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Tse CS, Melmed GY, Siegel CA, Weng CH, Shah SA, Weaver SA, Oliver BJ, Elwyn G, van Deen WK. Bidirectional Correlations Between Health Confidence and Inflammatory Bowel Disease Activity: A Nationwide Longitudinal Cohort Study. Inflamm Bowel Dis 2023; 29:161-166. [PMID: 35640124 DOI: 10.1093/ibd/izac107] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Indexed: 02/05/2023]
Abstract
Lay Summary
Health confidence—an individual’s belief in their ability and agency to affect disease outcomes—has bidirectional temporal correlations with inflammatory bowel disease activity. Low health confidence is associated with higher risks for future disease activity, and inflammatory bowel disease flares erode confidence.
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Affiliation(s)
- Chung Sang Tse
- Division of Gastroenterology, University of California, San Diego, La Jolla, CA, USA
| | - Gil Y Melmed
- Inflammatory Bowel and Immunobiology Research Institute, Karsh Division of Digestive and Liver Diseases, Cedars-Sinai, Los Angeles, CA, USA
| | - Corey A Siegel
- Inflammatory Bowel Disease Center, Section of Gastroenterology and Hepatology, Dartmouth Hitchcock Medical Center, Lebanon, NH, USA
| | - Chien-Hsiang Weng
- Department of Family Medicine, Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Samir A Shah
- Division of Gastroenterology, Warren Alpert Medical School of Brown University, Providence, RI, USA.,Gastroenterology Associates, Providence, RI, USA
| | | | - Brant J Oliver
- Department of Community and Family Medicine, Dartmouth Hitchcock Medical Center, Lebanon, NH, USA.,Department of Psychiatry, Dartmouth Hitchcock Medical Center, Lebanon, NH, USA.,Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine at Dartmouth, Lebanon, NH, USA.,Office of Patient Experience, Value Institute Learning Center, Dartmouth Hitchcock Medical Center, Lebanon, NH, USA
| | - Glyn Elwyn
- Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine at Dartmouth, Lebanon, NH, USA
| | - Welmoed K van Deen
- Health Technology Assessment Research Group, Erasmus School of Health Policy and Management, Erasmus University Rotterdam, Rotterdam, the Netherlands
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Yang YX, Zhang L, Zhao YY, Hao N, Wang BB, Lin YP. Self-efficacy of patients with inflammatory bowel disease: A review. Shijie Huaren Xiaohua Zazhi 2022; 30:425-430. [DOI: 10.11569/wcjd.v30.i10.425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Inflammatory bowel disease (IBD) is a chronic, recurrent, and incurable intestinal disease, which is easy to bring heavy physical and mental damage to patients, and self-efficacy is an important factor affecting physical and mental health. This article reviews the self-efficacy of patients with IBD, focusing on the measurement tools, influencing factors, influence on patients, and improvement measures, in order to provide reference for related research in the future.
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Affiliation(s)
- Ya-Xin Yang
- Nursing Department, The Second Affiliated Hospital of Zhengzhou University, Zhengzhou 450014, Henan Province, China
| | - Li Zhang
- Nursing Department, The Second Affiliated Hospital of Zhengzhou University, Zhengzhou 450014, Henan Province, China
| | - Yue-Yue Zhao
- Nursing Department, The Second Affiliated Hospital of Zhengzhou University, Zhengzhou 450014, Henan Province, China
| | - Na Hao
- Department of Gastroenterology, The Second Affiliated Hospital of Zhengzhou University, Zhengzhou 450014, Henan Province, China
| | - Bin-Bin Wang
- Department of Gastroenterology, The Second Affiliated Hospital of Zhengzhou University, Zhengzhou 450014, Henan Province, China
| | - Yu-Peng Lin
- Nursing Department, The Second Affiliated Hospital of Zhengzhou University, Zhengzhou 450014, Henan Province, China
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3
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Kantidakis JD, Moulding R, Knowles SR. Psychological mediators of psychological distress and quality of life in inflammatory bowel disease. J Psychosom Res 2021; 149:110596. [PMID: 34418720 DOI: 10.1016/j.jpsychores.2021.110596] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2020] [Revised: 08/01/2021] [Accepted: 08/03/2021] [Indexed: 12/11/2022]
Abstract
