Intest Res.  2017 Oct;15(4):434-445. 10.5217/ir.2017.15.4.434.

Medication adherence in inflammatory bowel disease

Affiliations
  • 1Gastroenterology and Liver Services, Concord Repatriation General Hospital, Sydney, Australia. webber.chan.p.w@singhealth.com.sg
  • 2Department of Gastroenterology and Hepatology, Singapore General Hospital, Singapore.
  • 3South Western Sydney Clinical School, University of New South Wales, Sydney, Australia.
  • 4Sydney Medical School, the University of Sydney, Sydney, Australia.
  • 5IBD Unit, Leeds Gastroenterology Institute, Leeds Teaching Hospitals NHS Trust, St James University Hospital, Leeds, UK.

Abstract

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.

Keyword

Medication adherence; Colitis, ulcerative; Crohn disease; Inflammatory bowel disease

MeSH Terms

Chronic Disease
Colitis, Ulcerative
Crohn Disease
Developed Countries
Developing Countries
Humans
Inflammatory Bowel Diseases*
Medication Adherence*
Necrosis

Figure

  • Fig. 1 Visual Analogue Scale.

  • Fig. 2 Attitudinal analysis. Horne et al.42 showed that compared to those who were “accepting” of maintenance therapies prescribed for IBD, participants in all 3 other attitudinal groups were significantly more likely to be non-adherent.


Cited by  3 articles

Factors Associated with Adherence to Allergen Specific Subcutaneous Immunotherapy
Ji-Ho Lee, So-Hee Lee, Ga-Young Ban, Young-Min Ye, Dong-Ho Nahm, Hae-Sim Park, Yoo Seob Shin
Yonsei Med J. 2019;60(6):570-577.    doi: 10.3349/ymj.2019.60.6.570.

Adherence to Asacol once daily versus divided regimen for maintenance therapy in ulcerative colitis: a prospective, multicenter, randomized study
Soo-Kyung Park, Sang Hyun Park, Chang Soo Eun, Geom Seog Seo, Jong Pil Im, Tae Oh Kim, Dong-Il Park
Intest Res. 2019;17(3):349-356.    doi: 10.5217/ir.2018.00064.

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.    doi: 10.5217/ir.2018.00033.


