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Original Article
IBD
Medication non-adherence in inflammatory bowel diseases is associated with disability
Jonathan Perry, Andy Chen, Viraj Kariyawasam, Glen Collins, Chee Choong, Wei Ling Teh, Nikola Mitrev, Friedbert Kohler, Rupert Wing Loong Leong
Intest Res 2018;16(4):571-578.   Published online October 10, 2018
DOI: https://doi.org/10.5217/ir.2018.00033
AbstractAbstract PDFPubReaderePub
Background/Aims
Medication non-adherence is common in inflammatory bowel diseases (IBD). The short-term consequences of non-adherence include increased disease relapse but the long-term impact upon patients in terms of daily functional impairment are less well characterized. Identifying negative outcomes, such as disability, may encourage adherence.
Methods
Consecutive ambulatory IBD subjects completed the Medication Adherence Rating Scale (MARS; non-adherence defined as ≤16), Inflammatory Bowel Diseases Disability Index (IBD-DI; disability: <3.5) and Beliefs about Medicines Questionnaire (high necessity/concerns: ≥16). The primary outcome was the association between medication non-adherence and disability. Secondary outcomes were the predictors of these outcomes.
Results
A total of 173 subjects on IBD maintenance medications were recruited (98 Crohn’s disease, 75 ulcerative colitis: median IBD-DI, –5.0; interquartile range [IQR], –14.0 to 4.0 and median MARS, 19.0; IQR, 18 to 20) of whom 24% were non-adherent. Disability correlated significantly with medication non-adherence (r=0.38, P<0.0001). Median IBD-DI for non-adherers was significantly lower than adherers (–16.0 vs. –2.0, P<0.0001). Predictors of disability included female sex (P=0.002), previous hospitalization (P=0.023), management in a referral hospital clinic (P=0.008) and medication concerns (P<0.0001). Non-adherence was independently associated with difficulty managing bowel movements (odds ratio [OR], 3.71; 95% confidence interval [CI], 1.50–9.16, P=0.005), rectal bleeding (OR, 2.69; 95% CI, 1.14–6.36; P=0.024) and arthralgia/arthritis (OR, 2.56; 95% CI, 1.11–5.92; P=0.028).
Conclusions
Medication non-adherence was associated with significantly increased disability in IBD. Female gender, higher disease severity and medication concerns were additional predictors of disability.

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Review
Medication adherence in inflammatory bowel disease
Webber Chan, Andy Chen, Darren Tiao, Christian Selinger, Rupert Leong
Intest Res 2017;15(4):434-445.   Published online October 23, 2017
DOI: https://doi.org/10.5217/ir.2017.15.4.434
AbstractAbstract PDFPubReaderePub

Inflammatory bowel disease (IBD) is a chronic idiopathic inflammatory condition with intestinal and extraintestinal manifestations. Medications are the cornerstone of treatment of IBD. However, patients often adhere to medication poorly. Adherence to medications is defined as the process by which patients take their medications as prescribed. Treatment non-adherence is a common problem among chronic diseases, averaging 50% in developed countries and is even poorer in developing countries. In this review, we will examine the adherence data in IBD which vary greatly depending on the study population, route of administration, and methods of adherence measurement used. We will also discuss the adverse clinical outcomes related to non-adherence to medical treatment including increased disease activity, flares, loss of response to anti-tumor necrosis factor therapy, and so forth. There are many methods to measure medication adherence namely direct and indirect methods, each with their advantages and drawbacks. Finally, we will explore different intervention strategies to improve adherence to medications.

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    PLOS ONE.2023; 18(3): e0282467.     CrossRef
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    Theresa Hunter Gibble, April N. Naegeli, Michael Grabner, Keith Isenberg, Mingyang Shan, Chia-Chen Teng, Jeffrey R. Curtis
    BMC Gastroenterology.2023;[Epub]     CrossRef
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    Kenneth Ernest-Suarez, Remo Panaccione
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    Advances in Therapy.2023; 40(5): 2311.     CrossRef
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    Nature Reviews Drug Discovery.2023; 22(5): 387.     CrossRef
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    Ole Haagen Nielsen, Theresa Louise Boye, John Gubatan, Deepavali Chakravarti, James B. Jaquith, Eric C. LaCasse
    Pharmacology & Therapeutics.2023; 245: 108402.     CrossRef
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    Neda Karimi, Alison Rotha Moore, Annabelle Lukin, Susan J Connor
    Crohn's & Colitis 360.2023;[Epub]     CrossRef
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    Obreniokibo Ibifubara Amiesimaka, Kristina Aluzaite, Rhiannon Braund, Michael Schultz
    Exploratory Research in Clinical and Social Pharmacy.2023; 12: 100385.     CrossRef
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    Patient Preference and Adherence.2023; Volume 17: 3265.     CrossRef
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    PLOS ONE.2023; 18(12): e0295832.     CrossRef
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    BMJ Open.2022; 12(4): e057656.     CrossRef
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    Frontiers in Medical Technology.2021;[Epub]     CrossRef
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    A I Parfenov, A V Kagramanova, A F Babayan, O V Knyazev
    Terapevticheskii arkhiv.2018; 90(12): 4.     CrossRef
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