Researching Interventions to Improve Medication Adherence in Ulcerative Colitis Patients

Pacheco, Mila Palma; Fortes, Flora Maria Lorenzo; Santos, Raquel Rocha; Santana, Genoile Oliveira

doi:10.1055/s-0041-1724053

Cited by 3 publications

(1 citation statement)

References 25 publications

(66 reference statements)

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“…Introducing a collaborative approach involving patients in decision-making regarding their medications, so that they have a sense of ownership of their treatment plan is of key importance [28]. Secondly, behavioural interventions [29] such as using the most simplified treatment regimen have demonstrated to be effectiveonce daily high dose tablets regimens are now the norm for the treatment of UC [30][31][32], and are recommended in treatment guidelines [16,33]. Lastly, monitoring medication adherence should be part of patient follow-up visits [28].…”

Section: Discussionmentioning

confidence: 99%

Medication Formulation Preference of Mild and Moderate Ulcerative Colitis Patients: a European Survey

Hébuterne¹,

Vavricka²,

Thorne³

et al. 2023

Inflamm Intest Dis

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Introduction: Patient adherence is a major challenge for the successful management of any chronic disease, and ulcerative colitis (UC) is no exception. Patient adherence is closely related to patient preference of medication and formulation used. Aim: The aim of this study was to investigate patient and physician perspectives around UC treatment preference. Methods: This study was conducted in France, Germany, Spain, and the UK. Physicians and UK inflammatory bowel disease (IBD) nurses answered an online questionnaire. In addition, adult mild-to-moderate UC patients, treated with oral mesalazine, were invited to answer a 30-min online survey which included a conjoint exercise. Results: 400 patients, 160 physicians, and 20 IBD nurses participated in the survey. 68% of patients were taking tablets and 32% granules. Physicians stated that from their perspective patients are more adherent to tablets than granules (76% vs. 24%), patients tended to have better relief of symptoms with tablets (69% vs. 31%), and patients found tablets to be the most convenient formulation (61% vs. 39%). From the patients’ perspective, when questioned which formulation they prefer, 58% answered tablets, 37% granules, and 5% none of these. When patients were asked about some negative attributes of tablets, the highest agreement was for “I would like to take fewer each day” (6.1/10) and “I wish I could take fewer at a time” (5.4/10). Conclusions: The majority of UC patients in this survey prefer the tablet formulation. A high strength tablet overcoming the high pill burden could be a good solution to address patient expectations.

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Section: Discussionmentioning

confidence: 99%

Medication Formulation Preference of Mild and Moderate Ulcerative Colitis Patients: a European Survey

Hébuterne¹,

Vavricka²,

Thorne³

et al. 2023

Inflamm Intest Dis

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Impact of an intervention program on drug adherence in patients with ulcerative colitis: Randomized clinical trial

Pacheco,

Sá,

Santos

et al. 2023

PLoS ONE

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Aims Evaluate the impact of an intervention program in non-adherent patients with ulcerative colitis. Methods Parallel controlled randomized clinical trial (1:1), approved by the ethics committee (No. 3.068.511/2018) and registered at The Brazilian Clinical Trials Registry (No. RBR-79dn4k). Non-adherent ulcerative colitis patients according to the Morisky-Green-Levine-test were included. Recruitment began in August 2019 until August 2020, with 6-month follow-up. All participants received standard usual care, and additionally the intervention group received educational (video, educational leaflet, verbal guidance) and behavioral interventions (therapeutic scheme, motivational and reminder type short message services). Researchers were blinded for allocation prior to data collection at Visits 1 and 2 (0 and 6 months). Primary outcome: 180-day adherence rate, with relative risk 95%CI. Secondary outcome: 180-day quality of life according to SF-36 domains, using Student’s t test. Variables with p<0.20 were selected for regression. Analysis included data from August/2019 to May/2021. Results Forty-six and 49 participants were allocated in control and intervention groups, respectively. Two were excluded due to intervention refusal, and 4 and 6 were lost to follow-up in control and intervention groups. There was no post-intervention adherence rate difference, even after adjustment for type of non-adherence (unintentional/both/intentional) as confounder, or if considered as adherent the intervention group participants lost in follow-up. Interventions promoted better quality of life scores even after multivariate analysis for “Pain”, when adjusted for ulcerative colitis severity, sex, and marital status (β = 18.352, p = 0.004), “Vitality”, when adjusted for ulcerative colitis severity (β = 10.568, p = 0.015) and “Emotional Aspects”, when adjusted for disease severity, income, and education (β = 24.907, p = 0.041). Conclusions The intervention program was not able to produce a significant medication adherence rate difference between comparative groups, however, there was a significant improvement in quality of life. Study limitations may include: sample size calculated to identify differences of 30%, leading to a possible insufficient power; non blinded participants, exposing the results to the risk of performance bias; outcomes based on self-reported data.

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Drug survival and adherence to biologic agents in patients with inflammatory bowel disease from a large health maintenance organization

Rosenberg,

Chodick,

Faccin

et al. 2024

Preprint

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Background With the increasing use of biologic therapies for the management of inflammatory bowel disease (IBD), it is important to understand their real-world persistence and adherence rates. Aims To assess adherence, drug survival, and risk for discontinuation with biologics in a large cohort of patients with Crohn's disease (CD) and ulcerative colitis (UC) Methods Adult biologic treatment-naive and treatment-experienced patients with CD and UC who initiated treatment with a biologic drug or tofacitinib during 2015–2017 with a large, state-mandated healthcare provider in Israel were included. Adherence and discontinuation rates were recorded. Risk for discontinuation was estimated using the Cox proportional hazard model. Results A total of 889 patients with CD (44.2% female; mean [SD] age, 36.9 [14.2] years; 73.0% biologic-naive) and 255 patients with UC (52.9% female, mean [SD] age, 41.3 [15.6] years; 71.8% biologic-naive) were included. Among patients with CD and UC receiving their first biologic, high adherence was calculated in 75.7% and 80.3%, respectively. Over the course of one year of follow-up, 32.1% of patients with CD and 37.0% of patients with UC discontinued their biologic therapy. In UC, patients receiving vedolizumab were less likely to discontinue treatment compared with those receiving adalimumab, whereas in CD, both treatments were at similar risk for discontinuation. Conclusions Although drug adherence was satisfactory, persistence rates for patients with IBD receiving biologics were suboptimal and varied based on disease, treatment episode, and treatment received.

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Researching Interventions to Improve Medication Adherence in Ulcerative Colitis Patients

Cited by 3 publications

References 25 publications

Medication Formulation Preference of Mild and Moderate Ulcerative Colitis Patients: a European Survey

Medication Formulation Preference of Mild and Moderate Ulcerative Colitis Patients: a European Survey

Impact of an intervention program on drug adherence in patients with ulcerative colitis: Randomized clinical trial

Drug survival and adherence to biologic agents in patients with inflammatory bowel disease from a large health maintenance organization

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