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. 2015 Jan;49(1):76-83.
doi: 10.1097/MCG.0000000000000055.

Self-efficacy and adherence to antiviral treatment for chronic hepatitis C

Jason E Bonner  1 , Denise A Esserman, Carol E Golin, Donna M Evon
Affiliations

Self-efficacy and adherence to antiviral treatment for chronic hepatitis C

Jason E Bonner et al. J Clin Gastroenterol. 2015 Jan.

Abstract

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.

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Conflict of interest statement

Conflict of Interest Statement: Donna M. Evon received research grant support from Roche, and served as an ad hoc consultant to Vertex in the past 12 months. All other authors have nothing to disclose.

Figures

Figure 1
Figure 1
Comparison of Global Self-Efficacy (GSE) Scores by Level of Depressive Symptomatology at Baseline (left panel, N=384) and Treatment Week 24 (right panel, N=165). Significance bars represent pairwise comparisons using Kruskal-Wallis test with a Bonferroni correction for multiple comparisons set at 0.05/3=0.0167. Among baseline participants, GSE was highest among those with no depressive symptomatology at baseline when compared to participants with mild-to-moderate (p<0.001) and severe (p<0.001) depressive symptoms, respectively. Among participants who continued on treatment from week 24 to 48, GSE at treatment week 24 was higher among those with no depressive symptoms when compared with those with severe depressive symptoms (p<0.001).
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