Reference

1. Morisky DE. Facilitating treatment adherence: a practitioner's guidebook. Patient Educ Couns. 1988; 12:173–175.
2. Sabaté E. Adherence to long-term therapies: evidence for action. Geneva: World Health Organization;2003.
3. Balkrishnan R. The importance of medication adherence in improving chronic-disease related outcomes: what we know and what we need to further know. Med Care. 2005; 43:517–520. PMID: 15908845.
Article
4. Sackett DL, Haynes RB. Compliance with therapeutic regimens. Baltimore: The Johns Hopkins University Press;1976.
5. Vrijens B, De Geest S, Hughes DA, et al. A new taxonomy for describing and defining adherence to medications. Br J Clin Pharmacol. 2012; 73:691–705. PMID: 22486599.
Article
6. Jackson CA, Clatworthy J, Robinson A, Horne R. Factors associated with non-adherence to oral medication for inflammatory bowel disease: a systematic review. Am J Gastroenterol. 2010; 105:525–539. PMID: 19997092.
Article
7. Kawakami A, Tanaka M, Nishigaki M, et al. Relationship between non-adherence to aminosalicylate medication and the risk of clinical relapse among Japanese patients with ulcerative colitis in clinical remission: a prospective cohort study. J Gastroenterol. 2013; 48:1006–1015. PMID: 23208019.
Article
8. Kim SB, Kim KO, Jang BI, et al. Patients' beliefs and attitudes about their treatment for inflammatory bowel disease in Korea. J Gastroenterol Hepatol. 2016; 31:575–580. PMID: 26313162.
Article
9. Spekhorst LM, Hummel TZ, Benninga MA, van Rheenen PF, Kindermann A. Adherence to oral maintenance treatment in adolescents with inflammatory bowel disease. J Pediatr Gastroenterol Nutr. 2016; 62:264–270. PMID: 26230905.
Article
10. Jeganathan J, Lee CH, Rahme A, et al. Medication adherence in transitional inflammatory bowel disease patients: a multicenter pilot study. J Gastroenterol Hepatol. 2014; 29:111.
11. Selinger C, Robinson A, Leong R. Non-adherence to inflammatory bowel disease maintenance medication: extent and predictors. J Gastroenterol Hepatol. 2011; 26:116.
12. Lopez A, Billioud V, Peyrin-Biroulet C, Peyrin-Biroulet L. Adherence to anti-TNF therapy in inflammatory bowel diseases: a systematic review. Inflamm Bowel Dis. 2013; 19:1528–1533. PMID: 23518810.
13. Kane S, Huo D, Aikens J, Hanauer S. Medication nonadherence and the outcomes of patients with quiescent ulcerative colitis. Am J Med. 2003; 114:39–43. PMID: 12543288.
Article
14. Khan N, Abbas AM, Bazzano LA, Koleva YN, Krousel-Wood M. Long-term oral mesalazine adherence and the risk of disease flare in ulcerative colitis: nationwide 10-year retrospective cohort from the veterans affairs healthcare system. Aliment Pharmacol Ther. 2012; 36:755–764. PMID: 22882428.
Article
15. van der Have M, Oldenburg B, Kaptein AA, et al. Non-adherence to anti-TNF therapy is associated with illness perceptions and clinical outcomes in outpatients with inflammatory bowel disease: results from a prospective multicentre study. J Crohns Colitis. 2016; 10:549–555. PMID: 26738757.
Article
16. Kane S, Shaya F. Medication non-adherence is associated with increased medical health care costs. Dig Dis Sci. 2008; 53:1020–1024. PMID: 17934828.
17. Hommel KA, Davis CM, Baldassano RN. Medication adherence and quality of life in pediatric inflammatory bowel disease. J Pediatr Psychol. 2008; 33:867–874. PMID: 18337262.
Article
18. Horváth G, Farkas K, Hollósi R, et al. Is there any association between impaired health-related quality of life and non-adherence to medical therapy in inflammatory bowel disease? Scand J Gastroenterol. 2012; 47:1298–1303. PMID: 22935014.
Article
19. Perry J, Chen A, Collins G, Chang J, Kohler F, Leong R. Medication non-adherence in inflammatory bowel diseases is significantly associated with disability. J Gastroenterol Hepatol. 2015; 30(Suppl 3):135–136.
20. Robinson A, Hankins M, Wiseman G, Jones M. Maintaining stable symptom control in inflammatory bowel disease: a retrospective analysis of adherence, medication switches and the risk of relapse. Aliment Pharmacol Ther. 2013; 38:531–538. PMID: 23834298.
Article
21. Wright S, Sanders DS, Lobo AJ, Lennard L. Clinical significance of azathioprine active metabolite concentrations in inflammatory bowel disease. Gut. 2004; 53:1123–1128. PMID: 15247179.
Article
22. Cuffari C, Hunt S, Bayless T. Utilisation of erythrocyte 6-thioguanine metabolite levels to optimise azathioprine therapy in patients with inflammatory bowel disease. Gut. 2001; 48:642–646. PMID: 11302961.
Article
