title: Current practice and clinicians' perception of medication non-adherence in patients with inflammatory bowel disease: A survey of 98 clinicians.
abstract: OBJECTIVE
  The survey ascertains perceptions and describes current practice of clinicians regarding medication non-adherence in patients with Inflammatory Bowel Disease.
  
  
  METHODS
  Gastroenterologists, trainees and inflammatory bowel disease (IBD) specialist nurses from the United Kingdom were invited to a web based survey collecting data on clinician demographics, patient volume and level of interest in IBD. Respondents were asked to estimate non-adherence levels and report use of screening tools and interventions to improve adherence.
  
  
  RESULTS
  Non-adherence was seen as an infrequent problem by 57% of 98 respondents. Levels of non-adherence were estimated lower than evidence suggests by 29% for mesalazine (5ASA), 26% for immunomodulators (IMM) and 21% for biologics (BIOL). Respondents reporting non-adherence as a frequent problem were more likely to report adherence levels in line with evidence (5ASAP< 0.001; IMMP= 0.012; BIOLP= 0.015). While 80% regarded screening as important only 25% screen regularly (40% of these with validated assessment tools). Respondents stated forgetfulness, beliefs about necessity of medication and not immediately apparent benefits as the main reasons for non-adherence. Patient counselling on benefits and risks of medication was a commonly used intervention.
  
  
  CONCLUSIONS
  Clinicians treating IBD patients frequently underestimate non-adherence and use of validated screening tools is infrequent. Most respondents identified the main factors associated with non-adherence in line with evidence and often counselled patients accordingly. Professional education should focus more on non-adherence practice to avoid adverse treatment outcomes associated with non-adherence.
authors.affiliation: Anisah Soobraty, Sarah Boughdady, Christian P Selinger, IBD Unit, Leeds Gastroenterology Institute, Leeds Teaching Hospitals NHS Trust, Leeds LS9 7TF, United Kingdom.
authors.forename: Anisah
authors.initials: A
authors.lastname: Soobraty
authors.affiliation: Anisah Soobraty, Sarah Boughdady, Christian P Selinger, IBD Unit, Leeds Gastroenterology Institute, Leeds Teaching Hospitals NHS Trust, Leeds LS9 7TF, United Kingdom.
authors.forename: Sarah
authors.initials: S
authors.lastname: Boughdady
authors.affiliation: Anisah Soobraty, Sarah Boughdady, Christian P Selinger, IBD Unit, Leeds Gastroenterology Institute, Leeds Teaching Hospitals NHS Trust, Leeds LS9 7TF, United Kingdom.
authors.forename: Christian P
authors.initials: CP
authors.lastname: Selinger
keywords: Clinical practice; Crohn’s disease; Inflammatory bowel disease; Non-adherence; Ulcerative colitis