BACKGROUND AND AIMS Using the Common Sense Model (CSM), this study aimed to examine the extent to which illness beliefs, coping styles, self-efficacy, and mindfulness mediate this relationship. METHODS Two hundred and sixty-one adults (198 females; 169 with Crohn's Disease) with IBD participated in this cross-sectional study. Measures used in this study were the short Crohn's Disease Activity Index, Ulcerative Colitis Lichtiger Index, Inflammatory Bowel Disease Questionnaire, New General Self-Efficacy Scale, Carver Brief COPE scale, Mindful Attention Awareness Scale, Brief Illness Perceptions Questionnaire, and the Depression and Anxiety Stress Scales. RESULTS Using structural equation modelling, the final model indicated IBD symptoms had a significant direct influence only on illness perceptions (β = 0.66, p < .001). In turn, illness perceptions had a significant direct influence on depression and anxiety (β = 0.34, p < .001) and QoL (β = -0.67, p < .001), and was also linked to higher maladaptive coping (β = 0.28, p < .001) and lower self-efficacy (β = -0.49, p < .001), but not with mindfulness or adaptive coping (p > .05). Maladaptive coping (β = 0.46, p < .001) and mindfulness (β = 0.23, p < .001) were linked with increased distress. QoL was influenced by distress (β = -0.40, p < .001). CONCLUSIONS Consistent with the predictions of the CSM, the relationships between IBD symptoms and depression and anxiety, and between IBD symptoms and quality of life, are statistically mediated via psychological variables including illness perceptions and maladaptive coping.
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Affiliation(s)
- J D Kantidakis
- Department of Psychology, Swinburne University of Technology, Melbourne, Australia; The Gut Centre, Melbourne, Australia; Department of Gastroenterology, St Vincent's Hospital, Melbourne, Australia
| | - R Moulding
- The Cairnmillar Institute, Melbourne, Australia; Deakin University, Geelong, Australia
| | - S R Knowles
- Department of Psychology, Swinburne University of Technology, Melbourne, Australia; Department of Mental Health, St Vincent's Hospital, Melbourne, Australia; Department of Psychiatry, The University of Melbourne, Melbourne, Australia.
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Braithwaite E, Carbonell J, Kane JS, Gracie D, Selinger CP. Patients' perception of colonoscopy and acceptance of colonoscopy based IBD related colorectal cancer surveillance. Expert Rev Gastroenterol Hepatol 2021; 15:211-216. [PMID: 32981385 DOI: 10.1080/17474124.2021.1829971] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
OBJECTIVES Patients with Inflammatory Bowel Disease (IBD) are at an increased risk of colorectal cancer (CRC). Current surveillance for CRC involves often uncomfortable colonoscopy. To assess IBD patients' perception of colonoscopy and examine preferences for hypothetical alternatives. METHODS IBD patients in clinical remission rated acceptable frequency of colonoscopy and hypothetical alternatives to colonoscopy-based surveillance (preference of yearly blood, yearly stool or 5-yearly imaging tests over 5-yearly colonoscopy). Participants rated discomfort of the last colonoscopy was compared with hospital records. RESULTS Of 282 patients with recollection of colonoscopy 65.8% rated the discomfort as moderate to severe, which correlated weakly with endoscopists' perception (r = 0.225; p = 0.015). There were no significant differences in patients' or endoscopists' perceptions of discomfort between sedated and unsedated colonoscopies. Undergoing a yearly colonoscopy was acceptable to 49.5%. Experienced discomfort did not correlate with patients' views on acceptable frequency of surveillance colonoscopy. Over 95% of patients would prefer blood, stool, or imaging tests over colonoscopy but nearly half expected sensitivities ≥95%. CONCLUSION A large proportion of IBD patients experienced colonoscopy as moderate to severely uncomfortable but would still accept colonoscopy surveillance frequency according to current guidance. Participants expected sensitivities ≥95% for potential alternatives to colonoscopy-based surveillance programs. EXPERT OPINION IBD patients frequently experience colonoscopy as uncomfortable but accept colonoscopy as the gold standard for colorectal cancer surveillance. The currently suggested frequencies of surveillance by colonoscopy are acceptable to IBD patients. They do however express a clear preference for non-invasive surveillance techniques. Some promising initial results have been obtained based on faecal or blood sampling. However, these have yet to be tested in large prospective studies to determine their sensitivity and specificity. IBD patients expect these non-invasive tests to meet high standards for sensitivity. In our view it is feasible that analogue to faecal immunochemistry based testing for general population bowel cancer screening non-invasive IBD surveillance techniques will emerge. This could lead to a reduction in the need for colonoscopy to those testing positive on faecal or blood based surveillance.
