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Current practice and clinicians' perception of medication non-adherence in patients with inflammatory bowel disease: A survey of 98 clinicians

Soobraty, Anisah    (Anisah Soobraty, Sarah Boughdady, Christian P Selinger, IBD Unit, Leeds Gastroenterology Institute, Leeds Teaching Hospitals NHS Trust, Leeds LS9 7TF, United Kingdom   ); Boughdady, Sarah    (Anisah Soobraty, Sarah Boughdady, Christian P Selinger, IBD Unit, Leeds Gastroenterology Institute, Leeds Teaching Hospitals NHS Trust, Leeds LS9 7TF, United Kingdom   ); Selinger, Christian P    (Anisah Soobraty, Sarah Boughdady, Christian P Selinger, IBD Unit, Leeds Gastroenterology Institute, Leeds Teaching Hospitals NHS Trust, Leeds LS9 7TF, United Kingdom  );
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    AIM The survey ascertains perceptions and describes current practice of clinicians regarding medication non-adherence in patients with Inflammatory Bowel Disease. METHODS Gastroenterologists, trainees and inflammatory bowel disease (IBD) specialist nurses from the United Kingdom were invited to a web based survey collecting data on clinician demographics, patient volume and level of interest in IBD. Respondents were asked to estimate non-adherence levels and report use of screening tools and interventions to improve adherence. RESULTS Non-adherence was seen as an infrequent problem by 57% of 98 respondents. Levels of non-adherence were estimated lower than evidence suggests by 29% for mesalazine (5ASA), 26% for immunomodulators (IMM) and 21% for biologics (BIOL). Respondents reporting non-adherence as a frequent problem were more likely to report adherence levels in line with evidence (5ASA P P = 0.012; BIOL P = 0.015). While 80% regarded screening as important only 25% screen regularly (40% of these with validated assessment tools). Respondents stated forgetfulness, beliefs about necessity of medication and not immediately apparent benefits as the main reasons for non-adherence. Patient counselling on benefits and risks of medication was a commonly used intervention. CONCLUSION Clinicians treating IBD patients frequently underestimate non-adherence and use of validated screening tools is infrequent. Most respondents identified the main factors associated with non-adherence in line with evidence and often counselled patients accordingly. Professional education should focus more on non-adherence practice to avoid adverse treatment outcomes associated with non-adherence.


  • 주제어

    Non-adherence .   Inflammatory bowel disease .   Crohn's disease .   Ulcerative colitis .   Clinical practice.  

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