Predictors of Medication Adherence in Inflammatory Bowel Disease

Ediger, Jason; Walker, John R.; Graff, Lesley A; Lix, Lisa M.; Clara, Ian; Rawsthorne, Patricia; Rogala, Linda; Miller, Norine; McPhail, Cory; Deering, Kathleen L.; Bernstein, Çharles N.

doi:10.1111/j.1572-0241.2007.01212.x

Cited by 242 publications

(234 citation statements)

References 36 publications

Supporting

Mentioning

197

Contrasting

Unclassified

Order By: Relevance

“…We report here that patients with CD were more likely to be nonadherent to medication than patients with UC. This is contrary to the findings of a study using self-reported adherence to all of the IBD medications, which suggested nonadherence was more common in UC [19]. Conversely, our data showed that 38%-45% of patients were fully adherent to their medications.…”

Section: Discussioncontrasting

confidence: 57%

“…Understanding the causes of nonadherence is important and is reported in the IBD literature [19]. In our pediatric IBD population the reasons for medication nonadherence were not reported, but possible explanations of nonadherenace include the following; medication side effects, child feeling well, belief medication was ineffective, longer disease duration or medication duration and the local pharmacy did not stock the medication.…”

Section: Discussionmentioning

confidence: 99%

“…In our study, 15.8% of patients were nonadherent to medication. This low percentage could be explained by not documenting and measuring adherence by the medication adherence reporting scale (MARS) and Morisky scale which have been proposed for use in measuring adherence in IBD [18,19,20].…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Treatment Profile of Pediatric Inflammatory Bowel Disease in Saudi Arabia: Issues in Treatment Adherence

Hasosah¹,

Mouzan²,

Saadah³

et al. 2015

app

View full text Add to dashboard Cite

Background: Inflammatory bowel disease (IBD), with its 3 subgroups: Crohn's disease (CD), ulcerative colitis (UC), and indeterminate colitis (IC), is a chronic relapsing inflammatory disorder of the gastrointestinal (GI) tract. Medication adherence is particularly problematic in pediatric IBD. To date this has not been studied in the Middle East. Objectives: The aim of this study was to describe the treatment modalities of IBD and to evaluate adherence to treatment in a population-based cohort of Saudi children. Methods: A cross-sectional study was conducted in all regions of Saudi Arabia. All participating centers were asked to provide information on IBD medications and adherence to prescribed therapies. Results: 354 children with IBD were identified from our database. The age at diagnosis ranged from 1to 14 years, with 145 (41%) diagnosed with UC, 195 (55%) with CD and 14 (4%) with IC. The most common drugs therapy used in IBD was corticosteroids in CD and 5-ASA in UC. Patients with UC were treated with 5-ASA significantly more than patients with CD (76% vs. 62%; P= 0.004). In contrast, patients with CD were treated with infliximab significantly more than patients with UC (22% vs. 6%; P= 0.000). Overall, 15.8% of patients were non-adherent with patients with CD demonstrating a higher level of nonadherence, although this was not significantly different from UC patients (11% vs. 3.8%; P>0.05). Poor adherence to specific drugs was reported significantly more in CD than UC patients; mesalamine (p= 0.022), steroids (p= 0.021) and thiopurines (p= 0.006). Conclusion: Poor adherence occurs most frequently in CD patients and with 5-ASA, corticosteroids and thiopurines. These data can be used to help care providers and policy makers such as the Ministry Of Health define and quantify the burden of IBD among children in Saudi Arabia. Further research in IBD is required to determine the reasons for nonadherence/ poor adherence in the pediatric IBD population so that strategies can be devised to reduce it. Key Points: Medication adherence is particularly problematic in pediatric inflammatory bowel disease (IBD). We found that steroids and 5-Amino salicylic acids are the most widely used medications in pediatric IBD patients. Nonadherence occurs most frequently with 5-ASA, steroids and thiopurines in Crohns. These data should help health care providers quantify the burden of IBD among children.

show abstract

Section: Discussioncontrasting

confidence: 57%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Treatment Profile of Pediatric Inflammatory Bowel Disease in Saudi Arabia: Issues in Treatment Adherence

Hasosah¹,

Mouzan²,

Saadah³

et al. 2015

app

View full text Add to dashboard Cite

show abstract

“…Th e presence of depression or other psychiatric disorders was found to be signifi cantly associated with non-compliance with medications. However, a more robust study in follow-up was done by Ediger et al ( 116 ) from Manitoba. In a cross-sectional study on adherence to medication, 326 IBD patients completed a multi-item self-report on adherence (Medication Adherence Report Scale), the Health Anxiety Questionnaire and a Brief Symptom Inventory to assess psychological state.…”

