Practical Strategies for Enhancing Adherence to Treatment Regimen in Inflammatory Bowel Disease

Abstract

Promoting adherence to treatment among pediatric and adult patients with inflammatory bowel disease (IBD) is a critical yet challenging task for health care providers. Several existing interventions to enhance adherence among individuals with IBD offer useful information about practical strategies to enhance adherence. The current review article has 3 goals. First, the review provides a context for understanding treatment regimen adherence in IBD by reviewing key definitional, measurement, and conceptual challenges in this area. Next, published studies focused on interventions to enhance adherence in IBD are briefly summarized, followed by a synthesis of practical adherence promotion strategies for use in IBD by health care providers. Strategies are distinguished by the level of evidence supporting their utility as well as by age group. Finally, recommendations for future research to facilitate the development and implementation of practical, evidence-based strategies for adherence promotion in IBD are provided. Findings from the literature review suggest that strategies including education, regimen simplification, and use of reminder systems and organizational strategies (e.g., pill boxes) are likely to be best suited for addressing accidental nonadherence. In contrast, addressing motivational issues, teaching problem-solving skills, and addressing problematic patterns of family functioning are more likely to benefit individuals displaying intentional nonadherence.

Clinical Pharmacist’s Interventions on Medication Adherence and Knowledge of Inflammatory Bowel Disease Patients

“…So additional care by clinical pharmacist resulted in improved medication adherence. Study conducted by Greenley R et al 26 proved that specific IBD education about its effects and management can possibly enhance patient adherence and improve the patients 'outcome. Majority of our patients had involuntary non-adherence.…”

Adherence and quality of care in IBD

“…A recently published review of IBD that included 10 studies with a total of 1267 patients found that strategies such as education, regimen simplification, reminder systems and organisational strategies seem to increase medical adherence. [11] A simple and inexpensive method of measuring adherence is self-reporting. Moreover, it is most likely that patients reporting non-adherence are being truthful and that the results are valid.…”

Medication Adherence in Children

“…In brief, measuring adherence is very challenging in chronic diseases; there is no gold standard test to assess adherence to oral medication and therefore multi-method approaches are needed to get a true adherence estimate over a period of time [3,10,11].…”