CP-113 Text message reminders increase antiviral therapy adherence in chronic hepatitis B patients

• Published in: European journal of hospital pharmacy. Science and practice 2016-03, Vol.23 (Suppl 1), p.A49-A50
• Main Authors: Abreu, RM, Hori, PCA, Rocha, PA, Minari, AB, Dias, MA, Pinto, VB, Carrilho, FJ, Ono, SK
• Format: Article
• Language: English
• Subjects: Hepatitis B
• ISSN: 2047-9956; 2047-9964
• DOI: 10.1136/ejhpharm-2016-000875.113

BackgroundAntiviral treatment suppresses viral load, the development of chronic hepatitis B (CHB) and prevents hepatocellular carcinoma. However, it does not eliminate hepatitis B virus (HBV) from infected hepatocytes. Among the factors directly linked to therapeutic success is adherence to treatment.PurposeWe assessed the impact of text message reminders on HBV treatment adherence.Material and methodsA randomised trial to test whether text message reminders were effective in increasing treatment adherence was performed with 137 patients from November 2013 to May 2014. Subjects receiving adefovir-dipivoxal or entecavir or lamivudine and/or tenofovir-DF were randomly assigned in a 1:1 ratio to receive or not to receive daily text message reminders “It’s time to take your medication” within the period of 6 months of treatment. All individuals received a booklet explaining the importance of adherence and treatment guidance from a clinical pharmacist. Treatment adherence was evaluated by a validated self-report questionnaire called CEAT-HBV, which shows that scores >80 points detect antiviral adherence with 81% sensitivity and 67% specificity. The Wilcoxon test was used to compare groups. The IRB approved the study.ResultsCEAT-HBV identified 102/137 (74%) patients on HBV treatment adherence. The non-adherence group (n = 16) increased from 77 points to 80 (p < 0.05) with the text intervention. The adherence group before the text message (n = 45) had a median of 84 points to 83 after intervention (p > 0.05). In the control groups (without text message), the non-adherence group (n = 19) had a median of 76 points (first evaluation) and 79 after 6 months (p < 0.05) and the adherence group (n = 57) had a median of 84 points and 83 (p > 0.05). The text message showed a positive impact in the non-adherence group because it was able to change the median similarly to the adherence group. Only booklet without text message increased the score in the non-adherence group and maintained the score for the adherence group. The CEAT-VHB showed that 104/137 (76%) of individuals were on treatment adherence after the intervention.ConclusionThe results suggest that a simple text message daily reminder could increase HBV treatment adherence for non-adherent subjects. The permanent treatment guidance oriented by clinical pharmacists could help to maintain adherence in individuals for a long treatment period.References and/or AcknowledgementsCNPq and mServices.No conflict of interest.