Revealing the Puzzle of Nonadherence in IBD—Assembling the Pieces

Eindor-Abarbanel, Adi; Naftali, Timna; Ruhimovich, Nahum; Shitrit, Ariella Bar-Gil; Sklerovsky-Benjaminov, Fabiana; Konikoff, Fred M.; Matalon, Shai; Shirin, Haim; Milgrom, Yael; Broide, Efrat

doi:10.1093/ibd/izy013

Cited by 11 publications

(11 citation statements)

References 33 publications

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“…Sense of coherence was already investigated among IBD patients [15] and was found to influence the development of anxiety and depression [15] regardless of disease severity. On the other hand, in our recently published study [23] of adherence in IBD patients, multivariate analysis did not find a significant difference in the SOC scores between adherent and non-adherent patients. These results, in addition to those of the current study, raise several questions.…”

Section: Discussioncontrasting

confidence: 73%

Sense of Coherence in People with and without Inflammatory Bowel Diseases – Is there a Difference?

Naftali

Eindor-Abarbanel

Ruhimovich

et al. 2019

JGLD

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Background & Aims: Sense of coherence (SOC) is a theoretical concept reflecting a person‘s resources and orientation, which enable individuals to cope with stressors in a health-promoting manner. In several multifactorial chronic diseases, such as diabetes mellitus and systemic lupus erythematosus, SOC was correlated with disease development. It was also related with the emotional distress in patients with inflammatory boweldisease (IBD).The aim of this study was to investigate the possible correlation between low SOC scores and the presence of IBD.Methods: A total of 183 Crohn’s disease (CD) and 71 ulcerative colitis (UC) patients completed questionnaires including demographic data and the 13 items for the SOC questionnaire. The IBD patients were matched to 124 healthy people according to age, gender, education, employment status and marital status.Results: In the CD cohort, 96 patients were matched to the healthy cohort according to the propensity score value, and in the UC cohort 57 were matched. Patients with Crohns’ disease had a median SOC score of 63 (IQR 56-71), and healthy matching controls of 62.5 (IQR 55.25- 68.75) p=0.369. Patients with ulcerative patients had a median SOC score of 66 (IQR 56-73) and healthy controls 62 (IQR 55-69) p=0.354.Conclusions: In our study SOC was not related to the development of IBD. The question of whether SOC is associated with the development of chronic disease and particularly with IBD remains open.

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Section: Discussioncontrasting

confidence: 73%

Sense of Coherence in People with and without Inflammatory Bowel Diseases – Is there a Difference?

Naftali

Eindor-Abarbanel

Ruhimovich

et al. 2019

JGLD

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“…A French study (Nahon and colleagues) reported that higher proportion of females were adherent to medication whereas Ediger et al and colleagues from Canada and another study from Israel reported higher rate of nonadherence in females. 24,27,28 Upto 10 more studies did not show any correlation between gender and adherence. 6 Lakatos, 29 reported low level of education was significantly associated with nonadherence (35.1%) compared with high education (13.8%) (P = 0.026).…”

Section: Discussionmentioning

confidence: 95%

“…UC was a risk factor for nonadherence in 2 studies whereas CD was associated with nonadherence in one study. 24,28,30 Left sided disease has been shown to associated with nonadherence whereas 4 other studies reported no association of disease extends and nonadherence. 6,26 Four studies reported that nonadherence is associated with shorter duration of disease 23,[31][32][33] whereas 1 study reported the contrary.…”

Section: Discussionmentioning

confidence: 98%

Impact of Demographic, Clinical and Psychosocial Variables on Drug Adherence and Outcomes in Indian Patients With Inflammatory Bowel Disease

Banerjee

Pal²,

Adigopula³

et al. 2021

Journal of Clinical Gastroenterology

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“…8 Others demonstrated that good communication with the physician and understanding the disease as predictors for high adherence. 9 Different tools such as patient questionnaire, patient diary, pharmacy refill data, interviews, physician perception, pill counters, drug levels and drug metabolites are used to identify and measure adherence. 10 In general, objective assessments of adherence are lower than subjective measurements.…”

Section: Introductionmentioning

confidence: 99%

“… 8 Others demonstrated that good communication with the physician and understanding the disease as predictors for high adherence. 9 …”

Section: Introductionmentioning

confidence: 99%

<p>Assessing Oral Medication Adherence and Identifying Predictors of Low Adherence in Chinese Inflammatory Bowel Disease Patients</p>

Hu¹,

Hu²,

Zhu³

et al. 2020

PPA

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Background: Poor medication adherence in inflammatory bowel disease (IBD) had a negative impact on disease outcomes. In this study, we aimed to determine predictors of low adherence in the Chinese IBD populations and also aimed to compare a self-reported scale to a pharmacy refill index in assessing adherence of 5-ASA and azathioprine taken by Chinese IBD patients. Patients and Methods: Adult patients with IBD who had been taking 5-ASA or azathioprine for at least 3 months were recruited from hospital outpatient clinics. The MPR was calculated from previous six-month pharmacy refill data and the self-reported Morisky Medication Adherence Scale (MMAS-8) was issued through QR code questionnaires. Intentional and unintentional adherence scores were calculated according to specific items. Non-adherence was defined as MMAS-8 scores <6 or MPR < 0.8. Results: The response rate in the IBD patients was as high as 97%. 5-ASA non-adherence rate assessed by MPR was 30% and 37% by MMAS-8, and azathioprine non-adherence rate assessed was 33% by both MPR and MMAS-8. In a linear regression analysis, MPR value was significantly correlated with MMAS-8 score in 5-ASA group (r=0.4, p=0.003), and significantly correlated with unintentional adherence score (r=0.47, p<0.001). No significant correlation was observed between MPR value and MMAS-8 score in azathioprine group. Multivariate analysis demonstrated that age (OR: 1.08; 95% CI: 1.02-1.13; P=0.0015) and previous abdominal surgery (OR: 3.18; 95% CI: 2.09-4.27; P=0.04) were associated with high medication adherence. While patients who had small intestine lesion (OR: 0.09; 95% CI: 0.01-0.17; P=0.006) were associated with low adherence. Conclusion: Predictors of low adherence were young age, lesions on small intestine, whereas previous abdominal surgery was a protective factor. This study also demonstrated that the MMAS-8 scale was a valid instrument for assessing 5-ASA adherence in IBD patients. Unintentional non-adherence was significantly related to the total non-adherence, which would allow to use the tool to seek ways for adherence improvement.

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Revealing the Puzzle of Nonadherence in IBD—Assembling the Pieces

Abstract: Nonmodifiable characteristics such as female sex and UC are associated with low adherence. Good communication with the treating physician and understanding the disease are modifiable factors associated with high adherence. Early intervention might improve patients' adherence.

Cited by 11 publications

References 33 publications

Sense of Coherence in People with and without Inflammatory Bowel Diseases – Is there a Difference?

Sense of Coherence in People with and without Inflammatory Bowel Diseases – Is there a Difference?

Impact of Demographic, Clinical and Psychosocial Variables on Drug Adherence and Outcomes in Indian Patients With Inflammatory Bowel Disease

<p>Assessing Oral Medication Adherence and Identifying Predictors of Low Adherence in Chinese Inflammatory Bowel Disease Patients</p>

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