Impact of a patient-support program on mesalamine adherence in patients with ulcerative colitis — A prospective study☆
Received 29 September 2009; received in revised form 7 October 2009; accepted 8 October 2009. published online 18 November 2009.
Abstract
Background
Patient adherence to medications, particularly mesalamine, is reported to be low in patients with ulcerative colitis. We sought to determine whether a nurse-delivered patient-support program could improve medication adherence in these patients.
Methods
Patients prescribed mesalamine for ulcerative colitis prospectively received either a 23week, nurse-delivered, patient support program (PSP) by phone, or standard care (SC). Medication adherence and quality of life were measured before and at 3 and 6months after the program started.
Results
Eighty-one patients completed the study; 60 who received standard care, and 21 who received the PSP. Patients were in remission (mean SCAI score 3) at enrollment. Mean % of prescribed mesalamine refilled was 71% and 74% in the SC and PSP groups at 3months (p=0.7), and 73% and 84% at 6months (p=0.4). The proportion of adherent patients at 3months (39% vs 44%, p=0.7) and 6months (50% vs 67%, p=0.3) were similar between the SC and PSP groups. There was no association between use of the PSP and adherence at 3 (OR 1.2, 95% CI 0.4 to 3.8) or 6months (OR 2, 95% CI 0.6 to 7). The change from baseline in SIBDQ scores were similar between SC and PSP groups at 3months (+0.3 vs +0.2, p=0.8), and 6months (+0.6 vs +0.2, p=0.2).
Conclusions
This nurse-delivered patient-support program did not significantly improve medication adherence or quality-of-life beyond standard care at short and medium-term time-points. Simply discussing and measuring adherence improved mesalamine adherence in both groups in this study.
ABSTRACT