Home Current Issue Previous Issues Published Ahead-of-Print For Authors Journal Info
Skip Navigation LinksHome > September 2013 - Volume 19 - Issue 10 > Modifiable Factors Associated with Nonadherence to Maintenan...
Inflammatory Bowel Diseases:
doi: 10.1097/MIB.0b013e31829ed8a6
Original Clinical Articles

Modifiable Factors Associated with Nonadherence to Maintenance Medication for Inflammatory Bowel Disease

Selinger, Christian P. MD, MSc*,†; Eaden, Jayne MBChB, MD; Jones, D. Brian MD*; Katelaris, Peter MBBS, MD*; Chapman, Grace MBBS*; McDonald, Charles MBBS*; Smith, Paul MBChB§; Lal, Simon BSc, MBChB, PhD; Leong, Rupert W. MBBS, MD*,‖; McLaughlin, John BSc, MBChB, PhD; Robinson, Andrew MBChB, PhD

Collapse Box

Abstract

Background: Poor adherence frequently impaired the efficacy of therapy to maintain remission from inflammatory bowel diseases (IBD). There is a lack of practical and effective interventions to improve adherence. This study aimed to identify modifiable risk factors, which may yield targets for new interventions.

Methods: Participants with IBD were recruited from hospital outpatient clinics and office-based gastroenterologists. Demographic and disease-related data were recorded by means of self-administered questionnaires. Modifiable risk factors were assessed with the validated Belief about Medicine Questionnaire, Hospital Anxiety and Depression Score, and short inflammatory bowel disease questionnaire. Adherence was assessed separately for 5-aminosalicylates, thiopurines, and biological agents using the validated Medicine Adherence Report Scale (good adherence defined as >16).

Results: Nonadherence occurred in 102 of 356 participants (28.7%). Adherence increased significantly with more aggressive therapies (median Medicine Adherence Report Scale: 5-aminosalicylates 18, thiopurines 19, biological 20; P < 0.0001). Nonadherence was not associated with anxiety and depression or disease-related patient knowledge. Adherent patients had significantly higher belief of necessity for medication (P < 0.0001) and a trend toward lower concerns about medication (P = 0.08). Membership of an IBD patient organization was associated with better adherence (P < 0.0001). Concerns about medication rose significantly with more aggressive therapies (P = 0.009), but belief of necessity was similar for all medications.

Conclusions: Nonadherence occurs most frequently with 5-aminosalicylates. Belief of necessity may prove the key target for future interventions, although general IBD education is unlikely to yield an adherence benefit. Patient organization membership should be encouraged.

© Crohn's & Colitis Foundation of America, Inc.

You currently do not have access to this article.

You may need to:

Note: If your society membership provides for full-access to this article, you may need to login on your society’s web site first.

Login

Search for Similar Articles
You may search for similar articles that contain these same keywords or you may modify the keyword list to augment your search.