title: Difficulties in Performing Mesalazine Enemas and Factors Related to Discontinuation Among Patients With Ulcerative Colitis.
abstract: Current first-line treatment of ulcerative colitis consists of a combination of mesalazine enemas and oral mesalazine; however, many patients may discontinue mesalazine enemas. In this single-center, cross-sectional study, 165 outpatients with ulcerative colitis completed a self-administered questionnaire regarding the frequency of mesalazine enemas, difficulties in performing these enemas, and factors possibly associated with their discontinuation, as well as patient clinical and demographic characteristics. Of 165 patients, 34 (20.6%) discontinued mesalazine enemas because of a lack of efficacy. Five of the 13 items assessing difficulties were answered affirmatively by the majority of patients. Discontinuation of enema application was associated with a perceived lack of efficacy, four or more bowel movements per day, and lower scores on measurement of the doctor-patient relationship. Application of mesalazine enemas by patients with ulcerative colitis may be improved by discussions with peers and healthcare professionals and by adjusting the frequency of application or the time of starting the enema based on worsening of ulcerative colitis.
authors.affiliation: Aki Kawakami, PhD, RN, PHN, is Visiting Scholar, Inflammatory Bowel Disease Center, Yokohama City University Medical Center, Yokohama, Japan. Makoto Tanaka, PhD, RN, PHN, is Lecturer, Department of Advanced Clinical Nursing, Graduate School of Medicine, the University of Tokyo, Tokyo, Japan. Ryota Ochiai, PhD, RN, PHN, is Associate Professor, Department of Adult Nursing, Yokohama City University, Yokohama, Japan. Makoto Naganuma, PhD, MD, is Lecturer, Center for Diagnostic and Therapeutic endoscopy, Keio University School of Medicine, Tokyo, Japan. Reiko Kunisaki, PhD, MD, is Associate Professor, Inflammatory Bowel Disease Center, Yokohama City University Medical Center, Yokohama, Japan. Keiko Kazuma, PhD, RN, PHN, is Former Professor, Department of Adult Nursing, Graduate School of Medicine, the University of Tokyo, Tokyo, Japan.
authors.forename: Aki
authors.initials: A
authors.lastname: Kawakami
authors.forename: Makoto
authors.initials: M
authors.lastname: Tanaka
authors.forename: Ryota
authors.initials: R
authors.lastname: Ochiai
authors.forename: Makoto
authors.initials: M
authors.lastname: Naganuma
authors.forename: Reiko
authors.initials: R
authors.lastname: Kunisaki
authors.forename: Keiko
authors.initials: K
authors.lastname: Kazuma
mesh_terms: D000285:Administration, Rectal; D000328:Adult; D003093:Colitis, Ulcerative / Q000175:diagnosis* / Q000188:drug therapy*; D003430:Cross-Sectional Studies; D004733:Enema / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006785:Hospitals, University; D006801:Humans; D007564:Japan; D016015:Logistic Models; D008297:Male; D019804:Mesalamine / Q000627:therapeutic use*; D008875:Middle Aged; D015999:Multivariate Analysis; D010349:Patient Compliance / Q000706:statistics & numerical data*; D010352:Patient Dropouts / Q000706:statistics & numerical data; D010865:Pilot Projects; D012189:Retrospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
chemical_list: D019804:Mesalamine