title: Treatment of inflammatory bowel disease: is your patient at risk of non-adherence?
abstract: BACKGROUND
  Adherence to therapy is a key factor when analyzing the efficacy of a treatment in clinical practice. The aim of our study was to assess the frequency of non-adherence to treatment among patients with inflammatory bowel disease and evaluate which factors could be related.
  
  
  METHODS
  One hundred thirty eight consecutive inflammatory bowel disease outpatients (55.8% with Crohn's disease and 44.2% with Ulcerative Colitis) filled in an anonymous questionnaire, which included information about demography, duration of the disease, specific therapy for inflammatory bowel disease, and data possibly related to extent of non-adherence to treatment. Statistics were performed with SPSS v.18.0. Categorical variables were compared with Fisher's exact test. A p value < 0.05 was considered statistically significant. Significant variables in univariate analysis were included in the logistic regression analysis.
  
  
  RESULTS
  Overall non-adherence was reported by 29.7% of patients. 70.7% of them reported unintentional non-adherence and 51.2% forgot at least one dose per week. Non-adherence was statistically associated with: short disease duration (p < 0.001); young age (p = 0.001); topical aminosalicylates (p = 0.005); the perception that medical therapy isn't effective enough (p = 0.007) and high educational level (p = 0.011). In a logistic regression analysis, topical aminosalicylates use (p = 0.004), short disease duration (p = 0.006) and young age (p = 0.027) were identified as significant predictors of non-adherence.
  
  
  CONCLUSIONS
  Young patients, patients with short disease duration and under topical aminosalicyates presented a higher risk for nonadherence to treatment.
  
  
  CONCLUSIONS
  Gastroenterologist's attention should be focused on the identification of risk factors potentially involved in non-adherence to therapy and in the promotion of measures to improve it.
authors.affiliation: Serviço de Gastrenterologia. Centro Hospitalar do Alto Ave. Guimarães. Portugal.
authors.forename: Joana
authors.initials: J
authors.lastname: Magalhães
authors.affiliation: Serviço de Gastrenterologia. Centro Hospitalar do Alto Ave. Guimarães. Portugal.
authors.forename: Francisca
authors.initials: F
authors.lastname: Dias de Castro
authors.affiliation: Serviço de Gastrenterologia. Centro Hospitalar do Alto Ave. Guimarães. Portugal.
authors.forename: Pedro
authors.initials: P
authors.lastname: Boal Carvalho
authors.affiliation: Serviço de Gastrenterologia. Centro Hospitalar do Alto Ave. Guimarães. Portugal.
authors.forename: Sílvia
authors.initials: S
authors.lastname: Leite
authors.affiliation: Serviço de Gastrenterologia. Centro Hospitalar do Alto Ave. Guimarães. Portugal.
authors.forename: Maria João
authors.initials: MJ
authors.lastname: Moreira
authors.affiliation: Serviço de Gastrenterologia. Centro Hospitalar do Alto Ave. Guimarães. Portugal. Life and Health Sciences Research Institute. School of Health Sciences. University of Minho. Braga. Portugal. ICVS/3Bâs PT Government Associate Laboratory. Braga/Guimarães. Portugal.
authors.forename: José
authors.initials: J
authors.lastname: Cotter
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance / Q000706:statistics & numerical data*; D012307:Risk Factors; D055815:Young Adult