23. Dubinsky MC, Lamothe S, Yang HY, et al. Pharmacogenomics and metabolite measurement for 6-mercaptopurine therapy in inflammatory bowel disease. Gastroenterology. 2000; 118:705–713. PMID: 10734022.
Article
24. Haines ML, Ajlouni Y, Irving PM, et al. Clinical usefulness of therapeutic drug monitoring of thiopurines in patients with inadequately controlled inflammatory bowel disease. Inflamm Bowel Dis. 2011; 17:1301–1307. PMID: 20812329.
Article
25. Cramer JA, Scheyer RD, Mattson RH. Compliance declines between clinic visits. Arch Intern Med. 1990; 150:1509–1510. PMID: 2369248.
Article
26. Fong S, Ward MG, Nasr I, et al. PWE-111 higher red blood cell methotrexate polyglutamates correlate with increased disease activity, and are useful in assessing adherence. Gut. 2014; 63(Suppl 1):A173.
27. Brooks AJ, Begg EJ, Zhang M, Frampton CM, Barclay ML. Red blood cell methotrexate polyglutamate concentrations in inflammatory bowel disease. Ther Drug Monit. 2007; 29:619–625. PMID: 17898653.
Article
28. Egan LJ, Sandborn WJ, Tremaine WJ, et al. A randomized dose-response and pharmacokinetic study of methotrexate for refractory inflammatory Crohn's disease and ulcerative colitis. Aliment Pharmacol Ther. 1999; 13:1597–1604. PMID: 10594394.
Article
29. Gifford AE, Berg AH, Lahiff C, Cheifetz AS, Horowitz G, Moss AC. A random urine test can identify patients at risk of mesalamine non-adherence: a prospective study. Am J Gastroenterol. 2013; 108:249–255. PMID: 23295279.
Article
30. Farmer KC. Methods for measuring and monitoring medication regimen adherence in clinical trials and clinical practice. Clin Ther. 1999; 21:1074–1090. PMID: 10440628.
Article
31. Andrade SE, Kahler KH, Frech F, Chan KA. Methods for evaluation of medication adherence and persistence using automated databases. Pharmacoepidemiol Drug Saf. 2006; 15:565–574. PMID: 16514590.
Article
32. Straka RJ, Fish JT, Benson SR, Suh JT. Patient self-reporting of compliance does not correspond with electronic monitoring: an evaluation using isosorbide dinitrate as a model drug. Pharmacotherapy. 1997; 17:126–132. PMID: 9017773.
33. Nguyen TM, La Caze A, Cottrell N. What are validated selfreport adherence scales really measuring? A systematic review. Br J Clin Pharmacol. 2014; 77:427–445. PMID: 23803249.
Article
34. Morisky DE, Green LW, Levine DM. Concurrent and predictive validity of a self-reported measure of medication adherence. Med Care. 1986; 24:67–74. PMID: 3945130.
Article
35. Morisky DE, DiMatteo MR. Improving the measurement of self-reported medication nonadherence: final response. J Clin Epidemiol. 2011; 64:262–263.
Article
36. Morisky DE, Malotte CK, Choi P, et al. A patient education program to improve adherence rates with antituberculosis drug regimens. Health Educ Q. 1990; 17:253–267. PMID: 2228629.
Article
37. Morisky DE, Ang A, Krousel-Wood M, Ward HJ. Predictive validity of a medication adherence measure in an outpatient setting. J Clin Hypertens (Greenwich). 2008; 10:348–354. PMID: 18453793.
Article
38. Trindade AJ, Ehrlich A, Kornbluth A, Ullman TA. Are your patients taking their medicine? Validation of a new adherence scale in patients with inflammatory bowel disease and comparison with physician perception of adherence. Inflamm Bowel Dis. 2011; 17:599–604. PMID: 20848512.
Article
39. Kane S, Becker B, Harmsen WS, Kurian A, Morisky DE, Zinsmeister AR. Use of a screening tool to determine nonadherent behavior in inflammatory bowel disease. Am J Gastroenterol. 2012; 107:154–160. PMID: 22306937.
Article
40. Horne R, Weinman J. Self-regulation and self-management in asthma: exploring the role of illness perceptions and treatment beliefs in explaining non-adherence to preventer medication. Psychol Health. 2002; 17:17–32.
Article
41. Ediger JP, Walker JR, Graff L, et al. Predictors of medication adherence in inflammatory bowel disease. Am J Gastroenterol. 2007; 102:1417–1426. PMID: 17437505.
Article
42. Horne R, Parham R, Driscoll R, Robinson A. Patients' attitudes to medicines and adherence to maintenance treatment in inflammatory bowel disease. Inflamm Bowel Dis. 2009; 15:837–844. PMID: 19107771.
Article
43. Selinger CP, Eaden J, Jones DB, et al. Modifiable factors associated with nonadherence to maintenance medication for inflammatory bowel disease. Inflamm Bowel Dis. 2013; 19:2199–2206. PMID: 23899547.
Article
44. Severs M, Zuithoff PN, Mangen MJ, et al. Assessing self-reported medication adherence in inflammatory bowel disease: a comparison of tools. Inflamm Bowel Dis. 2016; 22:2158–2164. PMID: 27482979.
Article
