ArticleCureus2026
Understanding Hepatic Encephalopathy: Patient Knowledge, Adherence, and Barriers to Care in Cirrhosis.
Article in Cureus, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionHepatic encephalopathy (HE) is a common and debilitating complication of liver cirrhosis, associated with impaired cognition, reduced quality of life, and frequent hospitalizations. Effective management requires adherence to medications such as lactulose and rifaximin; however, patient understanding and adherence remain suboptimal. This study aimed to assess patient knowledge of HE, medication adherence, and perceived barriers to care among patients with cirrhosis.
methodsWe conducted a cross-sectional study in Bahrain Government Hospitals between January 2022 and December 2024. Adult patients with liver cirrhosis were recruited during outpatient and inpatient encounters. A structured questionnaire assessed knowledge of HE, adherence to treatment, and barriers to care. Adherence and knowledge were assessed using self-reported measures. Factors associated with poor knowledge and non-adherence were analyzed using multivariable logistic regression.
resultsA total of 538 patients with cirrhosis were included. The mean age was 56 ± 13 years, and 312 (58.0%) were male. Only 214 patients (39.8%) demonstrated adequate knowledge of HE. While 402 patients (74.7%) were prescribed lactulose, only 279 (52.0%) reported good adherence. Rifaximin was prescribed in 409 patients (76.0%), with higher adherence rates at 74.3% (304 of 409 patients). The most common barriers to adherence included medication side effects (41.2%), lack of understanding of treatment purpose (38.5%), cost concerns (27.3%), and forgetfulness (24.1%). Patients with prior HE episodes had significantly higher knowledge scores (p<0.001). Poor adherence was independently associated with low educational level (OR 2.1, 95% CI 1.3-3.5), inadequate knowledge (OR 2.8, 95% CI 1.7-4.6), and lactulose-related side effects (OR 1.9, 95% CI 1.2-3.1).
conclusionPatient knowledge and adherence to HE therapy remain suboptimal, with significant barriers affecting effective management. Targeted patient education and strategies to improve the tolerability of therapy are essential to reduce HE-related morbidity.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.