Review article: medication non-adherence in ulcerative colitis--strategies to improve adherence with mesalazine and other maintenance therapies.
BACKGROUND
Significant number of patients with ulcerative colitis (UC) fail to comply with treatment.


OBJECTIVE
To review issues surrounding medication non-adherence in inflammatory bowel disease (IBD), including the clinical and health service implications in the UK, and discuss strategies for optimizing medication adherence.


METHODS
Articles cited were identified via a PubMed search, utilizing the words IBD, adherence, compliance, medication and UC.


RESULTS
Medication non-adherence is multifactorial involving factors other than dosing frequency. Male gender (OR: 2.06), new patient status (OR: 2.14), work and travel pressures (OR: 4.9) and shorter disease duration (OR: 2.1), among others are proven predictors of non-adherence in UC. These indicators can identify 'at-risk' patients and allow an individually tailored treatment approach to be introduced that optimizes medication adherence. A collaborative relationship between physician and patient is important; several strategies for improving adherence have been proven effective including open dialogue that takes into consideration the patient's health beliefs and concerns, providing educational (e.g. verbal/written information, self-management programmes) and behavioural interventions (e.g. calendar blister packs, cues/reminders).


CONCLUSIONS
Educational and behavioural interventions tailored to individual patients can optimize medication adherence. Additional studies combining educational and behavioural interventions may provide further strategies for improving medication adherence rates in UC.
Hawthorne
A B
AB
Department of Medicine, University Hospital of Wales, Heath Park, Cardiff, UK. barney.hawthorne@cardiffandvale.wales.nhs.uk
Rubin
G
G
Ghosh
S
S
D000328:Adult; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage*; D003093:Colitis, Ulcerative / Q000188:drug therapy* / Q000523:psychology; D005260:Female; D017048:Health Care Costs; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000188:drug therapy* / Q000523:psychology; D008297:Male; D019804:Mesalamine / Q000008:administration & dosage*; D010353:Patient Education as Topic; D010817:Physician-Patient Relations; D011237:Predictive Value of Tests; D055502:Secondary Prevention; D016312:Treatment Refusal / Q000523:psychology; D006113:United Kingdom
D000894:Anti-Inflammatory Agents, Non-Steroidal; D019804:Mesalamine