Adherence to Short-course Pharmacotherapy in Adults with Irritable Bowel Syndrome

Sherwin, LeeAnne B.; Deroche, Chelsea B; Krisanabud, Poungkamon; Matteson-Kome, Michelle L.; Bechtold, Matthew L.; Ruppar, Todd

doi:10.1177/0193945919872419

Cited by 5 publications

(8 citation statements)

References 38 publications

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“…Furthermore, rifaximin treatment significantly impacted bodily pain and general health in patients with a positive LHBT, regardless of whether SIBO was successfully eradicated. Interestingly, our findings indicate that treatment with rifaximin favorably improves the total QOL and seven subdomain scores in LHBT-negative patients with IBS-D, which is consistent with previously reported data [39]. Similar effects have been seen in another study, the findings of which suggested that the increased improvement in QOL following repeat treatment with rifaximin is associated with a reduced chance of subsequent symptom relapse [40].…”

Section: Discussionsupporting

confidence: 92%

Short-course Rifaximin therapy is effective and safe in patients with Diarrhea-Predominant Irritable Bowel Syndrome

Zhuang

Tian

Luo

et al. 2020

Preprint

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Background and Aim Gut dysbiosis has been implicated in the pathogenesis of irritable bowel syndrome (IBS). Small intestinal bacterial overgrowth (SIBO), a manifestation of gut dysbiosis, is associated with diarrhea-predominant IBS (IBS-D). Rifaximin could effectively and safely improve IBS symptoms. The aim of this study was to investigate the effect of rifaximin on Chinese IBS-D patients.Methods This study included 78 IBS-D patients defined by the Rome IV criteria. Patients received 400 mg rifaximin twice daily for 2 weeks and participated in a 10-week follow-up. Gastrointestinal (GI) symptoms, quality of life (QOL) and lactulose hydrogen breath test (LHBT) results were assessed before and after treatment. Results All participants showed significant improvements in all GI symptom subdomains after rifaximin treatment (all P < 0.05), which were maintained for at least 10 weeks of follow-up. Additionally, QOL scores were increased with concomitant improvement of clinical symptoms (all P < 0.05). The 45 rifaximin-responsive patients (57.7%) achieved significantly greater GI-symptom improvement than non-responders (all P < 0.05). No GI symptoms were associated with the presence of SIBO (all P > 0.05). SIBO normalization after rifaximin treatment measured by LHBT was found in 44.4% (20/45) of patients with SIBO before treatment. Conclusion A short course (2 weeks) of rifaximin effectively and safely improved GI symptoms and QOL in Chinese patients with IBS-D. However, it did not eradicate SIBO completely, indicating that rifaximin might not be closely associated with LHBT normalization and that an additional therapeutic mechanism of rifaximin is urgently needed.

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Section: Discussionsupporting

confidence: 92%

Short-course Rifaximin therapy is effective and safe in patients with Diarrhea-Predominant Irritable Bowel Syndrome

Zhuang

Tian

Luo

et al. 2020

Preprint

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show abstract

“…Furthermore, rifaximin treatment Table 4 Comparison between the Response and Non-Response Groups after rifaximin treatment at week 4 significantly impacted bodily pain and general health in patients with a positive LHBT, regardless of whether SIBO was successfully eradicated. Interestingly, our findings indicate that treatment with rifaximin favorably improves the total QOL and seven subdomain scores in LHBTnegative patients with IBS-D, which is consistent with previously reported data [41]. Similar effects have been seen in another study, the findings of which suggested that the increased improvement in QOL following repeat treatment with rifaximin is associated with a reduced chance of subsequent symptom relapse [42].…”

