Adherence rates with infliximab therapy in Crohn's disease


Dr S. Kane, Associate Professor of Medicine, University of Chicago, 5841 South Maryland Avenue, MC 4076, Chicago, IL 60637, USA.


Background  Inflammatory bowel disease is associated with non-adherence to treatment with oral medications.

Aim  To assess the intravenous infliximab adherence rate and identify risk factors for non-adherence to treatment.

Methods  Infliximab infusion dates for 1 June 2002–30 October 2003 were obtained. Additional information was obtained from two other administrative and patient-based databases. Non-adherence was defined as a ‘No Show’ designation for a scheduled appointment. Non-adherence rate, odds ratios for associations to ‘No Show’ appointments and analysis were performed to identify patient characteristics associated with non-adherent behaviour.

Results  One thousand hundred and eighty-five infliximab infusions were scheduled for 274 patients. Forty-eight (4%) of appointments were classified as ‘No Show’. Six patients accounted for 13/48 (27%) of failed appointments; another 35 patients missed one appointment. ‘No Show’ appointments were more likely to be for female patients, those on concomitant immunomodulators and those >18 weeks from initial infusion. Patients who missed >1 appointment were more likely to be female and have Medicaid vs. those with only one missed appointment (P < 0.05). Indication, patient area code and race were not significantly associated with single or repeated No Show behaviour.

Conclusions  Overall, the non-adherence rate for infliximab is low. Risk factors that may contribute to non-adherence to treatment include female gender and maintenance dosing.