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Introduction: Effective hepatitis B virus (HBV) disease management is of major importance and has been identified as a public health priority.
Objectives: The objective of this study is to determine if outreach to prescribers and members can result in the following: 1) increased medication adherence to HBV antiviral medications, as measured by a change in Proportion of Days Covered (PDC); and 2) reduced HBV viral load, for members identified as potentially nonadherent to HBV antiviral medications (PDC≤0.90).
Study Design: This project is an IRB exempt longitudinal cohort analysis.
Methods: The 78 members who were initially identified as nonadherent with their HBV medications, as evidenced by exhibiting less than or equal to 0.90 PDC in the 12 months preceding study initiation, were recruited into the study cohort and called to discuss their HBV medication adherence. Prescribers of nonadherent members were mailed initially in June 2014 and then if their patients remained nonadherent, mailed again in December 2014. PDC outcomes were obtained at 6 months (December 2014) and 12 months (June 2015). HBV DNA levels were obtained at the beginning of the study (June 2014) and at study completion (July 2015).
Results: Mean PDC significantly increased in the first 6 months and continued to increase significantly in the second 6 months of the study from 0.69 to 0.75 over the 12 month duration of the study (p<0.05). At one year, 13 members were moved into adherence (PDC>0.90). There was a significant difference between the PDC changes between males and females over time (p<0.05). The PDC significantly increased among females, but there was no statistically significant PDC change among males. There were no significant differences in HBV DNA.
Conclusions: The combination of provider and member outreach for nonadherent HBV members improved medication adherence (PDC). The effect of such interventions on HBV DNA levels needs further analysis.