Application of Adherence Scale and WeChat-based Continuing Nursing to Improve the Therapeutic Efficacy of Peg-IFN in CHB Patients

Abstract

Objective: To explore the effects of applying the eight-item Morisky Adherence Scale (MMAS-8) combined with WeChat-based continuing nursing on improving adherence and immunological response in patients with chronic hepatitis B (CHB) undergoing pegylated interferon (Peg-IFN) therapy. Methods: A total of 156 patients diagnosed with chronic hepatitis B and initiating Peg-IFN treatment in our outpatient department from January to December 2018, who returned for follow-up after 12 weeks of treatment, were included in the study. Based on MMAS-8 evaluation results, patients were categorized into high-adherence and low-adherence groups. The high-adherence group received routine education and nursing, while the low-adherence group received WeChat-based continuing nursing. Adherence was reassessed using MMAS-8 after 48 weeks of treatment, and Peg-IFN treatment's immunological response was assessed based on laboratory indicators. Results: Compared with baseline, at 12 weeks of treatment, the high-adherence group exhibited an immunological response rate of 44.9% (35/78), whereas the low-adherence group had a response rate of only 30.8% (24/78), showing a statistically significant difference between the groups (p<0.05, Fisher's exact test). By the 48th week of treatment with WeChat-based continuing nursing, the MMAS-8 scores were 7.0±0.6 and 7.1±0.6 in the high-adherence and low-adherence groups, respectively, with no statistically significant difference (p=0.20). There were no significant differences between the groups in immunological response rate, HBeAg seroconversion rate, or clinical cure rate. Conclusion: In the outpatient treatment of chronic hepatitis B with Peg-IFN, the application of the adherence scale combined with WeChat-based continuing nursing not only improves patient adherence but also enhances clinical treatment outcomes. Practice implications: Using classical scales and new media tools can help outpatient care providers deliver better care services and improve the treatment outcomes for chronic diseases.