Prescription Adherence and Its Related Factors in Chronic Hepatitis C patients Receiving Regimen of Interferon and Ribavirin Treatment-A Longitudinal Study
Date Issued
2006
Date
2006
Author(s)
Chen, Hung-Mei
DOI
zh-TW
Abstract
The major purpose of this research was to examine the relationship between prescription adherence and its related factors among chronic hepatitis C patients who received regimen of interferon and ribavirin. Thirty-three chronic hepatitis C patients aged over 18 years were recruited through purposive sampling from one teaching hospital which is located in a metropolitan area of north Taiwan between July 2004 to April 2005. The structured instruments were applied and the participants were asked to complete Physical Symptoms Scale, Mood States Scale, Self-efficacy Scale, Social Support Scale, Quality of Life Scale, Treatment Adherence Scale and the Demographic Profile. All participants who completed the questionnaire at baseline (T0) were interviewed again at two weeks (T1) one month (T2), two months (T3), and three months (T4) after baseline (T0). Data entry and analyses were performed in SPSS 12.0. Descriptive statistics, repeated measure ANOVA, Kruskal-wallis test, Pearson’s product-moment correlation were used for the data analyses.
The research sample in the study included 17 females and 16 males with an average age of 50 years. The majority of the genotype of hepatitis C virus is 1b and the degree of liver fibrosis is F2. The research found that the majority of chronic hepatitis C patients were able to take medication according to the timing and dosage prescribed by doctors. However, some patients changed the medication time for themselves due to personal reasons. In the first three months of the medication, the adherence rate of average oral dosage of ribavirin was calculated to be 93.99%, the adherence rate of average interferon injection dosage to be 95.86%, the adherence rate of medication timing to be 99.53%, clinic follow-up rate to be 100%, and most of chronic hepatitis C patients have relatively high medication adherence rate.
In the first three months of the medication of chronic hepatitis C with interferon and ribavirin, the experimental values, except for Seg values which displayed an initial decrease and a subsequent increase during the second week of the medication, including ALT, AST, total bilirubin, Cr, TSH and Free T4, all values showed gradual decrease. Flu-like symptoms for example, fatigue, muscular pain, insomnia, headache, dizziness, and joint pain, were commonly seen during the first three months. Fatigue was the most common negative mood symptom in this sample. The average intensity scores of fatigue-inertia subscale of the Mood States Scale were highly ranked in the first one both before and after the medication.
Chronic hepatitis C patients receiving medication of interferon and ribavirin reported fair quality of life in the first three months of medication. There was no significant difference in scores of the social relationships domain and the environment domain between before and after the medication. The psychological domain remained the lowest score during the first three months of the medication. According to results from the Social Support Scale, patients reported the highest scores on emotional support and the lowest scores on the tangible support (social support subscale- emotional support, informational support, appraisal support, and tangible support). The majority of the support sources came from family members, relatives, friends and spouse, while the least came from patient group. Although mild physical and emotional symptoms resulting from the adverse effect of the medicine made patients feel distress, the scores of the self-efficacy on treatment adherence remained high during the three months of the medication.
Findings from this research can help health professionals and contribute significantly to the literature on the prescription adherence and its related factors among chronic hepatitis C patients who receive medication of Interferon and Ribavirin. This research provides abundant information which can serve as a reference for holistic nursing care.
Subjects
慢性C型肝炎
治療遵從行為
身體症狀
情緒狀態
生活品質
自我效能
Chronic hepatitis C
treatment adherence behaviors
physical symptoms
mood states
quality of life
social support
self-efficacy
Type
other
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