Treatment of Inflammatory Bowel Disease: Is your Patient at Risk of Non-Adherence?

Authors

  • Joana Magalhães Serviço de Gastrenterologia. Centro Hospitalar do Alto Ave. Guimarães. Portugal.
  • Francisca Dias de Castro Serviço de Gastrenterologia. Centro Hospitalar do Alto Ave. Guimarães. Portugal.
  • Pedro Boal Carvalho Serviço de Gastrenterologia. Centro Hospitalar do Alto Ave. Guimarães. Portugal.
  • Sílvia Leite Serviço de Gastrenterologia. Centro Hospitalar do Alto Ave. Guimarães. Portugal.
  • Maria João Moreira Serviço de Gastrenterologia. Centro Hospitalar do Alto Ave. Guimarães. Portugal.
  • José Cotter Serviço de Gastrenterologia. Centro Hospitalar do Alto Ave. Guimarães. Portugal. Life and Health Sciences Research Institute. School of Health Sciences. University of Minho. Braga. Portugal. ICVS/3B’s PT Government Associate Laboratory. Braga/Guimarães. Portugal.

DOI:

https://doi.org/10.20344/amp.5090

Abstract

Introduction: Adherence to therapy is a key factor when analyzing the efficacy of a treatment in clinical practice. The aim of our study was to assess the frequency of non-adherence to treatment among patients with inflammatory bowel disease and evaluate which factors could be related.
Material and Methods: One hundred thirty eight consecutive inflammatory bowel disease outpatients (55.8% with Crohn’s disease and 44.2% with Ulcerative Colitis) filled in an anonymous questionnaire, which included information about demography, duration of the disease, specific therapy for inflammatory bowel disease, and data possibly related to extent of non-adherence to treatment. Statistics were performed with SPSS v.18.0. Categorical variables were compared with Fisher’s exact test. A p value < 0.05 was considered statistically significant. Significant variables in univariate analysis were included in the logistic regression analysis.
Results: Overall non-adherence was reported by 29.7% of patients. 70.7% of them reported unintentional non-adherence and 51.2% forgot at least one dose per week. Non-adherence was statistically associated with: short disease duration (p < 0.001); young age (p = 0.001); topical aminosalicylates (p = 0.005); the perception that medical therapy isn’t effective enough (p = 0.007) and high educational level (p = 0.011). In a logistic regression analysis, topical aminosalicylates use (p = 0.004), short disease duration (p = 0.006) and young age (p = 0.027) were identified as significant predictors of non-adherence.
Discussion: Young patients, patients with short disease duration and under topical aminosalicyates presented a higher risk for nonadherence to treatment.
Conclusions: Gastroenterologist’s attention should be focused on the identification of risk factors potentially involved in non-adherence to therapy and in the promotion of measures to improve it.


Keywords: Inflammatory Bowel Disease; Crohn Disease; Colitis, Ulcerative; Patient Compliance; Risk Factors; Treatment Refusal.

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Author Biographies

Joana Magalhães, Serviço de Gastrenterologia. Centro Hospitalar do Alto Ave. Guimarães. Portugal.

Francisca Dias de Castro, Serviço de Gastrenterologia. Centro Hospitalar do Alto Ave. Guimarães. Portugal.

Pedro Boal Carvalho, Serviço de Gastrenterologia. Centro Hospitalar do Alto Ave. Guimarães. Portugal.

Sílvia Leite, Serviço de Gastrenterologia. Centro Hospitalar do Alto Ave. Guimarães. Portugal.

Maria João Moreira, Serviço de Gastrenterologia. Centro Hospitalar do Alto Ave. Guimarães. Portugal.

José Cotter, Serviço de Gastrenterologia. Centro Hospitalar do Alto Ave. Guimarães. Portugal. Life and Health Sciences Research Institute. School of Health Sciences. University of Minho. Braga. Portugal. ICVS/3B’s PT Government Associate Laboratory. Braga/Guimarães. Portugal.

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Published

2014-09-25

How to Cite

1.
Magalhães J, Dias de Castro F, Boal Carvalho P, Leite S, Moreira MJ, Cotter J. Treatment of Inflammatory Bowel Disease: Is your Patient at Risk of Non-Adherence?. Acta Med Port [Internet]. 2014 Sep. 25 [cited 2024 Nov. 22];27(5):576-80. Available from: https://actamedicaportuguesa.com/revista/index.php/amp/article/view/5090