title: Medication non-adherence in adult patients affected by inflammatory bowel disease: a critical review and update of the determining factors, consequences and possible interventions.
abstract: Achieving adherence to medications can be a serious challenge for patients affected by inflammatory bowel disease (IBD). Medical treatment is fundamental for inducing and maintaining remission, preventing flares and reducing the risk of colorectal cancer. Non-adherence may affect patients' quality of life resulting in unfavourable treatment outcomes, more hospitalizations and higher healthcare-related costs. Recognising and improving adherence is therefore a primary aim for the treatment of IBD. Areas covered: We critically discuss the current knowledge on medication non-adherence in adult patients affected by IBD, also mentioning a few issues concerning the paediatric and adolescent populations. In particular, we reviewed the literature focusing on the definition and detection of non-adherence, on its extent and on the possible non-modifiable and modifiable factors involved (patient-centred, therapy-related, disease-related and physician-related). Furthermore, we analysed the interventional studies performed so far. The literature review was conducted through PubMed addressing medication non-adherence in IBD, using the keywords 'adherence' and related terms and 'IBD, ulcerative colitis or Crohn's disease'. Expert commentary: Adherence to therapy for IBD is a complex yet fundamental issue that cannot be solved by addressing a single aspect only. Future studies should focus on patient-tailored and multidimensional interventions.
authors.affiliation: a First Department of Internal Medicine , San Matteo Hospital Foundation; University of Pavia , Pavia , Italy.|b Department of Gastroenterology , Leeds Teaching Hospitals NHS Trust, University of Leeds , Leeds , UK.
authors.forename: Marco Vincenzo
authors.initials: MV
authors.lastname: Lenti
authors.affiliation: b Department of Gastroenterology , Leeds Teaching Hospitals NHS Trust, University of Leeds , Leeds , UK.
authors.forename: Christian P
authors.initials: CP
authors.lastname: Selinger
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior; D000328:Adult; D000367:Age Factors; D000893:Anti-Inflammatory Agents / Q000009:adverse effects / Q000191:economics / Q000627:therapeutic use*; D002648:Child; D002652:Child Behavior; D003093:Colitis, Ulcerative / Q000175:diagnosis / Q000188:drug therapy* / Q000191:economics / Q000523:psychology; D003424:Crohn Disease / Q000175:diagnosis / Q000188:drug therapy* / Q000191:economics / Q000523:psychology; D016527:Drug Costs; D005765:Gastrointestinal Agents / Q000009:adverse effects / Q000191:economics / Q000627:therapeutic use*; D007722:Health Knowledge, Attitudes, Practice; D006297:Health Services Accessibility / Q000191:economics; D006801:Humans; D055118:Medication Adherence; D011788:Quality of Life; D012008:Recurrence; D012074:Remission Induction; D012307:Risk Factors; D012959:Socioeconomic Factors; D016896:Treatment Outcome
chemical_list: D000893:Anti-Inflammatory Agents; D005765:Gastrointestinal Agents
keywords: Adherence; Crohn’s disease; healthcare costs; inflammatory bowel disease; long-term therapy; medication compliance; ulcerative colitis