Introduction Compliance with medication reduces the risk of flares and longer term complications in IBD. Drug non-compliance has been shown to be associated with a 12.5% increase in medical costs.1
Aims and objectives To assess and gain insight into the medication adherence of IBD patients and to explore possible solutions.
Method Data was collected using a self-reporting paper-based questionnaire. Patients were contacted directly using convenience sampling in the IBD clinics. Patients were split broadly into two groups: immunomodulator (IM) and 5-aminosalicylic acid (5-ASA) groups for analysis. The questionnaire included questions about drug compliance, reasons for missing doses, possible solutions to non-compliance, and if patients reported non-compliance to the professionals responsible for their care.
Results 147 patients completed the questionnaire. 77 participants were male (52.4%), 67 had Crohn’s, 69 UC, 8 indeterminate colitis, 3 were unsure. 105 patients were included in the 5-ASA group and 67 in the IM group (there were 25 patients who were taking both IM and 5-ASA drugs). Patients from both groups were more likely to take their medication when symptomatic: Always take: 61% in 5-ASA group, 38% in IM group; Very often take 7% in 5-ASA group, 4% in IM. Compliance dropped when asymptomatic: always take: 48% in 5-ASA group, 38% in IM group; very often take 10% in 5-ASA group, 7% in IM group. Only 5% inform their medical team of compliance problems. Suggested solutions to aid compliance (% of participants agreeing): Once a day dosing (20%), more contact with IBD team (19%), text reminders (14%), reduced pill burden (12%), more drug information (12%), phone calls (4%), e-mail reminders (3%).
Conclusion Self reported drug compliance in IBD is a significant problem. Compliance appears to be poorer for IM drugs than 5-ASA’s. The attending medical team is often not informed of possible compliance problems. Solutions include medication review to ease timing and pill burden, education with more contact and information on therapies and communication via text, phone call and e-mail reminders.
Disclosure of interest None Declared.
Zelante A, De Giorgi A, Borgoni R, Trevisani L, Gallerani M. Adherence to medical treatment in inflammatory bowel disease. Minerva Gastroenterol Dietol. 2014;60(4):269–74
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