Treatment Adherence in Inflammatory Bowel Disease Patients from Argentina: A Multicenter Study

Abstract

Background and Aim. Treatment adherence is a frequent problem in inflammatory bowel disease (IBD). No study has assessed adherence in Argentinian patients with IBD. The aim of this study was to determine inadequate adherence to oral and parenteral therapies in patients with IBD from Argentina and to identify factors associated with it. Methods. A multicenter cross-sectional study involving seven referral centers from three cities of Argentina was undertaken. Patients with a diagnosis of ulcerative colitis (UC), Crohn’s disease (CD), or indeterminate colitis (IBDU/IC) were invited to answer an anonymous survey, which included a 5-point Likert scale to evaluate adherence to therapies. Independent variables associated with inadequate adherence were evaluated. Results. Overall, 447 UC/IBDU and 135 CD patients were enrolled. Median age was 37 years (range 21-72); 39.8% were male; median time from diagnosis was 6 years (0.5-35). 91.4% were under treatment with at least one oral medication; 50.3% of patients reported inadequate adherence to oral medications. Patients with UC/IBDU had a lower risk of inadequate adherence when compared to patients with CD (OR 0.57 (0.37-0.87)). 21.8% reported inadequate adherence to biologics; subcutaneous administration was significantly associated with inadequate adherence to biologics (OR 4.8 (1.57-14.66)). Conclusion. Inadequate treatment adherence is common among patients with IBD, and potentially modifiable factors were identified.

Patients’ perspectives on medication for inflammatory bowel disease: a mixed-method systematic review

“…Mikocka-Walus et al [64] identified increases in medication usage after the introduction of an IBD dedicated nurse. Furthermore, the role of IBD nurses is an essential component of integrated models of care (IMC); a model of care for IBD that can increase healthcare access, improve medication adherence, and improve other healthcare outcomes [65][66][67]. In fact, IMC for IBD are recommended due to their multiple positive impacts on patient outcomes [68][69][70].…”

IBD barriers across the continents: a continent-specific analysis: Latin America

“…Biologic use was seen in 24.8% (111/447) and 33.3% (45/135) of the patients with UC and CD, respectively ( p = 0.06). 28 Inadequate adherence to biologics was seen in 15.3% of patients (19.5% in UC versus 24% in CD, p = 0.6). The risk of inadequate adherence to biologics was significantly lower than oral 5-aminosalicylates (OR 4.1; 95% CI 2.7–6.3) and thiopurines (OR 1.7; 95% CI 1.1–2.7).…”

“…The risk of inadequate adherence to biologics was significantly lower than oral 5-aminosalicylates (OR 4.1; 95% CI 2.7–6.3) and thiopurines (OR 1.7; 95% CI 1.1–2.7). 28 …”

Chemoprevention with a tea from hawthorn (Crataegus oxyacantha) leaves and flowers attenuates colitis in rats by reducing inflammation and oxidative stress

“…Such diseases possess a high prevalence in Europe and are increasing at a high incidence rate since the ’90s in newly industrialized countries, such as Brazil and Taiwan ( Ng et al, 2017 ). Treatment options for IBDs are commonly not well accepted or tolerable for a great part of patients ( Horne et al, 2009 , Lasa et al, 2020 , Pieper et al, 2009 ), suggesting the need for studies capable of proving new effective options. From our knowledge, four studies to date have attested the positive effects of hawthorn in IBDs; however, these investigations used the fruits, not the leaves or flowers, and distinct hawthorn species ( Fujisawa et al, 2005 , Guo et al, 2021 , Liu et al, 2020 , Malekinejad et al, 2013 ).…”