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  1. A D Spence1,
  2. R Lee2,
  3. D Keegan2,
  4. G A Doherty2,
  5. H Mulcahy2,
  6. D O'Donoghue2,
  7. S J Murphy1
  1. 1 Department of Medicine, Daisy Hill Hospital, Newry, Northern Ireland
  2. 2 Department of Gastroenterology, St Vincent's University Hospital, Elm Park, Dublin, Ireland.


Introduction Azathioprine, an important immunomodulator in the management of Inflammatory Bowel Disease (IBD), has potential serious side-effects about which patients should have awareness.

Aims/Background The aim was to assess understanding of side-effects of azathioprine in patients with IBD.

Method A 10-question survey was completed anonymously by IBD patients attending St. Vincent's Hospital, Dublin. Information received prior to treatment, side-effect awareness and blood monitoring data were collated.

Results 96 patients completed questionnaires (52% male, 48% female). Fifty-nine (61%) patients had Crohn's disease, 33 (34%) ulcerative colitis, and 4 indeterminate colitis. Sixty-two (65%) received information about azathioprine from their physician (23% written, 37% verbal, 39% written and verbal). 83 (93%) patients took their medication daily. 61 (71%) were aware of the complication of low WBC count. Eighty-nine (93%) had blood monitoring, but frequency varied. Awareness of other side-effects was lower (38% skin rash, 30% pancreatitis, and 36% lymphoma). Thirty-eight (40%) patients had felt unwell while taking azathioprine. 34% of patients who had felt unwell on azathioprine visited their GP; only one-third had blood tests.

Conclusion Although compliance with azathioprine was high, only 65% of patients recalled receiving information on azathioprine side-effects. Most patients had monitoring for neutropenia, but frequency varied. Awareness of important side-effects (lymphoma) was low. These findings emphasize the importance of reminding patients of the side-effects of azathioprine, and blood monitoring. The use of smart phones with ‘apps’, in these young patients, may be helpful as reminders of adverse effects and blood monitoring.

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