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Published in: Journal of General Internal Medicine 3/2014

Open Access 01-03-2014 | Original Research

Disease and Treatment Perceptions Among Asian Americans Diagnosed with Chronic Hepatitis B Infection

Authors: Kalman Tokes, BA, Syed Quadri, PharmD, Patrick Cahill, MSc, Grace Chiu, MBA, Angel Ivanov, MMR, Hong Tang, MD

Published in: Journal of General Internal Medicine | Issue 3/2014

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ABSTRACT

BACKGROUND

In the US, over 1 million Asian Americans are estimated to be living with chronic hepatitis B (CHB). Research has shown low awareness of CHB and different attitudes towards its treatment among the diverse ethnicities of Asian Americans.

OBJECTIVE

This study aimed to understand the perceptions and attitudes of CHB treatment among Asian Americans diagnosed with CHB who were either treatment-naïve or being treated for CHB with oral antivirals, and to understand the relative importance of different clinical and economic attributes of oral antivirals that affect CHB treatment decisions and choices.

DESIGN

Face-to-face structured survey administered to participants at central research facilities by interviewers of each participating ethnicity.

PARTICIPANTS

CHB patients from Chinese, Korean, and Vietnamese communities of New York metropolitan, San Francisco/Bay, and Los Angeles/Orange County areas.

MAIN MEASURES

A ‘conjoint’ exercise (discrete choice model) assessed the relative impact of treatment attributes on treatment choice. Implicit “trade-off” decisions made by respondents were estimated using a hierarchical Bayesian model.

KEY RESULTS

Among 252 participants, 36 % were Chinese, 34 % Vietnamese, and 31 % Korean; 56 % were treatment-naïve and 44 % were being treated with an oral antiviral for CHB. The majority (88 %) believed that, if left untreated, CHB can lead to serious liver damage; 72 % believed there are effective prescription medications to treat CHB; and 39 % showed reluctance to be on long-term therapy for CHB because of concerns over side effects. Long-term risk of kidney damage was given the highest relative importance (38 %) when choosing CHB treatment, followed by medication cost (23.4 %), long-term risk of bone thinning (18 %), long-term efficacy (9 %), time on US market (6.8 %), and number of patients treated globally (4.9 %). Results were consistent across ethnicities.

CONCLUSIONS

Patients need access to improved education regarding CHB disease progression, its management, disease outcomes, and the importance of long-term treatment of the disease.
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Literature
1.
go back to reference Kowdley KV, Wang CC, Welch S, Roberts H, Brosgart CL. Prevalence of chronic hepatitis B among foreign-born persons living in the united states by country of origin. Hepatology. 2012;56:422–33.PubMedCrossRef Kowdley KV, Wang CC, Welch S, Roberts H, Brosgart CL. Prevalence of chronic hepatitis B among foreign-born persons living in the united states by country of origin. Hepatology. 2012;56:422–33.PubMedCrossRef
2.
go back to reference Sorrell MF, Belongia EA, Costa J, et al. National institutes of health consensus development conference statement: management of hepatitis B. Ann Intern Med. 2009;150(2):104–10.PubMedCrossRef Sorrell MF, Belongia EA, Costa J, et al. National institutes of health consensus development conference statement: management of hepatitis B. Ann Intern Med. 2009;150(2):104–10.PubMedCrossRef
3.
go back to reference Tong MJ, Pan CQ, Hann HW, et al. The management of chronic hepatitis B in Asian Americans. Dig Dis Sci. 2011;56(11):3143–62.PubMedCrossRef Tong MJ, Pan CQ, Hann HW, et al. The management of chronic hepatitis B in Asian Americans. Dig Dis Sci. 2011;56(11):3143–62.PubMedCrossRef
4.
go back to reference European Association For The Study Of The Liver. EASL clinical practice guidelines: management of chronic hepatitis B virus infection. J Hepatol. 2012;57(1):167–85. European Association For The Study Of The Liver. EASL clinical practice guidelines: management of chronic hepatitis B virus infection. J Hepatol. 2012;57(1):167–85.
6.
go back to reference Cohen C, Holmberg SD, McMahon BJ, et al. Is chronic hepatitis B being undertreated in the United States? J Viral Hepat. 2011;18(6):377–83.PubMedCrossRef Cohen C, Holmberg SD, McMahon BJ, et al. Is chronic hepatitis B being undertreated in the United States? J Viral Hepat. 2011;18(6):377–83.PubMedCrossRef
9.
go back to reference Hu KQ, Pan CQ, Goodwin D. Barriers to screening for hepatitis B virus infection in Asian Americans. Dig Dis Sci. 2011;56(11):3163–71.PubMedCrossRef Hu KQ, Pan CQ, Goodwin D. Barriers to screening for hepatitis B virus infection in Asian Americans. Dig Dis Sci. 2011;56(11):3163–71.PubMedCrossRef
10.
go back to reference Upadhyaya N, Chang R, Davis C, Conti MC, Salinas-Garcia D, Tang H. Chronic hepatitis B: perceptions in Asian American communities and diagnosis and management practices among primary care physicians. Postgrad Med. 2010;122(5):165–75.PubMedCrossRef Upadhyaya N, Chang R, Davis C, Conti MC, Salinas-Garcia D, Tang H. Chronic hepatitis B: perceptions in Asian American communities and diagnosis and management practices among primary care physicians. Postgrad Med. 2010;122(5):165–75.PubMedCrossRef
11.
go back to reference Chang ET, Sue E, Zola J, So SK. 3 for life: a model pilot program to prevent hepatitis B virus infection and liver cancer in Asian and Pacific Islander Americans. Am J Health Promot. 2009;23(3):176–81.PubMedCrossRef Chang ET, Sue E, Zola J, So SK. 3 for life: a model pilot program to prevent hepatitis B virus infection and liver cancer in Asian and Pacific Islander Americans. Am J Health Promot. 2009;23(3):176–81.PubMedCrossRef
12.
go back to reference Hsu CE, Liu LC, Juon HS, et al. Reducing liver cancer disparities: a community-based hepatitis-B prevention program for Asian-American communities. J Natl Med Assoc. 2007;99(8):900–7.PubMedCentralPubMed Hsu CE, Liu LC, Juon HS, et al. Reducing liver cancer disparities: a community-based hepatitis-B prevention program for Asian-American communities. J Natl Med Assoc. 2007;99(8):900–7.PubMedCentralPubMed
13.
go back to reference Hsu CE, Zhang G, Yan FA, Shang N, Le T. What made a successful hepatitis B program for reducing liver cancer disparities: an examination of baseline characteristics and educational intervention, infection status, and missing responses of at-risk Asian Americans. J Community Health. 2010;35(3):325–35.PubMedCrossRef Hsu CE, Zhang G, Yan FA, Shang N, Le T. What made a successful hepatitis B program for reducing liver cancer disparities: an examination of baseline characteristics and educational intervention, infection status, and missing responses of at-risk Asian Americans. J Community Health. 2010;35(3):325–35.PubMedCrossRef
14.
go back to reference Shiau R, Bove F, Henne J, Zola J, Fang T, Fernyak S. Using survey results regarding hepatitis B knowledge, community awareness and testing behavior among Asians to improve the San Francisco hep B free campaign. J Community Health. 2012;37(2):350–64.PubMedCrossRef Shiau R, Bove F, Henne J, Zola J, Fang T, Fernyak S. Using survey results regarding hepatitis B knowledge, community awareness and testing behavior among Asians to improve the San Francisco hep B free campaign. J Community Health. 2012;37(2):350–64.PubMedCrossRef
15.
go back to reference Train KE. Discrete choice methods with simulation. Cambridge: Cambridge University Press; 2003.CrossRef Train KE. Discrete choice methods with simulation. Cambridge: Cambridge University Press; 2003.CrossRef
16.
go back to reference Viread (tenofovir) US prescribing information. Gilead Biosciences. August 2012. Viread (tenofovir) US prescribing information. Gilead Biosciences. August 2012.
17.
go back to reference Baraclude (entecavir) US prescribing information. Bristol-Myers Squibb. December 2010. Baraclude (entecavir) US prescribing information. Bristol-Myers Squibb. December 2010.
18.
go back to reference Hepsera (adefovir) US prescribing information. Gilead Biosciences. February 2012. Hepsera (adefovir) US prescribing information. Gilead Biosciences. February 2012.
19.
go back to reference Tyzeka (telbivudine), US prescibing information. Novartis. December 2011. Tyzeka (telbivudine), US prescibing information. Novartis. December 2011.
20.
go back to reference Epivir (lamivudine), US prescribing information. ViiV Healthcare. November 2011. Epivir (lamivudine), US prescribing information. ViiV Healthcare. November 2011.
21.
go back to reference Yoo GJ, Fang T, Zola J, Dariotis WM. Destigmatizing hepatitis B in the asian american community: lessons learned from the San Francisco hep B free campaign. J Cancer Educ. 2012;27(1):138–44.PubMedCrossRef Yoo GJ, Fang T, Zola J, Dariotis WM. Destigmatizing hepatitis B in the asian american community: lessons learned from the San Francisco hep B free campaign. J Cancer Educ. 2012;27(1):138–44.PubMedCrossRef
22.
go back to reference Manns MP, Akarca US, Chang TT, et al. Long-term safety and tolerability of entecavir in patients with chronic hepatitis B in the rollover study ETV-901. Expert Opin Drug Saf. 2012;11(3):361–8.PubMedCrossRef Manns MP, Akarca US, Chang TT, et al. Long-term safety and tolerability of entecavir in patients with chronic hepatitis B in the rollover study ETV-901. Expert Opin Drug Saf. 2012;11(3):361–8.PubMedCrossRef
23.
go back to reference Chang TT, Lai CL, Kew YS, et al. Entecavir treatment for up to 5 years in patients with hepatitis B e antigen-positive chronic hepatitis B. Hepatology. 2010;51(2):422–30.PubMedCrossRef Chang TT, Lai CL, Kew YS, et al. Entecavir treatment for up to 5 years in patients with hepatitis B e antigen-positive chronic hepatitis B. Hepatology. 2010;51(2):422–30.PubMedCrossRef
24.
go back to reference Seto WK, Lai CL, Fung J, Yuen JC, Wong DK, Yuen MF. Outcome of 4-year treatment of entecavir for treatment-naïve chronic hepatitis B. J Hepatol. 2011;54:S301.CrossRef Seto WK, Lai CL, Fung J, Yuen JC, Wong DK, Yuen MF. Outcome of 4-year treatment of entecavir for treatment-naïve chronic hepatitis B. J Hepatol. 2011;54:S301.CrossRef
25.
go back to reference Marcellin P, Buti M, Gane EJ, et al. Five years of treatment with tenofovir DF (TDF) for chronic hepatitis B (CHB) infection is associated with sustained viral suppression and significant regression of histological fibrosis and cirrhosis. Hepatology. 2011;54(4, suppl):1011A. Marcellin P, Buti M, Gane EJ, et al. Five years of treatment with tenofovir DF (TDF) for chronic hepatitis B (CHB) infection is associated with sustained viral suppression and significant regression of histological fibrosis and cirrhosis. Hepatology. 2011;54(4, suppl):1011A.
26.
go back to reference Mauss S, Berger F, Filmann N, et al. Effect of HBV polymerase inhibitors on renal function in patients with chronic hepatitis B. J Hepatol. 2011;55(6):1235–40.PubMedCrossRef Mauss S, Berger F, Filmann N, et al. Effect of HBV polymerase inhibitors on renal function in patients with chronic hepatitis B. J Hepatol. 2011;55(6):1235–40.PubMedCrossRef
27.
go back to reference Pol S, Lampertico P. First-line treatment of chronic hepatitis B with entecavir or tenofovir in ‘real-life’ settings: from clinical trials to clinical practice. J Viral Hepat. 2012;19(6):377–86.PubMedCentralPubMedCrossRef Pol S, Lampertico P. First-line treatment of chronic hepatitis B with entecavir or tenofovir in ‘real-life’ settings: from clinical trials to clinical practice. J Viral Hepat. 2012;19(6):377–86.PubMedCentralPubMedCrossRef
28.
go back to reference Brown A, Goodman Z. Hepatitis B-associated fibrosis and fibrosis/cirrhosis regression with nucleoside and nucleotide analogs. Expert Rev Gastroenterol Hepatol. 2012;6(2):187–98.PubMedCrossRef Brown A, Goodman Z. Hepatitis B-associated fibrosis and fibrosis/cirrhosis regression with nucleoside and nucleotide analogs. Expert Rev Gastroenterol Hepatol. 2012;6(2):187–98.PubMedCrossRef
Metadata
Title
Disease and Treatment Perceptions Among Asian Americans Diagnosed with Chronic Hepatitis B Infection
Authors
Kalman Tokes, BA
Syed Quadri, PharmD
Patrick Cahill, MSc
Grace Chiu, MBA
Angel Ivanov, MMR
Hong Tang, MD
Publication date
01-03-2014
Publisher
Springer US
Published in
Journal of General Internal Medicine / Issue 3/2014
Print ISSN: 0884-8734
Electronic ISSN: 1525-1497
DOI
https://doi.org/10.1007/s11606-013-2673-0

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