Factors that modify therapy adherence in patients with inflammatory bowel disease

Bermejo, Fernando; Román, Antonio López-San; Algaba, Alicia; Guerra, Iván; Valer, Paz; García-Garzón, Silvia; Piqueras, B.; Villa, Carlos; Bermejo, Andrea; Rodríguez-Agulló, J.L.

doi:10.1016/j.crohns.2010.01.005

Cited by 31 publications

(19 citation statements)

References 30 publications

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“…Broadly speaking the prevalence of thiopurine non-adherence, we report here is similar to that demonstrated in early therapeutic drug monitoring studies of thiopurines in IBD [37][38][39] and to those adherence studies that have used a drug metabolite to define adherence. [8][9][10][11][12] It is, however, lower than rates reported from studies that relied only on questionnaires, 7,13,14,26,[40][41][42][43][44][45][46] pharmacy refill data 3,47 or patient diaries 48 to define non-adherence, which suggest that between 25% and 72%, IBD patients are non-adherent. While these studies are subject to recall, social desirability and concealment biases, this apparent discrepancy probably reflects the fact that most people tell the truth when asked about adherence, and that drug metabolites, although markers of major non-adherence are poor measures of unintentional/partial adherence.…”

Section: Discussionmentioning

confidence: 99%

“…Likewise, there was no difference in the frequency of doses required per day or in the total pill burden between groups. Adults attended significantly more out-patient appointments than young adults [median (range) 6 (1-16) vs. 4.5 (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13), respectively, P < 0.001] in the preceding year; however, there were no differences in the number of hospital admissions between groups (Table 4).…”

Section: Uc Montreal Classification Treatments and Disease Activitymentioning

confidence: 99%

“…4,5 Accepting that most patients are non-adherent, at least some of the time, it is important to recognise the difference between partial and complete non-adherence, as the determinants are reportedly different. 6,7 Partial non-adherence is usually unintentional, and occurs when the patient intends to take the medication but is prevented from doing so by limitations in capacity and resources (e.g. 'forgetting', poor comprehension, lack of funds).…”

Section: Introductionmentioning

confidence: 99%

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Factors associated with thiopurine non-adherence in patients with inflammatory bowel disease

Goodhand

Kamperidis

Sirwan

et al. 2013

Aliment Pharmacol Ther

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Section: Discussionmentioning

confidence: 99%

Section: Uc Montreal Classification Treatments and Disease Activitymentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Factors associated with thiopurine non-adherence in patients with inflammatory bowel disease

Goodhand

Kamperidis

Sirwan

et al. 2013

Aliment Pharmacol Ther

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“…In real life treatment adherence is lower, with percentage of non-adherent patients ranging between 38% to 70%. 3,[9][10][11][12][13] In our work we found a lower percentage of non-adherent behavior (29.7%), even so, a significant number of our patients are not benefiting from the full potential of their therapy. There is no gold standard method to measure adherence, but interview and questionnaire methods are most commonly used because they are easy to obtain and inexpensive.…”

Section: Discussionmentioning

confidence: 56%

“…Bermejo et al 13 describe 66% of some involuntary non-adherence. The involuntary non-adherence that we report in our study is similar (70.7%).…”

Section: Discussionmentioning

confidence: 99%

Treatment of Inflammatory Bowel Disease: Is your Patient at Risk of Non-Adherence?

et al. 2014

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Acta Med Port 2014 Sep-Oct;27(5):576-580 RESUMOIntrodução: A adesão à terapêutica é um aspecto chave para a eficácia da terapêutica. O objectivo deste estudo foi avaliar a frequên-cia e factores de risco associados à não adesão à terapêutica na doença inflamatória intestinal. ABSTRACT Introduction:Adherence to therapy is a key factor when analyzing the efficacy of a treatment in clinical practice. The aim of our study was to assess the frequency of non-adherence to treatment among patients with inflammatory bowel disease and evaluate which factors could be related. Material and Methods:One hundred thirty eight consecutive inflammatory bowel disease outpatients (55.8% with Crohn's disease and 44.2% with Ulcerative Colitis) filled in an anonymous questionnaire, which included information about demography, duration of the disease, specific therapy for inflammatory bowel disease, and data possibly related to extent of non-adherence to treatment. Statistics were performed with SPSS v.18.0. Categorical variables were compared with Fisher's exact test. A p value < 0.05 was considered statistically significant. Significant variables in univariate analysis were included in the logistic regression analysis.Results: Overall non-adherence was reported by 29.7% of patients. 70.7% of them reported unintentional non-adherence and 51.2% forgot at least one dose per week. Non-adherence was statistically associated with: short disease duration (p < 0.001); young age (p = 0.001); topical aminosalicylates (p = 0.005); the perception that medical therapy isn't effective enough (p = 0.007) and high educational level (p = 0.011). In a logistic regression analysis, topical aminosalicylates use (p = 0.004), short disease duration (p = 0.006) and young age (p = 0.027) were identified as significant predictors of non-adherence. Discussion: Young patients, patients with short disease duration and under topical aminosalicyates presented a higher risk for nonadherence to treatment. Conclusions: Gastroenterologist's attention should be focused on the identification of risk factors potentially involved in non-adherence to therapy and in the promotion of measures to improve it.

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An education‐based telehealth group improves the management and clinical outcomes of patients with inflammatory bowel disease in China (THEIM study)

Kang,

Su,

Wang

et al. 2023

UEG Journal

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BackgroundAlthough poor medication adherence has a negative impact on disease prognosis in patients with inflammatory bowel disease (IBD), finding proven solutions remains a challenge. In this study, we developed a telehealth management model based on education and patient‐centered medical care (PCEB) using the social media platform WeChat.ObjectiveTo investigate the effect of PCEB on adherence and clinical outcomes.MethodsIn this retrospective cohort, 543 IBD patients (274 in the PCEB group and 269 in the routine group) at the IBD center of Renmin Hospital (Wuhan University, Wuhan, China) were enrolled between January 2020 and September 2022. The routine group received routine follow‐up and management, while for PCEB patients, a comprehensive IBD education program and PCEB were conducted. Medication adherence and clinical outcomes were also evaluated.ResultsThere were no differences between the PCEB and routine groups in terms of patient demographics and clinical characteristics, including disease classification, duration, biological treatment, and educational background at baseline. Compared with routine treatment, PCEB greatly improved patient medication adherence, as assessed by compliance with oral medication, enteral nutrition, biological infusion, and scheduled endoscopic assessment. Clinical and endoscopic remission in patients with PCEB increased during short‐term (month 4) and long‐term (month 12) follow‐ups, along with a decrease in relapse rates for CD (13.3% vs. 31.8%) and UC (19.8% vs. 37.2%).ConclusionThe telehealth model applied to the PCEB group improved medication adherence and clinical outcomes in patients with IBD. This is a new and powerful solution for the long‐term management of this chronic and progressive disease.

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Factors that modify therapy adherence in patients with inflammatory bowel disease

Abstract: Adherence to therapy in inflammatory bowel disease patients is not satisfactory, and worse in patients treated with mesalazine. Optimizing the information on the disease and giving the medication in one or two daily doses could enhance therapeutic adherence.

Cited by 31 publications

References 30 publications

Factors associated with thiopurine non-adherence in patients with inflammatory bowel disease

Factors associated with thiopurine non-adherence in patients with inflammatory bowel disease

Treatment of Inflammatory Bowel Disease: Is your Patient at Risk of Non-Adherence?

An education‐based telehealth group improves the management and clinical outcomes of patients with inflammatory bowel disease in China (THEIM study)

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