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Affiliation(s)
- Eve Braithwaite
- Gastroenterology, Leeds Teaching Hospitals NHS Trust , Leeds, UK
| | | | - John S Kane
- Gastroenterology, Leeds Teaching Hospitals NHS Trust , Leeds, UK
| | - David Gracie
- Gastroenterology, Leeds Teaching Hospitals NHS Trust , Leeds, UK.,Leeds Institute of Medical Research at St James's, University of Leeds , Leeds, UK
| | - Christian P Selinger
- Gastroenterology, Leeds Teaching Hospitals NHS Trust , Leeds, UK.,Leeds Institute of Medical Research at St James's, University of Leeds , Leeds, UK
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Friedman S. DDS Profile: Sonia Friedman, MD. Dig Dis Sci 2019; 64:2703-2705. [PMID: 31388857 DOI: 10.1007/s10620-019-05764-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/09/2022]
Affiliation(s)
- Sonia Friedman
- Division of Gastroenterology, Hepatology and Endoscopy, Brigham and Women's Hospital, 75 Francis Street, Boston, MA, 02115, USA.
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Chao CY, Lemieux C, Restellini S, Afif W, Bitton A, Lakatos PL, Wild G, Bessissow T. Maladaptive coping, low self-efficacy and disease activity are associated with poorer patient-reported outcomes in inflammatory bowel disease. Saudi J Gastroenterol 2019; 25:159-166. [PMID: 30900609 PMCID: PMC6526742 DOI: 10.4103/sjg.sjg_566_18] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND/AIMS Patient-reported outcomes (PRO) are key aspects in the management of inflammatory bowel disease (IBD). This study aims to evaluate factors associated with adverse PRO, including modifiable social constructs of maladaptive coping and self-efficacy as well as physician-patient concordance on PRO. PATIENTS AND METHODS This cross-sectional study was performed in patients with Crohn's disease (CD) or ulcerative colitis (UC) from September 2015 to March 2016. Validated questionnaires were used to assess quality of life (Short IBD Questionnaire), disability (IBD disability index), productivity (work productivity and activity impairment questionnaire), anxiety/depression (Hospital Anxiety and Depression Scale), coping strategies [Brief Coping Operations Preference Enquiry (Brief COPE)], and self-efficacy (General Self-Efficacy Scale). Independent physician assessment was used to compare concordance with patients. RESULTS In all, 207 (CD: 144 and UC: 63) patients, with median age of 39 years, were included, with 42.5% males. Significant proportion of patients reported moderate/severe impairment of disability (30.5%), quality of life (29.4%), productivity (52.4%), anxiety (32.9%) and depression (23.3%). Disease activity and maladaptive coping were independently associated with unfavourable PRO, whereas self-efficacy had a positive effect in multivariate analysis. Physicians could accurately identify the magnitude of PRO impairment in standard clinical settings (r = 0.59-0.65, P < 0.001). CONCLUSION Disease activity and modifiable psychological constructs are associated with unfavorable PRO in patients with IBD. These factors could assist with identifying high-risk patients, many of whom may benefit from targeted interventions to improve health outcomes.
