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Inflammatory Bowel Disease Pharmacist Adherence Counseling Improves Medication Adherence in Crohn's Disease and Ulcerative Colitis

Tiao, Darren K. BPharm, MBBS*,†; Chan, Webber MBBS, MRCP*; Jeganathan, Jayson BSc(adv), MBBS*,†; Chan, Jenny T. BPharm*; Perry, Jonathan BPharm*,†; Selinger, Christian P. MD*; Leong, Rupert W. MBBS, MD, AGAF*,†,‡

doi: 10.1097/MIB.0000000000001194
IBD LIVE Articles

Background: While inflammatory bowel diseases (IBD) require long-term medication usage to maintain remission, nonadherence is common and adversely associated with poorer clinical outcomes. Personalized IBD Pharmacist Adherence Counselling, based on the Health Beliefs Model of medication perception, may increase medication adherence.

Methods: This prospective multi-center longitudinal parallel study recruited consecutive IBD subjects that were classified as baseline medication non-adherers and adherers. Non-adherers received a single IBD Pharmacist Adherence Counselling intervention at baseline, while adherers served as controls. Medication Adherence Report Scale and Beliefs about Medicines Questionnaire were administered up to 24 months. Medication acceptance was defined as high perception of medication necessity with low concerns. The primary endpoint was medication adherence at 24 months.

Results: Of 114 subjects approached, 100 completed follow-up, with 36 being baseline nonadherers (median Medication Adherence Report Scale = 15.0) and 64 baseline adherers (median Medication Adherence Report Scale = 19.0; P < 0.001). At 24 months, nonadherence in the IBD Pharmacist Adherence Counselling group decreased from 100% to 44.4% (P = 0.001), whereas nonadherence in controls remained unchanged (P = 0.38). Individually, Beliefs about Medicines Questionnaire Necessity and Concern scores showed no significant changes in both groups, but medication acceptance significantly improved in baseline nonadherers at 12 months (P = 0.031) with a trend toward durable improvement at 24 months (P = 0.063).

Conclusions: Medication nonadherence in IBD can be improved through a single personalized counseling session by an IBD pharmacist, and the benefit was durable for 2 years. This benefit was through improving the acceptance of medication.

Article first Published online 17 July 2017.

*Gastroenterology and Liver Services, Concord Hospital, Sydney, Australia;

Sydney Medical School, The University of Sydney, Sydney, Australia; and

South Western Sydney Clinical School, UNSW, Sydney, Australia.

Address correspondence to: Rupert W. Leong, MBBS, MD, AGAF, Concord Hospital, IBD Services, Hospital Road, Concord NSW 2139, Sydney, Australia (e-mail: rupertleong@outlook.com).

Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Web site (www.ibdjournal.org).

This study was partly supported through an unrestricted educational grant from the Gastroenterological Society of Australia and Shire. There was no influence on the study design, data collection or interpretation or manuscript writing (grant number IST-AUS-000556).

R. W. Leong has served as an advisory board member for AbbVie, Aspen, Celgene, Ferring, Pfizer-Hospira, Janssen, MSD, Takeda, and has received research funding from National Health Medical Research Council, Janssen, Shire Pharmaceuticals and the Gastroenterological Society of Australia. The remaining authors have no conflict of interest to disclose.

Received January 29, 2017

Accepted April 04, 2017

© Crohn's & Colitis Foundation
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