Section: Discussionsupporting

confidence: 92%

Short-course Rifaximin therapy efficacy and lactulose hydrogen breath test in Chinese patients with diarrhea-predominant irritable bowel syndrome

et al. 2020

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Background: Gut microbiota alterations including small intestinal bacterial overgrowth (SIBO) might play a role in pathogenesis of irritable bowel syndrome (IBS). Rifaximin could effectively and safely improve IBS symptoms. The aim of this study was to investigate the effect of rifaximin on Gastrointestinal (GI) symptoms, quality of life (QOL) and SIBO eradication in Chinese IBS-D patients. Methods: This study included 78 IBS-D patients defined by the Rome IV criteria. Patients received 400 mg rifaximin twice daily for 2 weeks and 10-week follow-up. GI symptoms were assessed at week 0, 2, 4, 8 and 12. QOL and lactulose hydrogen breath test (LHBT) results were estimated at week 0 and 4. Results: All participants showed significant improvements in GI symptom subdomains after rifaximin treatment (all P < 0.05), which could maintain at least 10 weeks of follow-up. Additionally, QOL scores were increased with concomitant improvement of clinical symptoms (all P < 0.05). The 45 rifaximin-responsive patients (57.7%) achieved significantly greater GI-symptom improvement than non-responders (all P < 0.05). No GI symptoms were associated with SIBO (all P > 0.05). SIBO normalization after rifaximin treatment measured by LHBT was found in 44.4% (20/45) of patients with SIBO before treatment. Conclusion: A short course (2 weeks) of rifaximin improved GI symptoms and QOL in Chinese IBS-D patients whether they had SIBO or not. However, the efficacy of rifaximin could not be explained by the successful eradication of SIBO. Further studies on the therapeutic mechanisms of rifaximin in IBS are urgently needed.

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“…Participants acknowledged that the midday dose was the most difficult to remember. Nonadherence, whether through omission of a dose or delay in taking a dose, is the most common deviations reported in the literature ( 14 , 19 ). Forgetfulness was attributed as a barrier to taking the midday dose in this study.…”

Section: Discussionmentioning

confidence: 99%

“…Objective adherence was assessed with the Medication Event Monitoring System cap ( 13 ). PDRATx-IBS study design, recruitment, and findings have been previously described elsewhere ( 14 ). In brief, PDRATx-IBS participants included 73 adult patients receiving 14 days of thrice-daily rifaximin treatment for IBS-D.…”

Section: Methodsmentioning

confidence: 99%

Patient Perspectives on Short-Course Pharmacotherapy: Barriers and Facilitators to Medication Adherence

Sherwin

Ross

Matteson-Kome

et al. 2019

Journal of Patient Experience

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Background: Medication nonadherence is a public health issue that contributes to poor health outcomes and health-care costs. Factors influencing long-term medication adherence are known; however, little is known about short-course medication adherence. Objective: This study examined patient perspectives on adherence and factors that influence adherence to short-course pharmacotherapy in diarrhea-predominant irritable bowel syndrome. Method: Twenty-seven participants were interviewed to identify their perceptions of barriers and facilitators to thrice-daily, 14-day rifaximin. Results: Participants were primarily female (89%), aged 18 to 65 years. Sixty-eight percent of interviewees were identified as “low-adherers,” meaning the percentage of days with correct daily dosing of rifaximin was <80%. The final coding framework identified social/economic-related (family support and medication expense), system-related (relationship with provider and medication knowledge), condition-related (symptom severity), therapy-related (inconvenient dosing), and patient-related (forgetfulness and busyness of daily life) factors that influenced adherence. Conclusion: The resulting patient perspectives highlight a diverse set of factors that influence short-course adherence and the need for tailored interventions that address these various factors resulting in enhanced patient outcomes.

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Adherence to Short-course Pharmacotherapy in Adults with Irritable Bowel Syndrome

Cited by 5 publications

References 38 publications

Short-course Rifaximin therapy is effective and safe in patients with Diarrhea-Predominant Irritable Bowel Syndrome

Short-course Rifaximin therapy is effective and safe in patients with Diarrhea-Predominant Irritable Bowel Syndrome

Short-course Rifaximin therapy efficacy and lactulose hydrogen breath test in Chinese patients with diarrhea-predominant irritable bowel syndrome

Patient Perspectives on Short-Course Pharmacotherapy: Barriers and Facilitators to Medication Adherence

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