Funded in part by the Danish Colitis-Crohn association (grant number 8889) and the A.P. Moeller Foundation of the Advancement of Medical Science. The Danish Ministry of Health has financially supported Dr. Mette Julsgaard (identification number 271-05-0775). The funding in no way affected the study design, collection, analysis, interpretation of the data or the writing of the report.
Self-reported adherence to medical treatment prior to and during pregnancy among women with ulcerative colitis†
Article first published online: 9 DEC 2010
Copyright © 2010 Crohn's & Colitis Foundation of America, Inc.
Inflammatory Bowel Diseases
Volume 17, Issue 7, pages 1573–1580, July 2011
How to Cite
Julsgaard, M., Nørgaard, M., Hvas, C. L., Buck, D. and Christensen, L. A. (2011), Self-reported adherence to medical treatment prior to and during pregnancy among women with ulcerative colitis. Inflamm Bowel Dis, 17: 1573–1580. doi: 10.1002/ibd.21522
- Issue published online: 14 JUN 2011
- Article first published online: 9 DEC 2010
- Manuscript Accepted: 13 SEP 2010
- Manuscript Received: 19 AUG 2010
- Danish Colitis-Crohn association. Grant Number: 8889
- A.P. Moeller Foundation of the Advancement of Medical Science
- Danish Ministry of Health. Grant Number: 271-05-0775
- ulcerative colitis;
- medical treatment;
Adherence to medical treatment among women with ulcerative colitis (UC) prior to and during pregnancy has never been investigated. The aim was to examine predictors for and prevalence rates of nonadherence to maintenance treatment among women with UC prior to and during pregnancy.
We identified 115 women with UC having given birth during 2000–2005 within a population of 1.6 million. They received a questionnaire about predictors and adherence and relapses were registered. We retrieved information on medical treatment from prescription databases and used logistic regression to estimate prevalence odds ratios (POR) for nonadherence by different predictors.
Among 93 (81%) respondents, 63 (68%) reported taking medication, 53 of whom had filled prescriptions for relevant medication, yielding a positive predictive value of self-reported use of medical treatment of 84.1% (95% confidence interval [CI] 72.7–92.1). Approximately 60% reported adhering to medical treatment. Those who received counseling regarding medical treatment were less likely to be nonadherent compared with no counseling, especially during pregnancy (POR 0.2, 95% CI 0.04–0.94). Of those who were nonadherent, fear of a negative effect on fertility/fetus was stated as the reason by 23% prior to and by 50% during pregnancy. Notably, 40.3% reported an episode of relapse during the pregnancy period, compared with 13.6% in the period 6 months prior to pregnancy.
Adherence was high despite fear of a negative effect on fertility or the fetus. Counseling predicted higher adherence. This may be important because our study suggests an increase in UC activity during pregnancy. (Inflamm Bowel Dis 2010)