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

Andrade, Laila; Oliveira, Fernanda; Mariano, Victor; Santos, Monique Ca; Pereira, Fernanda Ávila da Costa; Santos, Cláudia Ivanilda N Dos; Fortes, Flora Maria Lorenzo; Pimentel, Andréa; Mota, Jaciane; Almeida, Neogélia; Surlo, Valdiana; Silva, Bruno C. da; Pacheco, Mila Palma; Santana, Genoile Oliveira

doi:10.1155/2020/5269493

Cited by 5 publications

(4 citation statements)

References 24 publications

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“…As for the clinical status for UC, most of them had active disease at baseline, comparable to the proportion of patients with moderate to severe UC in Brazil [ 33 ]. Other studies in the country have found inverse results, with a higher proportion of patients with disease in remission, differing from the results presented here in [ 31 , 36 ]. It is noteworthy that the participants were assisted at a pharmaceutical service, while in other studies in Brazil, participants were interviewed during medical care assistance.…”

Section: Discussioncontrasting

confidence: 99%

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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Section: Discussioncontrasting

confidence: 99%

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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“…As regard to residence, more than half of the studied sample was coming from urban areas. This finding is in agreement with (Andrade et al, 2020) who mentioned that more than three quarter of his study claimed to be from an urban area. This may be due to unavailable of specialized hospitals in rural areas and Westernization of lifestyle.…”

Section: Resultssupporting

confidence: 93%

Effect of Educational Instructions on knowledge of Patients with Ulcerative Colitis

shabaan

Hassaneen

Badran

et al. 2022

Mansoura Nursing Journal

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Background: Ulcerative colitis is the most common type of inflammatory bowel disease affecting a person's social and psychological wellbeing, quality of life and educational performance. Aim of the study: Evaluate the effect of educational instructions on knowledge of patients with ulcerative colitis. Methodology: Quasi-experimental design was conducted at inpatient and outpatient clinic in Specialized Medical Hospital at Mansoura University. Purposive sample of 50 patients who were willing to participate in the study according to inclusion and exclusion criteria. Tool: One tool structured questionnaire sheet was used in this study. Results: The present study showed statistically significant improvement in patient's knowledge level noticed in posttest and follow up after implementation of educational instructions. Conclusion: The study concluded that there was a positive effect of educational instructions on improving knowledge level among ulcerative colitis patients. Recommendation: It was recommended that all ulcerative colitis patients have access to a basic-colored educational leaflet published in simple Arabic language

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“…Furthermore, highest prevalence of low adherence to pharmacological treatment of chronic diseases was associated with living in the Northeast and Midwest regions of the country and with worse self-perception of health (33) . Andrade et al (2020) assessed adherence to treatment among patients with the diagnosis of IBD in Bahia, Brazil, and most of them were classified as non-adherent (72.7%). Significant differences in adherence pattern were only found for gender among patients with UC (34) .…”

Section: Discussionmentioning

confidence: 99%

“…Andrade et al (2020) assessed adherence to treatment among patients with the diagnosis of IBD in Bahia, Brazil, and most of them were classified as non-adherent (72.7%). Significant differences in adherence pattern were only found for gender among patients with UC (34) .…”

Section: Discussionmentioning

confidence: 99%

Adherence and Persistence to Treatment With Infliximab: Analysis of a Patient Support Program Cohort in Brazil

BRANCO,

ARGOLO,

SANTOS

et al. 2024

Arq. Gastroenterol.

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Background: Monoclonal antibodies have proven efficacy in the management of several conditions and infliximab (IFX) is one of the most important drugs of the class. Some recent data have shown low rates of both persistence and adherence to several available biologics. Objective: The objective of this study was to describe adherence and persistence rate to IFX treatment and also persistence in the patient support program (PSP), among patients diagnosed with inflammatory bowel diseases (IBD) or rheumatic diseases (RD) enrolled in the program of a large pharmaceutical company in Brazil. Methods: Retrospective observational analysis using the PSP database. IBD or RD patients using IFX enrolled on the PSP database between September 2015 and August 2019 were retrospectively evaluated to identify the persistence rate and adherence and followed up until March 1, 2020. Patients were excluded if treatment start date was prior to program entry; first infusion prior to September 1st, 2015 or after August 31st, 2019; the patients did not started treatment; and patients with “OTHERS” in “Indication” field. Persistence was assessed considering both persistence in the program (“PSP persistence”) and persistence on IFX in the PSP (“IFX persistence in the PSP”). PSP persistence was defined as the proportion of patients remaining in the program at 6, 12, 24, 36 and 48 months after initiating IFX. To determine IFX persistence in the PSP, censoring was defined at the time the patient left the program, died, or was lost to follow-up. Adherence to treatment was measured by medication possession ratio ((MPR) - All days supply / elapsed days from first prescription to last day of medication possession)). Descriptive statistics were initially used. Kaplan-Meier curve, the median time estimated by the survival function, Cox regression model, and restricted mean survival time (RMST) were used to evaluate the treatment persistence time at 24 months and the logistic regression model was performed aiming to identify variables associated with adherence (MPR ≥80%). Results: A total of 10,233 patients were analyzed, 5,826 (56.9%) with the diagnosis of RD and 4,407 (43.1%) of IBD. At the end of the follow-up (median 9.1 months from PSP entry to the last infusion), persistence in the PSP was 65.6%, 48.2%, 31.0%, 20.7% and 13.1% at 6, 12, 24, 36 and 48 months, respectively. Considering persistence on IFX in the PSP, estimates were 93.7%, 87.8%, 77.0%, 62.4% and 53.0% at 6, 12, 24, 36 and 48 months, respectively. Variables associated with the risk of non-persistence were gender, country region and diagnosis of rheumatoid arthritis and ankylosing spondylitis. Median MPR was 94.2%, while the percentage of patients with MPR ≥80% was 91.0%. Variables associated with MPR≥80% were country region and diagnosis of Crohn’s disease. Conclusion: Many patients leave the program without discontinuing IFX, since the 12-month persistence were very different between program and medication estimates, while high adherence rates were observed among patients enrolled in the PSP. Data highlights the benefits of a PSP.

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

Cited by 5 publications

References 24 publications

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

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

Effect of Educational Instructions on knowledge of Patients with Ulcerative Colitis

Adherence and Persistence to Treatment With Infliximab: Analysis of a Patient Support Program Cohort in Brazil

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