Disease and treatment perceptions among Asian Americans diagnosed with chronic hepatitis B infection.

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.