Review article: medication non-adherence in ulcerative colitis – strategies to improve adherence with mesalazine and other maintenance therapies
Article first published online: 31 MAR 2008
© 2008 The Authors. Journal compilation © 2008 Blackwell Publishing Ltd
Alimentary Pharmacology & Therapeutics
Volume 27, Issue 12, pages 1157–1166, June 2008
How to Cite
HAWTHORNE, A. B., RUBIN, G. and GHOSH, S. (2008), Review article: medication non-adherence in ulcerative colitis – strategies to improve adherence with mesalazine and other maintenance therapies. Alimentary Pharmacology & Therapeutics, 27: 1157–1166. doi: 10.1111/j.1365-2036.2008.03698.x
- Issue published online: 31 MAR 2008
- Article first published online: 31 MAR 2008
- Publication data Submitted 30 January 2008 First decision 13 February 2008 Resubmitted 26 March 2008 Accepted 27 March 2008 Epub OnlineAccepted 31 March 2008
Background Significant number of patients with ulcerative colitis (UC) fail to comply with treatment.
Aims To review issues surrounding medication non-adherence in inflammatory bowel disease (IBD), including the clinical and health service implications in the UK, and discuss strategies for optimizing medication adherence.
Methods Articles cited were identified via a PubMed search, utilizing the words IBD, adherence, compliance, medication and UC.
Results Medication non-adherence is multifactorial involving factors other than dosing frequency. Male gender (OR: 2.06), new patient status (OR: 2.14), work and travel pressures (OR: 4.9) and shorter disease duration (OR: 2.1), among others are proven predictors of non-adherence in UC. These indicators can identify ‘at-risk’ patients and allow an individually tailored treatment approach to be introduced that optimizes medication adherence. A collaborative relationship between physician and patient is important; several strategies for improving adherence have been proven effective including open dialogue that takes into consideration the patient’s health beliefs and concerns, providing educational (e.g. verbal/written information, self-management programmes) and behavioural interventions (e.g. calendar blister packs, cues/reminders).
Conclusions Educational and behavioural interventions tailored to individual patients can optimize medication adherence. Additional studies combining educational and behavioural interventions may provide further strategies for improving medication adherence rates in UC.