Medication adherence in Chinese adults with chronic hepatitis B based on theory of planned behavior

Purpose To investigate the factors related to medication adherence in patients with chronic hepatitis B (CHB) infection by considering the theory of planned behavior (TPB). Methods In this cross-sectional study, medication adherence information was collected from outpatients with CHB in China. Pearson correlation analysis was performed to evaluate the association between medication adherence and TPB items. A structural equation model was established to further assess the effects of the latent TPB variables on medication adherence. Results A total of 225 patients with CHB recruited from the outpatient department of Qingdao Public Health Clinical Center were included, 67.6% of whom reported moderate medication adherence, as assessed using Morisky Adherence Assessment Score. Medication adherence was significantly positively correlated with behavioral intention ( r = 0.51, P < 0.001), perceived behavioral control ( r = 0.63, P < 0.001), and subjective norms ( r = 0.52, P < 0.001). Perceived behavioral control both directly and indirectly affected medication adherence, with the correlation coefficients being 0.14 and 0.32, respectively. The structural equation model revealed behavioral attitude and subjective norms as the strongest predictors of medication adherence, both of which indirectly affected behavior (correlation coefficients: 0.13 × 0.66 = 0.09 and 0.39 × 0.66 = 0.25, respectively). The optimal fitted model of TPB variables explained 58.5% of the variance in medication adherence. Conclusions Moderate medication adherence was discovered among Chinese adults with CHB. Behavioral attitude, subjective norms, and perceived behavioral control indirectly affected medication adherence.