The complexity of evaluating and increasing adherence in inflammatory bowel disease

Factors influencing medication adherence among patients with idiopathic inflammatory bowel disease in Greece and Cyprus: a cross-sectional study

OBJECTIVE

. Aim: To examine the level of medication adherence among individuals diagnosed with inflammatory bowel disease (IBD) in Greece and Cyprus and assess the demographic, clinical, and psychosocial variables affecting it.

PATIENTS AND METHODS

Materials and Methods: An anonymous self-administered questionnaire was administered to adult patients attending hospitals and treatment centers in Greece and Cyprus.

RESULTS

Results: From the total of 150 participants, 48.7% of patients took their medication when they had no symptoms, compared to 84% of symptomatic patients. For almost half of the patients, the main reason for non-adherence was daily obligations, while for 40.7% the reported reason was treatment-related side effects. 51.3% of the patients stated that they didn't require any assistance or reminders to improve their adherence. Adherence and reasons for not regularly taking medications were associated with sex, age, type, and duration of the disease as well as the type of treatment received.

CONCLUSION

Conclusions: According to the findings of our study, patients perceived various obstacles, such as daily obligations and the side effects of prescribed drugs, which hindered their adherence to treatment. Adherence levels were found to be associated with demographic, disease-related, and treatment-related factors. These results underscore the importance of implementing timely and targeted interventions to enhance treatment adherence among patients with IBD.

Thiopurine adherence: high prevalence with low impact in UC outcomes

Introduction Thiopurines are used as maintenance therapy in patients with ulcerative colitis (UC). There are contradictory results regarding the relationship between adherence to treatment and risk of relapse. Objectives To quantify and evaluate the trends in thiopurines prescription rates, and to determine the impact and risk factors of non-adherence. Methods Analytical, observational and retrospective study of UC patients, on thiopurines, included in the ENEIDA single-center registry from October 2017 to October 2019. We included adult patients under clinical remission at the beginning of the study on thiopurines maintenance treatment for at least 6 months before recruitment. Adherence was evaluated with an electronic pharmaceutical prescription system. Adherence was considered when 80% or more of the prescribed medication was dispensed at the pharmacy. Kaplan-Meier curves and a regression model were used to examine year-to-year treatment dispensation and identify factors associated to non-adherence. Results A total of 41 patients were included, of whom 71% were males with a mean age of 44 (14) and 26.8% were concomitantly managed with biological therapy. Overall, 22% were non-adherent to thiopurines. No predictive factors of non-adherence were identified. Adherence rate did not correlate with disease activity for two years follow-up (OR 1.6; 95CI =0.3-9.1). Left-sided colitis and concomitant biological treatment were related with disease relapses (p ≤0.01). Conclusion The adherence to thiopurines in UC patients is high (78%). Non-adherence is not related to clinical or pharmacological factors. Adherence rate was not associated with disease activity.