Factors that modify therapy adherence in patients with inflammatory bowel disease☆
Received 1 November 2009; received in revised form 4 January 2010; accepted 18 January 2010. published online 15 February 2010. Corrected Proof
Abstract
Objectives
Inflammatory bowel disease is associated with a high risk of deficient adherence to therapy. Our study was designed to analyze the adherence to treatment in a specialized inflammatory bowel disease clinic, and to study which factors could influence it.
Methods
107 consecutive patients (64% Crohn's disease, 36% ulcerative colitis) filled up an anonymous survey with data on demography, disease, therapy and a self-applied adherence declaration.
Results
A 69% (95%CI: 60–77%) showed some type of non-adherence. A 66% (95CI%: 57–75%) acknowledged some involuntary non-adherence: either forgetting to take their dose (63%) or being careless about having taken it (27%). A 16% (95CI%: 9–22%) showed some voluntary non-adherence: interrupting the therapy when feeling better (13%) or when feeling worse (6%). A 25% forgot at least a dose a week in the last 12months. Multivariate analysis identified as risk factors for a lower adherence the dosing in three or more takes a day (OR 3; 95%CI: 1.1–8.4; p=0.03) and feeling little informed about their disease (OR 4.9; 95%CI: 1.1–23.8; p=0.04). Immunomodulator therapy predicted better adherence (OR 0.29; 95%CI: 0.11–0.74; p=0.01).
Conclusions
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.
☆ Data presented previously at 4th Congress of ECCO, Hamburg, 2009 and Digestive Disease Week, 2009, Chicago and published as abstract in Journal of Crohn & Colitis 2009; 3: S49 and Gastroenterology 2009; 136 Supplement 1: A-680.
ABSTRACT
months. Multivariate analysis identified as risk factors for a lower adherence the dosing in three or more takes a day (OR 3; 95%CI: 1.1–8.4; p