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Affiliation(s)
- Che-Yung Chao
- Division of Gastroenterology, McGill University Health Centre, Montreal, Canada,Department of Gastroenterology and Hepatology, Princess Alexandra Hospital, Brisbane, Australia
| | - Carolyne Lemieux
- Division of Gastroenterology, McGill University Health Centre, Montreal, Canada
| | - Sophie Restellini
- Division of Gastroenterology, McGill University Health Centre, Montreal, Canada,Department of Gastroenterology and Hepatology, Geneva University Hospitals and University of Geneva, Switzerland
| | - Waqqas Afif
- Division of Gastroenterology, McGill University Health Centre, Montreal, Canada
| | - Alain Bitton
- Division of Gastroenterology, McGill University Health Centre, Montreal, Canada
| | - Peter L. Lakatos
- Division of Gastroenterology, McGill University Health Centre, Montreal, Canada,Department of Gastroenterology, Semmelweis University, Budapest, Hungary
| | - Gary Wild
- Division of Gastroenterology, McGill University Health Centre, Montreal, Canada
| | - Talat Bessissow
- Division of Gastroenterology, McGill University Health Centre, Montreal, Canada,Address for correspondence: Dr. Talat Bessissow, Division of Gastroenterology, Montreal General Hospital, McGill University Health Center, 1650 Avenue Cedar C7-200, Montreal, Quebec, H3G 1A4, Canada. E-mail:
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Azulay R, Valinsky L, Hershkowitz F, Magnezi R. Is the patient activation measure associated with adherence to colonoscopy after a positive fecal occult blood test result? Isr J Health Policy Res 2018; 7:74. [PMID: 30577883 PMCID: PMC6303990 DOI: 10.1186/s13584-018-0270-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2018] [Accepted: 12/10/2018] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND Colorectal cancer (CRC) is a major cause of morbidity and mortality worldwide, but these can be reduced significantly with population screening using annual fecal occult blood tests (FOBT)A positive FOBT requires timely follow-up with colonoscopy to maximize screening benefits.. Several barriers to follow-up have been identified, with patient health behaviors and choices comprising a significant part of these. The Patient Activation Measure (PAM) assesses knowledge, skills, beliefs, and confidence in managing health. Increased patient activation is related to positive health outcomes. The aim of this study is to examine the association between patient empowerment, as reflected in the PAM, and follow-up colonoscopy within 90 days of a positive FOBT result. METHODS This case-control study included 429 patients with a positive FOBT, 174 who had a colonoscopy within 90 days, and 255 who did not.. Participants completed a PAM telephone questionnaire (Cronbach's α = 0.785). We used both univariate and multivariate analyses to examine the effect of the PAM score as on the likelihood of undergoing colonoscopy, after adjusting for the independent variables. RESULTS In this study we did not find a significant association between PAM and adherence to colonoscopy, using both univariate and multivariate analyses (p = .334 and p = .697, whether PAM was defined as a continuous or as categorical, respectively). CONCLUSIONS This study was the first to examine the association between patient empowerment, as reflected in the patient activation measure, and adherence to colonoscopy after a positive FOBT. The findings did not support such an association. Further examination is required to clarify the relation between patient empowerment and activation and personal healthcare in general, and in the Israeli population in particular. Future policy should include specific, technical interventions to improve FOBT follow-up among all groups, until the patient-related barriers are better understood. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT02534142 https://clinicaltrials.gov/ct2/show/NCT02534142.
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Affiliation(s)
- Revital Azulay
- Department of Management, MHA Program, Bar Ilan University, Ramat Gan, Israel. .,Central Laboratory, Meuhedet Health Care, 5 Pesach lev, Lod, Israel.
| | - Liora Valinsky
- Quality Department, Meuhedet Health Care, 124 Eben Gvirol, Tel Aviv, Israel
| | | | - Racheli Magnezi
- Department of Management, MHA Program, Bar Ilan University, Ramat Gan, Israel
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Senore C, Bellisario C, Hassan C. Organization of surveillance in GI practice. Best Pract Res Clin Gastroenterol 2016; 30:855-866. [PMID: 27938781 DOI: 10.1016/j.bpg.2016.08.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2016] [Accepted: 08/07/2016] [Indexed: 02/08/2023]
Abstract
BACKGROUND Several reports documented an inefficient utilisation of available resources, as well as a suboptimal compliance with surveillance recommendations. Although, evidence suggests that organisational issues can influence the quality of care delivered, surveillance protocols are usually based on non-organized approaches. METHODS We conducted a literature search (publication date: 01/2000-06/2016) on PubMed and Cochrane Database of Systematic Reviews, Database of Abstracts of Reviews of Effects and Cochrane Central Register of Controlled Trials for guidelines, or consensus statements, for surveys of practice, reporting information about patients, or providers attitudes and behaviours, for intervention studies to enhance compliance with guidelines. Related articles were also scrutinised. Based on the clinical relevance and burden on endoscopy services this review was focused on surveillance for Barrett's oesophagus, IBD and post-polypectomy surveillance of colonic adenomas. RESULTS Existing guidelines are generally recognising structure and process requirements influencing delivery of surveillance interventions, while less attention had been devoted to transitions and interfaces in the care process. Available evidence from practice surveys is suggesting the need to design organizational strategies aimed to enable patients to attend and providers to deliver timely and appropriate care. Well designed studies assessing the effectiveness of specific interventions in this setting are however lacking. Indirect evidence from screening settings would suggest that the implementation of automated standardized recall systems, utilisation of clinical registries, removing financial barriers, could improve appropriateness of use and compliance with recommendations. CONCLUSIONS Lack of sound evidence regarding utility and methodology of surveillance can contribute to explain the observed variability in providers and patients attitudes and in compliance with the recommended surveillance.
