First People's Hospital of Nanjing Medical University, Suqian, Jiangsu Province, China.

School of Nursing, Nanjing Medical University, Nanjing, Jiangsu Province, China.

出版信息

Heliyon. 2024 Sep 26;10(19):e38485. doi: 10.1016/j.heliyon.2024.e38485. eCollection 2024 Oct 15.

Abstract

OBJECTIVES

To investigate the developmental trajectory of medication adherence and its predictors in chronic hepatitis B (CHB) patients taking nucleos(t)ide analogues.

METHODS

A longitudinal study was conducted. Patients with CHB who met the inclusion criteria were selected using convenience sampling. Follow-ups were conducted at baseline, 3 months, 6 months, 9 months, and 12 months. Medication adherence was assessed using a medication adherence scale. Group-based trajectory modeling (GBTM) was used to explore medication adherence trajectories, and repeated measures ANOVA was used to describe changes in each trajectory. Unordered multinomial logistic regression analysis was used to explore predictive factors.

RESULTS

A total of 305 patients completed all follow-ups. Medication adherence was categorized into four trajectory groups: low adherence (4.9 %), decreasing adherence (24.3 %), increasing adherence (48.2 %), and high adherence (22.6 %). Multinomial logistic regression results showed that HBV-infected discrimination, depression, self-efficacy, and social support were significantly different among different medication adherence levels (p < 0.05).

CONCLUSIONS

Medication adherence trajectories in patients with CHB exhibit heterogeneity. Healthcare professionals can develop personalized treatment plans based on patients' social and psychological characteristics to improve medication adherence.

摘要

目的

探讨服用核苷(酸)类似物的慢性乙型肝炎(CHB)患者的药物依从性发展轨迹及其预测因素。

方法

进行一项纵向研究。采用便利抽样法选取符合纳入标准的CHB患者。在基线、3个月、6个月、9个月和12个月进行随访。使用药物依从性量表评估药物依从性。采用基于组的轨迹模型(GBTM)探索药物依从性轨迹,并使用重复测量方差分析描述各轨迹的变化。采用无序多项逻辑回归分析探索预测因素。

结果

共有305例患者完成了所有随访。药物依从性分为四个轨迹组:低依从性(4.9%)、依从性下降(24.3%)、依从性增加(48.2%)和高依从性(22.6%)。多项逻辑回归结果显示,不同药物依从性水平之间的乙肝病毒感染歧视、抑郁、自我效能感和社会支持存在显著差异(p<0.05)。

结论

CHB患者的药物依从性轨迹存在异质性。医护人员可根据患者的社会和心理特征制定个性化治疗方案,以提高药物依从性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/42a5/11466648/d7e53d4650fe/gr1.jpg

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