Section: Summary Of Evidencementioning

confidence: 99%

ACG Clinical Guideline: Preventive Care in Inflammatory Bowel Disease

Farraye

Melmed

Lichtenstein

et al. 2017

American Journal of Gastroenterology

380

413

View full text Add to dashboard Cite

Recent data suggest that infl ammatory bowel disease (IBD) patients do not receive preventive services at the same rate as general medical patients. Patients with IBD often consider their gastroenterologist to be the primary provider of care. To improve the care delivered to IBD patients, health maintenance issues need to be co-managed by both the gastroenterologist and primary care team. Gastroenterologists need to explicitly inform the primary care provider of the unique needs of the IBD patient, especially those on immunomodulators and biologics or being considered for such therapy. In particular, documentation of up to date vaccinations are crucial as IBD patients are often treated with long-term immune-suppressive therapies and may be at increased risk for infections, many of which are preventable with vaccinations. Health maintenance issues addressed in this guideline include identifi cation, safety and appropriate timing of vaccinations, screening for osteoporosis, cervical cancer, melanoma and non-melanoma skin cancer as well as identifi cation of depression and anxiety and smoking cessation. To accomplish these health maintenance goals, coordination between the primary care provider, gastroenterology team and other specialists is necessary. of evidence, we entered data from the papers of highest evidence into the GRADE program (accessible at http://www.gradepro.org ). Th e recommendation statements from this guideline are shown in Table 1 . Summary statements, when listed, are designed to be descriptive in nature without associated evidence-based ratings. VACCINATIONSRecent data suggest that IBD patients do not receive preventive services at the same rate as general medical patients ( 2 ). Members of the gastroenterology team are oft en the only clinicians that a patient with IBD will see. As such, it is incumbent upon gastroenterologists to take a proactive role in the health care needs of their IBD patients ( 3-5 ). It is crucial to clarify with the patient the limits of the specialist's responsibilities and delegate routine health care issues to the primary care clinician. It is equally important to educate the primary care clinician to the unique health maintenance needs of the IBD patient, especially those on immunomodulators and biologic agents. Although it appears that both primary care clinicians and gastroenterologists are hesitant to take ownership of vaccinations ( 6-8 ), it is reasonable ( 9 ) that vaccination recommendations be the responsibility of the treating gastroenterologist, but the actual delivery/administration of these vaccines may be a shared responsibility ( 10-13 ). Communicating specifi c recommendations to the primary care team in a concise fashion are needed. Consider empowering the patient by giving written recommendations to bring to their primary care physician. Clinicians sharing an electronic medical record should use this platform to send recommendations to the referring clinician.Patients with IBD are oft en treated with long-term immunesuppressive therapies and may t...

show abstract

“…1,2 Few studies have used objective markers of non-adherence such as drug metabolite levels to confirm complete non-adherence in patients with IBD. [8][9][10][11][12] However, non-adherence is perceived to be a particular problem in younger patients with IBD [11][12][13][14][15][16] and in particular, young adults transferring from paediatric to adult healthcare services. 17,18 The reasons for this have not been investigated, because the body of paediatric and/or adolescent literature has focused on children under the age of 17 years.…”

Section: Introductionmentioning

confidence: 99%

Factors associated with thiopurine non-adherence in patients with inflammatory bowel disease

Goodhand

Kamperidis

Sirwan

et al. 2013

Aliment Pharmacol Ther

View full text Add to dashboard Cite

show abstract

Predictors of Medication Adherence in Inflammatory Bowel Disease

Abstract: Approximately one-third of IBD patients were low adherers. Predictors of adherence differed markedly between genders, although obstacles such as medication cost were relevant for both men and women.

Cited by 242 publications

References 36 publications

Treatment Profile of Pediatric Inflammatory Bowel Disease in Saudi Arabia: Issues in Treatment Adherence

Treatment Profile of Pediatric Inflammatory Bowel Disease in Saudi Arabia: Issues in Treatment Adherence

ACG Clinical Guideline: Preventive Care in Inflammatory Bowel Disease

Factors associated with thiopurine non-adherence in patients with inflammatory bowel disease

Contact Info

Product

Resources

About