Hepatitis B Patients' Adherence to Treatment in Relation to Knowledge, Attitudes, and Practices (KAP) in the West Bank, Palestine, 2022–2023

Hepatitis B is an infectious disease that inflicts high health and economic costs on the healthcare system. Poor adherence to treatment increases that cost. We aimed to assess the levels of knowledge, attitudes and practices (KAP) among patients in the West Bank, Palestine, and identify factors associated with good adherence. We conducted a cross-sectional study surveying hepatitis B patients visiting primary healthcare during October 2022 until June 2023 using an interviewer-administered questionnaire covering qualitative and quantitative aspects regarding hepatitis B. We considered adherence as good if participants received > 90% of their monthly prescription antiviral doses. Among 386 participants, the median age was 45 years (range 20-81); 80% had good adherence to treatment. Mean knowledge score was 11.4 (on a 13-point scale), mean attitude score was 3.4 (on a 4-point scale), mean practices score was 6 (on a 7-point scale) and the mean overall KAP score was 21.8 (on a 24-point scale). KAP components (Cronbach alpha = 0.820) were correlated with good adherence (p < 0.001). After adjustment for other factors, participants with good KAP scores had better adherence to treatment than those without (prevalence ratio: 1.41, 95% CI: 1.10-1.84, p-value = 0.011). We recommend investment in education and awareness campaigns to improve adherence.