Effects of a culturally tailored intervention on medication adherence in Chinese and Vietnamese Americans with hepatitis B: a randomized controlled trial

IntroductionAsian Americans are disproportionately affected by chronic hepatitis B (CHB), which is caused by infection with hepatitis B virus (HBV). While adherence to antiviral medication is an effective practical approach to managing CHB and preventing liver cancer, medication adherence rates among Chinese and Vietnamese Americans with CHB, two vulnerable yet understudied populations, remain largely unknown.MethodsWe designed and implemented a randomized controlled clinical trial to investigate the potential improvement of long-term adherence to HBV medication in Asian American populations. Eligible Asian American HBV patients were recruited from the Greater Philadelphia and New York City. HBV medication adherence was assessed using the 8-Item Morisky Medication Adherence Scale. We conducted ordinary least squares (OLS) regression to examine the intervention effects on medication adherence among 129 Chinese and Vietnamese Americans taking CHB medication.ResultsAmong 129 participants (91 Chinese and 38 Vietnamese), about three-quarters (74.4%) reported limited English proficiency. Almost one out of 10 (9.3%) did not have any health insurance. OLS regression results indicated that the intervention had a significant impact on improving medication adherence at 12-month follow-up assessment (coefficient = 0.56, p = 0.04). In addition, we found that depression score at baseline was negatively associated with medication adherence at 12-month follow-up assessment (coefficient = −0.10, p = 0.003), with other covariates held constant.DiscussionThe findings show that a community-based culturally appropriate intervention significantly improved adherence to medication among Chinese and Vietnamese Americans with CHB in a 12-month period. Providing mental health support to CHB patients in this population may play an important role in improving medication adherence.Clinical trial registration[https://clinicaltrials.gov/study], identifier [NCT04082338].