Assessing medication adherence in inflammatory bowel diseases. A comparison between a self-administered scale and a pharmacy refill index

Castro, María Luisa de; Sanromán, Luciano; Martin, A. Daniel; Figueira, M; Martínez, N. Ramírez; Hernández, Vicent; Campo, Víctor del; Pineda, Juan Ramón; Martínez-Cadilla, Jesús; Pereira, Santos; Prada, José Ignacio Rodríguez

doi:10.17235/reed.2017.5137/2017

Cited by 9 publications

(15 citation statements)

References 21 publications

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“…Adherence rates reported in the literature span from 7 to 72%, with an average of 30–40% [1, 11, 20]. In our study, the rate of perceived adherence to treatment is concordant with the published literature, as gastroenterologists believe that about 60% of the patients they treat are adherent to the prescribed therapy.…”

Section: Discussionsupporting

confidence: 87%

Patient Preference and Physician Perceptions of Patient Preference for Oral Pharmaceutical Formulations: Results from a Real-Life Survey

et al. 2018

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Background: Pharmaceutical treatment prescribed according to patient preference for a formulation may have a positive impact on adherence to treatment and consequently on treatment outcomes. Aim: This study aimed at understanding patient preference for pharmaceutical formulations and attributes that trigger patient preference and physician perception of patient preference. Methods: Between August and September 2017, gastroenterologists and patients with mild to moderate ulcerative colitis from France, Germany, Spain, and the UK participated in an online survey. The investigation was exploratory in nature, and descriptive results are presented. Results: Patient (n = 380) preference appears to be driven by the appearance (format, shape, size, and color – 44%), number of units per administration (39%), and number of administrations per day (17%). Gastroenterologist (n = 159) preference is instead driven by the number of administrations per day (55%), number of units per day (26%), and tablet size (19%). Overall, 254 (67%) patients preferred a tablet formulation, 111 (29%) preferred granules, and 15 (4%) other formulations. According to gastroenterologist perception of patient preference, only 49% of patients prefer tablets, 38% prefer granules, and 13% have no preference. After switching from granules to tablets, 25% patients expressed negative feelings for granules. However, after switching from tablets to granules, 44% of patients still have positive perceptions of tablets. Among patients receiving tablets (n = 255), 18 (7%) perceived their treatment to be not at all effective versus 16 (13%) patients receiving granules (n = 125). A similar proportion of patients in the two groups perceived their treatment as extremely effective (48 vs. 46%, respectively). Conclusions: Patients generally prefer tablets. Patient and gastroenterologist perception of patient preference for different oral drug formulations is triggered by the same attributes but with inverse importance. To improve adherence, patients should be involved in the choice of the treatment formulation.

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Section: Discussionsupporting

confidence: 87%

Patient Preference and Physician Perceptions of Patient Preference for Oral Pharmaceutical Formulations: Results from a Real-Life Survey

et al. 2018

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“…A meta-analysis [ 10 ] involving 569 studies on medication adherence in chronic diseases did not show a statistically significant difference between gender and nonadherence, although it signals that the prevalence of adherence is higher among female patients. Other studies [ 18 – 20 , 22 , 24 , 25 ] that used indirect methods (application of questionnaires) to assess adherence in patients with IBD did not show statistical significance between nonadherence behavior and gender. In a systematic review that addresses risk factors associated with poor adherence in IBD, the results regarding gender were contradictory, showing that for all studies that report a significant association between any demographic variable and poor adherence, there were at least the same number of studies reporting no significant association between this variable and nonadherence [ 16 ].…”

Section: Discussionmentioning

confidence: 92%

“…Most studies that disagree with this percentage [ 19 – 21 ] use other methods of analysis for adherence degree, such as 8-item Morisky Medication Adherence Scale which has items addressing the circumstances of adherence behavior; this score presents conflicting data in the literature about its performance in IBD patients [ 8 ]. Another explanation could be the fact that many patients tend to overestimate their adherence when questioned by their physicians, thus decreasing specificity and increasing false positive results [ 20 ]. In the case of the current study, the data collection was performed by medical students in an environment outside the medical care room, which possibly contributed to the patient not feeling the need to overestimate their adherence to the doctor-oriented treatment.…”

Section: Discussionmentioning

confidence: 99%

“…This study, however, used a 24-item self-administered questionnaire, in which the disease activity was measured through the patient's self-perception. Other studies point out that, in patients in remission from IBD, medication adherence decreases over time and is harder to maintain than in active disease [ 20 ]. This can be attributed to the lower intensity and number of symptoms in the long-term remission periods, symptoms that would act as a constant reminder of the importance of following the treatment properly.…”

Section: Discussionmentioning

confidence: 99%

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Adherence to Medical Treatment in Inflammatory Bowel Disease Patients from a Referral Center in Bahia-Brazil

Andrade¹,

Oliveira

Mariano

et al. 2020

BioMed Research International

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Background/Aims. Identify the degree of adherence to drug therapy in patients with inflammatory bowel diseases followed up at a referral center in Bahia-Brazil. Methods. Observational, analytical, and cross-sectional studies carried out from June/2017 to July/2018, with questionnaire application and medical record review at a referral center in inflammatory bowel diseases in Salvador, Bahia. The Morisky Green Levine Scale was applied to assess adherence. Mean, standard deviation, and frequency analyses were performed using the statistical package SPSS, and chi-square was used to evaluate the association between categorical variables and adherence degree to treatment. Significant associations were considered with p<0.05. Results. 302 patients with inflammatory bowel diseases were included. Nonadherence was highlighted in the sample. Most part of the study population was female, declared themselves to be mixed race, claimed to be from urban areas, and married. Nonadherence was more frequent than adherence in most sociodemographic variables of the present study. Nonadherence also stood out among the clinical variables, such as disease activity, drug side effect, and use of more than two additional medications. The association between all studied variables and adherence degree to treatment, considering the general sample, did not show statistical significance. When Crohn’s disease and ulcerative colitis patients were evaluated separately, a statistically significant association between nonadherence and female patients with ulcerative colitis was observed. Conclusions. The high frequency of nonadherence was observed in the studied sample. Female gender was associated to nonadherence in the subpopulation with ulcerative colitis.

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“…In countries such as Switzerland, non-adherence is as high as 18% and low adherence is more common among patients that consider that the information available to them was insufficient (20,21). Information was also important in other circumstances for patients.…”

Section: Discussionmentioning

confidence: 99%

Using the internet to evaluate the opinion of patients with inflammatory bowel disease with regard to the available information

Fernández¹,

Martín²,

Fernández-Salazar³

2018

Rev Esp Enferm Dig

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Assessing medication adherence in inflammatory bowel diseases. A comparison between a self-administered scale and a pharmacy refill index

Abstract: The accuracy of MMAS-8 to identify medication non-adherence in inactive IBD outpatients in our setting is poor due to a low specificity and a negative predictive value. Psychosocial factors such as beliefs about medication seem to be related to IBD non-adherence.

Cited by 9 publications

References 21 publications

Patient Preference and Physician Perceptions of Patient Preference for Oral Pharmaceutical Formulations: Results from a Real-Life Survey

Patient Preference and Physician Perceptions of Patient Preference for Oral Pharmaceutical Formulations: Results from a Real-Life Survey

Adherence to Medical Treatment in Inflammatory Bowel Disease Patients from a Referral Center in Bahia-Brazil

Using the internet to evaluate the opinion of patients with inflammatory bowel disease with regard to the available information

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