Predictors of persistence with 5-aminosalicylic acid therapy for ulcerative colitis.
BACKGROUND
Individuals with ulcerative colitis (UC) are at risk for poor persistence with therapy.


OBJECTIVE
To identify factors predicting persistence with 5-aminosalicylic acid (5-ASA) therapy after 3 and 12 months in subjects with UC.


METHODS
In this retrospective cohort study, persistence with 5-ASA therapy was determined from prescription refill data from a commercial health insurance claims database. The analysis included subjects with UC who filled a prescription for any oral 5-ASA between October 2002 and September 2004. Persistence was defined as prescription refill at 3 and/or 12 months. Multivariate logistic regression modelling identified variables independently associated with persistence at 3 and 12 months.


RESULTS
In all, 3574 subjects were identified. Fifty-seven per cent (2044) were persistent at 3 months. Glucocorticoid use before the index prescription predicted improved persistence at 3 months. Psychiatric diagnosis, mail order of the index prescription, female gender and co-pay predicted decreased persistence. At 12 months, 1124 (55%) remained persistent. Rectal 5-ASA use, older age and switching to a different 5-ASA predicted improved persistence at 12 months. Hospitalization for a gastrointestinal condition, mail order of the 3-month prescription and number of co-morbid illnesses predicted lower persistence.


CONCLUSIONS
Persistence with 5-ASA treatment in UC is complex and multifactorial, and differs by time period.
Kane
S V
SV
Mayo Clinic College of Medicine, Mayo Clinic, Rochester, MN 55905, USA. kane.sunanda@mayo.edu
Accortt
N A
NA
Magowan
S
S
Brixner
D
D
D000293:Adolescent; D000328:Adult; D000368:Aged; D000636:Aminosalicylic Acids / Q000627:therapeutic use*; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use*; D015331:Cohort Studies; D003093:Colitis, Ulcerative / Q000188:drug therapy*; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D055118:Medication Adherence; D008875:Middle Aged; D055656:Prescriptions; D012189:Retrospective Studies; D055815:Young Adult
D000636:Aminosalicylic Acids; D000894:Anti-Inflammatory Agents, Non-Steroidal