Adherence and quality of care in IBD.
OBJECTIVE
In inflammatory bowel disease (IBD), adherence to both medical treatment and other aspects of care has a substantial impact on the course of the disease. Most studies of medical adherence have reported that 30-45% of patients with IBD were non-adherent. Our study aimed to investigate the different aspects of adherence and to identify predictors of non-adherence, including the quality of care, for outpatients with IBD.


METHODS
An anonymous electronic questionnaire was used to investigate different aspects of adherence, the quality of care, patient involvement and shared decision making among 377 IBD outpatients.


RESULTS
Three hundred (80%) filled in the questionnaire. The overall adherence rate was 93%. Young age (< 35 years old) and smoking were significantly associated with non-adherence (prevalence odds ratio (POR) 2.98, 95% CI 1.04-8.52, p < 0.05 and POR 3.88, 95% CI 1.36-11.05, p < 0.05, respectively). The lowest medical adherence rates were found for 5-ASA and topical treatments among patients with inactive disease. A large majority of patients stated that treatment strategies were agreed upon as a shared decision between the patient and the health care professionals.


CONCLUSIONS
Predictors for non-adherence were young age and smoking. High adherence rates could be explained by a high patient satisfaction and a high degree of shared decision making.
a Department of Hepatology and Gastroenterology V , Aarhus University Hospital , Aarhus C , Denmark.
Palle
P
Bager
a Department of Hepatology and Gastroenterology V , Aarhus University Hospital , Aarhus C , Denmark.
Mette
M
Julsgaard
a Department of Hepatology and Gastroenterology V , Aarhus University Hospital , Aarhus C , Denmark.
Thea
T
Vestergaard
a Department of Hepatology and Gastroenterology V , Aarhus University Hospital , Aarhus C , Denmark.
Lisbet Ambrosius
LA
Christensen
a Department of Hepatology and Gastroenterology V , Aarhus University Hospital , Aarhus C , Denmark.
Jens Frederik
JF
Dahlerup
D000328:Adult; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000145:classification / Q000627:therapeutic use*; D003657:Decision Making; D003718:Denmark; D005260:Female; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000188:drug therapy*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D017060:Patient Satisfaction; D011787:Quality of Health Care / Q000592:standards*; D012307:Risk Factors; D011795:Surveys and Questionnaires; D062606:Tertiary Care Centers; D055815:Young Adult; D016903:Drug Monitoring
D000894:Anti-Inflammatory Agents, Non-Steroidal
Adherence; Crohn’s disease; decision making; inflammatory bowel disease; patient compliance; quality of health care; ulcerative colitis