The adherence to the therapy in inflammatory bowel disease: beyond the number of the tablets

Scand J Gastroenterol. 2018 Feb;53(2):141-146. doi: 10.1080/00365521.2017.1405070. Epub 2017 Dec 11.

Abstract

Objectives: The therapy of the inflammatory bowel diseases is quite complex. A partial compliance increases the relapse probability and the health expenditure. The aim of the study is to correctly study the adherence to the therapy in a single centre eliminating the bias of a different relationship of trust with different doctors.

Materials and methods: We conducted a blind prospective study on the adherence evaluated for mesalazine.

Results: Three hundred and seventy-six patients were included in the final analysis. Of the patients, 57.4% never missed a single dose of mesalazine, 29.3% missed one or two doses, 7.4% missed three to four doses, 5.9% missed more than five doses. A greater adherence among males (p = .015) and, in ulcerative colitis, among the group with a disease duration of <2 years compared to the one with a disease duration between 2 and 5 years (p = .04) were found. In Crohn's diseases, among the patients who had never undergone to surgical interventions, the adherence was 49.6%, compared to 51.9% among patients who underwent to one surgical resection and 78.6% among patients underwent to multiple surgical resections (p = .001).

Conclusions: The factors influencing the adherence to the therapy are only partly related to the prescribed therapy, but also to factors affecting the patient life: to increase the adherence rate it would be necessary not only interventions on the posology but also the psychological support to the patient at the time of the visit.

Keywords: Adherence; Crohn’s disease; mesalazine; therapy; ulcerative colitis.

MeSH terms

  • Adolescent
  • Adult
  • Age Distribution
  • Aged
  • Anti-Inflammatory Agents, Non-Steroidal / therapeutic use
  • Colitis, Ulcerative / therapy*
  • Crohn Disease / therapy*
  • Digestive System Surgical Procedures
  • Female
  • Humans
  • Inflammatory Bowel Diseases / therapy*
  • Italy
  • Male
  • Medication Adherence / statistics & numerical data*
  • Mesalamine / therapeutic use
  • Middle Aged
  • Multivariate Analysis
  • Prospective Studies
  • Recurrence
  • Regression Analysis
  • Severity of Illness Index
  • Sex Distribution
  • Young Adult

Substances

  • Anti-Inflammatory Agents, Non-Steroidal
  • Mesalamine