Medication adherence and quality of life in pediatric inflammatory bowel disease.
OBJECTIVE
To examine the relationship between medication adherence and quality of life (QOL) in adolescent patients with inflammatory bowel disease (IBD) utilizing a multimethod adherence assessment approach.


METHODS
Medication adherence in 36 adolescents with IBD was assessed via interviews, pill counts, and biological assays. QOL was assessed via patient and parent report. Pediatric gastroenterologists provided disease severity assessments.


RESULTS
Hierarchical multiple regression analyses revealed that adherence contributed significant variance to patient-reported QOL but not parent-reported QOL. Nonadherence to 6-MP/azathioprine was related to poorer patient-reported physical health QOL. Greater self-reported 5-ASA adherence was related to poorer overall psychological health QOL, and particularly social functioning QOL.


CONCLUSIONS
Results provide preliminary support for the negative effects of 6-MP/azathioprine nonadherence on QOL and an inverse relationship between 5-ASA adherence and QOL in this population. Adherence burden in patients and the utility of multimethod adherence assessment in research are discussed.
Hommel
Kevin A
KA
Cincinnati Children's Hospital Medical Center, Center for the Promotion of Treatment Adherence and Self Management, Division of Behavioral Medicine and Clinical Psychology, 3333 Burnet Ave. MLC 7039, Cincinnati, OH 45229, USA. kevin.hommel@cchmc.org
Davis
Christine M
CM
Baldassano
Robert N
RN
D000293:Adolescent; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage* / Q000009:adverse effects; D001379:Azathioprine / Q000008:administration & dosage* / Q000009:adverse effects; D003093:Colitis, Ulcerative / Q000188:drug therapy* / Q000523:psychology*; D003424:Crohn Disease / Q000188:drug therapy* / Q000523:psychology*; D003863:Depression / Q000175:diagnosis / Q000523:psychology; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D005260:Female; D006150:Guanine Nucleotides / Q000008:administration & dosage* / Q000009:adverse effects; D006801:Humans; D055809:Illness Behavior; D008297:Male; D055118:Medication Adherence / Q000523:psychology*; D015122:Mercaptopurine / Q000008:administration & dosage* / Q000009:adverse effects; D019804:Mesalamine / Q000008:administration & dosage* / Q000009:adverse effects; D011788:Quality of Life / Q000523:psychology*; D013873:Thionucleotides / Q000008:administration & dosage* / Q000009:adverse effects
D000893:Anti-Inflammatory Agents; D006150:Guanine Nucleotides; D013873:Thionucleotides; C003964:6-thioguanylic acid; D019804:Mesalamine; D015122:Mercaptopurine; D001379:Azathioprine