Impact of a patient-support program on mesalamine adherence in patients with ulcerative colitis--a prospective study.
BACKGROUND
Patient adherence to medications, particularly mesalamine, is reported to be low in patients with ulcerative colitis. We sought to determine whether a nurse-delivered patient-support program could improve medication adherence in these patients.


METHODS
Patients prescribed mesalamine for ulcerative colitis prospectively received either a 23 week, nurse-delivered, patient support program (PSP) by phone, or standard care (SC). Medication adherence and quality of life were measured before and at 3 and 6 months after the program started.


RESULTS
Eighty-one patients completed the study; 60 who received standard care, and 21 who received the PSP. Patients were in remission (mean SCAI score 3) at enrollment. Mean % of prescribed mesalamine refilled was 71% and 74% in the SC and PSP groups at 3 months (p=0.7), and 73% and 84% at 6 months (p=0.4). The proportion of adherent patients at 3 months (39% vs 44%, p=0.7) and 6 months (50% vs 67%, p=0.3) were similar between the SC and PSP groups. There was no association between use of the PSP and adherence at 3 (OR 1.2, 95% CI 0.4 to 3.8) or 6 months (OR 2, 95% CI 0.6 to 7). The change from baseline in SIBDQ scores were similar between SC and PSP groups at 3 months (+0.3 vs +0.2, p=0.8), and 6 months (+0.6 vs +0.2, p=0.2).


CONCLUSIONS
This nurse-delivered patient-support program did not significantly improve medication adherence or quality-of-life beyond standard care at short and medium-term time-points. Simply discussing and measuring adherence improved mesalamine adherence in both groups in this study.
Center for Inflammatory Bowel Disease, Beth Israel Deaconess Medical Center, Rose 1 / East, BIDMC, 330 Brookline Ave, Boston, MA 02215, United States. amoss@bidmc.harvard.edu
Alan C
AC
Moss
Nabeel
N
Chaudhary
Melissa
M
Tukey
Jahvari
J
Junior
Didia
D
Cury
Kenneth R
KR
Falchuk
Adam S
AS
Cheifetz
D000328:Adult; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use*; D015331:Cohort Studies; D003093:Colitis, Ulcerative / Q000188:drug therapy* / Q000451:nursing*; D005260:Female; D006801:Humans; D008297:Male; D055118:Medication Adherence; D019804:Mesalamine / Q000627:therapeutic use*; D008875:Middle Aged; D011446:Prospective Studies; D011788:Quality of Life; D012720:Severity of Illness Index; D012944:Social Support
D000894:Anti-Inflammatory Agents, Non-Steroidal; D019804:Mesalamine