Studies of compliance with delayed‐release mesalazine therapy in patients with inflammatory bowel disease

Abstract

SUMMARYBackground: Non-compliance with maintenance mesalazine therapy may be a risk factor for relapse in inflammatory bowel disease, but the prevalence and determinants of non-compliance are unknown. Aim: To study the prevalence and determinants of noncompliance in patients with inflammatory bowel disease. Methods: Out-patients receiving delayed-release mesalazine were studied. Compliance was determined by direct enquiry and by analysis of urine samples for 5-aminosalicylic acid/N-acetyl-5-aminosalicylic acid. Potential determinants of compliance were assessed. Results: Ninety-eight patients were studied. Forty-two patients (43%) reported taking < 80% of their prescribed dose. Logistic regression revealed the independent predictors of non-compliance to be three-times daily dosing [odds ratio (OR), 3.1; 95% confidence

Prevalence, predictors, and clinical consequences of medical adherence in IBD: How to improve it?

“…A higher education level and full time employment was also associated with a non-adherent patient behavior in some [5,16,21] , but not all, studies [14] .…”

Depression and anxiety in inflammatory bowel disease: A review of comorbidity and management

“…75,76 The relationship between depression and disease course may be influenced in part by the effect of the disorder on treatment adherence, as there is significantly poorer adherence to treatment regimens by those with a comorbid psychiatric disorder. 77,78 Finally, 17% of those with a major depressive disorder and IBD had considered suicide in the previous 12 months, 34 raising a concern about the mortality risks associated with comorbid depression.…”

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

“…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.…”

“…[19][20][21][22][23][24] However, psychological co-morbidity has been implicated as a potentially reversible cause in children 24 and adults with IBD. 11,16,25,26 On the basis of our previous retrospective observations, 18 we hypothesised that non-adherence, objectively defined using thiopurine metabolite levels, is more common in young adults attending our adolescent transition clinic than adults with IBD and that psychological co-morbidity is a contributing factor. We also sought to further validate the Modified Morisky 8-item adherence scale 26 in patients with IBD to assess its usefulness in detecting non-adherence.…”