Skip to main content

Advertisement

SpringerLink
Log in

Medication-Taking Behavior in a Cohort of Patients with Inflammatory Bowel Disease

  • Original Article
  • Published:
Digestive Diseases and Sciences Aims and scope Submit manuscript

Abstract

Recent studies have shown a low adherence rate to maintenance treatment in patients with inflammatory bowel disease (IBD). We sought to assess the medication-taking behavior in a cohort of patients with IBD. We prospectively included IBD patients from the outpatient clinic who agreed to answer a questionnaire about prescribed treatment and adherence. Physicians registered clinical data including prescribed medications. Two hundred fourteen patients (115 Crohn's disease/99 ulcerative colitis) were included. The most prescribed medications were oral mesalazine (56.5%) and immunomodulators (41.1%). Forty-three percent of patients admitted to occasionally forgetting to take their medication but only 7.5% of them did it voluntary. Oral mesalazine and azathioprine were the drugs with the poorest compliance, with nonadherence rates of 45% and 25% of the total prescribed doses, respectively. The only factor associated with a better adherence was a more complicated course of the disease—steroid dependency, steroid refractoriness, need for infliximab treatment, hospitalization, or surgery (P=.02). Twenty percent of patients admitted to self-medicating. An important proportion of patients with IBD admit to forget some doses of the prescribed medication in the setting of a specialized unit of a referral centre.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Haynes RB (2001) Improving patient adherence: state of the art, with a special focus on medication taking for cardiovascular disorders. In: Compliance in Health Care and research. Burke LE, Ockene IS, eds. New York: Futura Publishing; pp 3–21

  2. Van Hees PA, Van Tongeren JH (1982) Compliance to therapy in patients on a maintenance dose of sulphasalazine. J Clin Gastroenterol 4:333–336

    Article  CAS  PubMed  Google Scholar 

  3. Kane SV, Cohen RD, Aikens JE, Hanauer SB (2001) Prevalence of nonadherence with maintenance mesalamine in quiescent ulcerative colitis. Am J Gastroenterol 96:2933

    Google Scholar 

  4. Nigro G, Angelini G, Grosso SB, Caula G, Sategna-Guidetti C (2001) Psychiatric predictors of noncompliance in inflammatory bowel disease. Psychiatry and compliance. J Clin Gastroenterol 32:66–68

    Article  CAS  PubMed  Google Scholar 

  5. Farup PG, Hovde O, Halvorsen FA, et al (1995) Mesalazine suppositories versus hydrocortisone foam in patients with distal ulcerative colitis. A comparison of the efficacy and practicality of two topical treatment regimens. Scand J Gastroenterol 30:164–170

    CAS  PubMed  Google Scholar 

  6. Riley SA, Mani V, Goodman MJ, Lucas S (1990) Why do patients with ulcerative colitis relapse? Gut 31:179–183.

    CAS  PubMed  Google Scholar 

  7. DiMatteo MR (1997) Adherence to treatment. In: Feldman MD, Christensen JF, eds. Behavioral medicine. A primary care handbook. New York: Appleton & Lange; 136–140

    Google Scholar 

  8. Kane SV (2006) Systematic review: adherence issues in the treatment of ulcerative colitis. Aliment Pharmacol Ther 23:577–585

    Article  CAS  PubMed  Google Scholar 

  9. Shale MJ, Riley SA (2003) Studies of compliance with delayed-release mesalazine therapy in patients with inflammatory bowel disease. Aliment Pharmacol Ther 18:191–198

    Article  CAS  PubMed  Google Scholar 

  10. Kane S, Huo D, Aikens J, Hanauer S (2003) Medication nonadherence and the outcomes of patients with quiescent ulcerative colitis. Am J Med 114:39–43

    Article  PubMed  Google Scholar 

  11. Moody GA, Jayanthi V, Probert CS, Mac Kay H, Mayberry JF (1996) Long-term therapy with sulphasalazine protects against colorectal cancer in ulcerative colitis: a retrospective study of colorectal cancer risk and compliance with treatment in Leicestershire. Eur J Gastroenterol Hepatol 8:1179–1183

    CAS  PubMed  Google Scholar 

  12. Osterberg L, Blaschke T (2005) Adherence to medication. N Engl J Med 353:487–497

    Article  CAS  PubMed  Google Scholar 

  13. Sewitch MJ, Abrahamowicz M, Barkun A, et al (2003) Patient nonadherence to medication in inflammatory bowel disease. Am J Gastroenterol 98:1535–1544

    Article  PubMed  Google Scholar 

  14. López San Román A, Bermejo F, Carrera E, Pérez-Abad M, Boixeda D (2005) Adherence to treatment in inflammatory bowel disease. Rev Esp Enferm Dig 97:249–257

    PubMed  Google Scholar 

  15. Kane S, Huo D, Magnanti K (2003) A pilot feasibility study of once daily versus conventional dosing mesalamine for maintenance of ulcerative colitis. Clin Gastroenterol Hepatol 1:170–173

    Article  CAS  PubMed  Google Scholar 

  16. Mackner LM, Crandall WV (2005) Oral medication adherence in pediatric inflammatory bowel disease. Inflamm Bowel Dis 11:1006–1011

    Article  PubMed  Google Scholar 

  17. Bloomfeld RS, Onken JE (2003) Mercaptopurine metabolite results in clinical Gastroenterology practice. Aliment Pharmacol Ther 17:69–73

    Article  CAS  PubMed  Google Scholar 

  18. Kane SV, Hanauer SB (2001) National adherence rates with IBD therapy: PO vs PR. Am J Gastroenterol 96:s296

    Article  Google Scholar 

  19. Claxton AJ, Cramer J, Pierce C (2001) A systematic review of the associations between dose regimens and medication compliance. Clin Ther 23:1296–1310

    Article  CAS  PubMed  Google Scholar 

  20. Gasche C, Scholmerich J, Brynskov J, et al (1998) A simple classification of Crohn's disease: report of the working party for the World Congresses of Gastroenterology, Vienna 1998. Inflamm Bowel Dis 5:8–15

    Google Scholar 

Download references

Acknowledgments

This study was supported in part by a grant of Instituto de Salud Carlos III (C03/02), from the Spanish Ministry of Health.

Author information

Authors and Affiliations

  1. Gastroenterology Department, Hospital Universitari Germans Trias i Pujol, 5a planta, edifici general, Ctra. del Canyet, s/n, 08916, Badalona, Catalonia, Spain

    Isabel Bernal, Eugeni Domènech, Esther Garcia-Planella, Laura Marín, Míriam Mañosa, Mercè Navarro, Eduard Cabré & Miquel A. Gassull

Authors
  1. Isabel Bernal
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Eugeni Domènech
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Esther Garcia-Planella
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Laura Marín
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Míriam Mañosa
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Mercè Navarro
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Eduard Cabré
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Miquel A. Gassull
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Eugeni Domènech.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Bernal, I., Domènech, E., Garcia-Planella, E. et al. Medication-Taking Behavior in a Cohort of Patients with Inflammatory Bowel Disease. Dig Dis Sci 51, 2165–2169 (2006). https://doi.org/10.1007/s10620-006-9444-2

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10620-006-9444-2

Keywords

Search

Navigation