45. Moss AC, Lillis Y, Edwards George JB, et al. Attitudes to mesalamine questionnaire: a novel tool to predict mesalamine nonadherence in patients with IBD. Am J Gastroenterol. 2014; 109:1850–1855. PMID: 24913040.
Article
46. Horne R. Representations of medication and treatment: advances in theory and measurement. In : Petrie KJ, Weinman JA, editors. Perceptions of health and illness: current research and applications. London: Harwood Academic Press;1997. p. 155–187.
47. Horne R, Weinman J, Hankins M. The beliefs about medicines questionnaire: the development and evaluation of a new method for assessing the cognitive representation of medication. Psychol Health. 1999; 14:1–24.
Article
48. Waters BM, Jensen L, Fedorak RN. Effects of formal education for patients with inflammatory bowel disease: a randomized controlled trial. Can J Gastroenterol. 2005; 19:235–244. PMID: 15861266.
Article
49. Tiao DK, Jeganathan J, Chen A. . Impact of targeted pharmacist counselling intervention on IBD medication adherence. J Gastroenterol Hepatol. 2014; 29:106.
50. Kripalani S, Yao X, Haynes RB. Interventions to enhance medication adherence in chronic medical conditions: a systematic review. Arch Intern Med. 2007; 167:540–550. PMID: 17389285.
Article
51. Kane S, Huo D, Magnanti K. A pilot feasibility study of once daily versus conventional dosing mesalamine for maintenance of ulcerative colitis. Clin Gastroenterol Hepatol. 2003; 1:170–173. PMID: 15017487.
Article
52. Dignass AU, Bokemeyer B, Adamek H, et al. Mesalamine once daily is more effective than twice daily in patients with quiescent ulcerative colitis. Clin Gastroenterol Hepatol. 2009; 7:762–769. PMID: 19375519.
Article
53. Suzuki Y, Iida M, Ito H, et al. 2.4 g Mesalamine (Asacol 400 mg tablet) once daily is as effective as three times daily in maintenance of remission in ulcerative colitis: a randomized, noninferiority, multi-center trial. Inflamm Bowel Dis. 2017; 23:822–832. PMID: 28368909.
Article
54. Fenerty SD, West C, Davis SA, Kaplan SG, Feldman SR. The effect of reminder systems on patients' adherence to treatment. Patient Prefer Adherence. 2012; 6:127–135. PMID: 22379363.
55. Greenley RN, Gumidyala AP, Nguyen E, et al. Can you teach a teen new tricks? Problem solving skills training improves oral medication adherence in pediatric patients with inflammatory bowel disease participating in a randomized trial. Inflamm Bowel Dis. 2015; 21:2649–2657. PMID: 26218142.
Article
56. Cook PF, Emiliozzi S, El-Hajj D, McCabe MM. Telephone nurse counseling for medication adherence in ulcerative colitis: a preliminary study. Patient Educ Couns. 2010; 81:182–186. PMID: 20079598.
Article
57. Elkjaer M, Shuhaibar M, Burisch J, et al. E-health empowers patients with ulcerative colitis: a randomised controlled trial of the web-guided ‘Constant-care’ approach. Gut. 2010; 59:1652–1661. PMID: 21071584.
Article
58. Moshkovska T, Stone MA, Smith RM, Bankart J, Baker R, Mayberry JF. Impact of a tailored patient preference intervention in adherence to 5-aminosalicylic acid medication in ulcerative colitis: results from an exploratory randomized controlled trial. Inflamm Bowel Dis. 2011; 17:1874–1881. PMID: 21830265.
Article
59. Hommel KA, Herzer M, Ingerski LM, Hente E, Denson LA. Individually tailored treatment of medication nonadherence. J Pediatr Gastroenterol Nutr. 2011; 53:435–439. PMID: 21519282.
Article
60. Hommel KA, Hente EA, Odell S, et al. Evaluation of a group-based behavioral intervention to promote adherence in adolescents with inflammatory bowel disease. Eur J Gastroenterol Hepatol. 2012; 24:64–69. PMID: 21989119.
Article
61. Aguas Peris M, Del Hoyo J, Bebia P, et al. Telemedicine in inflammatory bowel disease: opportunities and approaches. Inflamm Bowel Dis. 2015; 21:392–399. PMID: 25437818.
62. Pedersen N, Thielsen P, Martinsen L, et al. eHealth: individualization of mesalazine treatment through a self-managed webbased solution in mild-to-moderate ulcerative colitis. Inflamm Bowel Dis. 2014; 20:2276–2285. PMID: 25248002.
63. Cross RK, Cheevers N, Rustgi A, Langenberg P, Finkelstein J. Randomized, controlled trial of home telemanagement in patients with ulcerative colitis (UC HAT). Inflamm Bowel Dis. 2012; 18:1018–1025. PMID: 21688350.
Article
64. Hommel KA, Hente E, Herzer M, Ingerski LM, Denson LA. Telehealth behavioral treatment for medication nonadherence: a pilot and feasibility study. Eur J Gastroenterol Hepatol. 2013; 25:469–473. PMID: 23325274.
Full Text Links
  • IR
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr