Identifying Adherence Trajectories in Chronic Hepatitis B: A Cluster-Based Approach to Long-Term Treatment Management

Abstract

This study aimed to investigate the levels and longitudinal trajectories of medication adherence among patients with chronic hepatitis B (CHB), identify key psychosocial factors influencing adherence and provide evidence to inform strategies for optimising long-term treatment and enhancing patients' quality of life. A longitudinal study was conducted among CHB patients, 305 completing a 12-month follow-up. Medication adherence and psychosocial data were collected at baseline and at 3, 6, 9 and 12 months. K-means cluster analysis was performed to identify distinct adherence patterns, and differences in psychosocial characteristics across clusters were analysed. Four adherence trajectories were identified: improvement, low adherence, decline and high adherence. Significant differences were observed among the groups in terms of medication adherence scores and psychosocial factors (p < 0.05). Higher adherence was positively correlated with self-efficacy and social support, while lower adherence was associated with higher levels of perceived stigma and depression. Medication adherence among CHB patients exhibits distinct dynamic patterns, strongly influenced by psychosocial factors. Targeted interventions focusing on psychological support, stigma reduction and strengthening social support networks may improve adherence and ultimately enhance the quality of life for patients with chronic hepatitis B.