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Affiliation(s)
- Carlo Senore
- SC Epidemiologia, Screening, Registro Tumori - CPO, AOU Città della Salute e della Scienza, Torino, Italy.
| | - Cristina Bellisario
- SC Epidemiologia, Screening, Registro Tumori - CPO, AOU Città della Salute e della Scienza, Torino, Italy
| | - Cesare Hassan
- Servizio di Gastroenterologia, Ospedale Nuovo Regina Margherita, Roma, Italy
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Validating a Measure of Patient Self-efficacy in Disease Self-management Using a Population-based IBD Cohort: The IBD Self-efficacy Scale. Inflamm Bowel Dis 2016; 22:2165-72. [PMID: 27542132 DOI: 10.1097/mib.0000000000000856] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
BACKGROUND Self-efficacy describes a person's confidence in their ability to manage demands, and is predictive of health outcomes in chronic disease such as hospitalization and health status. However, meaningful measurement must be domain (e.g., disease) specific. This study aims to provide validation of the Inflammatory Bowel Disease Self-Efficacy scale (IBD-SE), using a population-based IBD sample. METHODS Manitoba IBD Cohort Study participants completed a survey and clinical interview at a mean of 12 years postdiagnosis (n = 121 Crohn's disease; n = 108 ulcerative colitis), which included validated measures of psychological functioning, disability, disease-specific quality of life, perceived health, and current and recent disease activity, in addition to the IBD-SE. RESULTS The IBD-SE had high internal consistency (Cronbach's α = 0.97), and a 4-factor structure was confirmed. Construct validity was demonstrated as follows: the IBD-SE was strongly correlated with mastery (r = 0.53), highly correlated in the expected directions with measures of psychological well-being (r = 0.70), stress (r = -0.78), distress (r = -0.71), disability (r = -0.48), disease-specific quality of life (r = 0.68), and overall perceived health (r = 0.52) (all P < 0.001). Those with currently inactive disease had higher self-efficacy than the active disease group (Crohn's disease: mean = 232 versus 195, P < 0.001; ulcerative colitis: mean = 233 versus 202, P < 0.01), with similar findings for recent symptomatic disease activity. CONCLUSIONS The IBD-SE is a reliable, valid, and sensitive measure as demonstrated in this population-based sample, supporting its utility in IBD. Because self-efficacy is a modifiable psychological characteristic that can contribute to positive health outcomes, the IBD-SE may prove to be a valuable instrument for research and in targeted intervention with IBD patients.
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Treatment Nonadherence in Inflammatory Bowel Disease: Identification, Scope, and Management Strategies. Inflamm Bowel Dis 2015; 21:2979-84. [PMID: 26355470 DOI: 10.1097/mib.0000000000000581] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Treatment adherence is of critical importance in the management of patients with IBD. Poor adherence can lead to increased disease activity, loss of response to therapy, and increased costs of care. It has been well established that adherence to long-term therapy for chronic illnesses is extremely poor, averaging around 50% in developed countries. Measured rates of nonadherence in IBD are similar, but vary depending on the type of therapy and the population being observed. This article reviews the scientific data on treatment nonadherence in IBD. The methods commonly used to evaluate treatment adherence investigation are reviewed. The consequences and scope of treatment nonadherence are summarized. Finally, the scientific data on management strategies to address the problem of treatment nonadherence are explored.
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