Shared Decision Making and Its Association with Antiviral Therapy Adherence in Patients with Chronic Hepatitis B: Single-Center Cross-Sectional Analysis

Purpose. To evaluate the level and influencing factors of shared decision making in patients with chronic hepatitis B and explore its effects on antiviral treatment adherence. Methods. A cross-sectional study was conducted with 239 chronic hepatitis B patients using a general information and disease-related information questionnaire, the 9-item Shared Decision Making Questionnaire, the Self-Efficacy for Appropriate Medication Use Scale, and the Morisky Medication Adherence Scale–8. A structural equation model was built to analyze the pathways through which shared decision making affects medication adherence. Results. The standardized shared decision-making score for patients with chronic hepatitis B was 71.99 ± 9.22, with higher levels of shared decision making observed in males and patients with cirrhosis. Shared decision making significantly affected self-efficacy for appropriate medication use (β = 0.568, P < 0.001) and adherence (β = 0.413, P < 0.001). Moreover, self-efficacy for appropriate medication mediated the relationship between shared decision making and adherence (β = 0.219, P = 0.002). Conclusions. Patients with chronic hepatitis B show above-average levels of shared decision making, with considerable individual differences. Promoting the use of shared decision making can significantly improve patients’ medication self-efficacy and adherence to treatment. Highlights Shared decision making (SDM) in chronic hepatitis B (CHB) patients is at an above-average level, with significant individual differences. Gender and cirrhosis status are key independent factors influencing SDM levels. Higher SDM levels positively affect both medication self-efficacy and adherence, with self-efficacy serving as a mediator.