Factors that modify therapy adherence in patients with inflammatory bowel disease.
OBJECTIVE
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% (95 CI%: 57-75%) acknowledged some involuntary non-adherence: either forgetting to take their dose (63%) or being careless about having taken it (27%). A 16% (95 CI%: 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 12 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=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.
Department of Gastroenterology, Hospital Universitario de Fuenlabrada, Fuenlabrada, Madrid, Spain. fbermejos@medynet.com
Fernando
F
Bermejo
Antonio
A
López-San Román
Alicia
A
Algaba
Iván
I
Guerra
Paz
P
Valer
Silvia
S
García-Garzón
Belén
B
Piqueras
Carlos
C
Villa
Andrea
A
Bermejo
José L
JL
Rodríguez-Agulló
D000328:Adult; D003093:Colitis, Ulcerative / Q000188:drug therapy / Q000523:psychology; D003424:Crohn Disease / Q000188:drug therapy / Q000523:psychology; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage / Q000627:therapeutic use; D015212:Inflammatory Bowel Diseases / Q000188:drug therapy* / Q000523:psychology; D008297:Male; D055118:Medication Adherence / Q000523:psychology; D015999:Multivariate Analysis; D016017:Odds Ratio; D010353:Patient Education as Topic
D007166:Immunosuppressive Agents