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Self-Efficacy and Adherence to Antiviral Treatment for Chronic Hepatitis C

Bonner, Jason E. PhD*; Esserman, Denise A. PhD†,‡; Golin, Carol E. MD§; Evon, Donna M. PhD*

Journal of Clinical Gastroenterology: January 2015 - Volume 49 - Issue 1 - p 76–83
doi: 10.1097/MCG.0000000000000055
LIVER, PANCREAS AND BILIARY TRACT: Original Articles
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Goals: To investigate the role of self-efficacy (SE) during hepatitis C virus (HCV) treatment.

Background: Adherence to chronic HCV treatment is critical. SE is an important predictor of medication adherence in a number of chronic disease populations and medication regimens, but its role during HCV treatment remains unknown.

Study: Data from the prospective Virahep-C study were analyzed to examine relationships between SE and patient-driven deviations (ie, missed doses measured using electronic pill caps, and nonpersistence) from adherence to HCV antiviral treatment. SE was measured using the 17-item HCV Treatment Self-Efficacy scale. This measure provides a global estimate of a patient’s confidence to undergo and adhere to HCV treatment, and can estimate SE in 4 underlying domains: communication SE (ie, confidence to communicate with health care provider), physical coping SE (ie, confidence to cope with physical side effects), psychological coping SE (ie, confidence to cope with psychiatric side effects), and treatment adherence SE (ie, confidence to take all medications as prescribed and attend doctor visits). Generalized estimating equations and Cox proportional hazards models were used to assess associations between SE and missed doses and nonpersistence, respectively.

Results: SE was associated with being in a relationship, educated, privately insured, and less depressed. Higher communication SE at TW24 reduced the risk of missed doses between TW24 and TW48. Higher baseline treatment adherence SE reduced the likelihood of nonpersistence between baseline and TW24.

Conclusions: SE’s relationship to HCV treatment adherence has promising clinical and research implications.

Departments of *Medicine, Division of Gastroenterology and Hepatology

Medicine

Biostatistics, Gillings School of Public Health

§Division of General Medicine and Clinical Epidemiology, University of North Carolina, Chapel Hill, NC

Supported, in part, by the UNC Clinical and Translational Science Award (UL1RR025747; J.E.B. and D.A.E.); a Center for Aids Research grant (P30-AI50410; C.E.G.); and by the National Institutes of Health Award (K23DK089004-02; D.M.E.).

The VIRAHEP-C study was conducted by multiple investigators and supported by the National Institute of Digestive and Kidney Diseases (NIDDK). This manuscript was not prepared in collaboration with the investigators of Virahep-C and does not necessarily reflect the opinions or views of the Virahep-C study or the NIDDK.

D.M.E. received research grant support from Roche, and served as an ad hoc consultant to Vertex in the past 12 months. The remaining authors declare that they have nothing to disclose.

Reprints: Donna M. Evon, PhD, Department of Medicine, Division of Gastroenterology and Hepatology, CB# 7584, 8010 Burnett-Womack, University of North Carolina, Chapel Hill, NC 27599 (e-mail: donna_evon@med.unc.edu).

Received July 22, 2013

Accepted November 12, 2013

© 2015 by Lippincott Williams & Wilkins