Year 2022 / Volume 114 / Number 3
Review
Adherence improvement in patients with ulcerative colitis: a multidisciplinary consensus document

156-165

DOI: 10.17235/reed.2021.8130/2021

Francesc Casellas, Yago González-Lama, Daniel Ginard Vicens, Santiago García-López, Fernando Muñoz, Laura Marín Sánchez, Laura Camacho, Ana Cabez, Pilar Fortes, Susana Gómez, Pablo Bella Castillo, Manuel Barreiro-de Acosta,

Abstract
Objectives: a) to analyze the evidence available about poor adherence/non-adherence, including prevalences, associated factors, and interventions in ulcerative colitis (UC) patients; b) to provide a framework to improve poor adherence/non-adherence. Methods: a qualitative approach was used. A literature review was performed using Medline. Primary searches were performed with Mesh and free texts to identify articles that analyzed prevalence, causes, associated factors, and interventions designed to improve poor adherence/non-adherence in UC patients. Study quality was evaluated using the Oxford scale. The results were presented and discussed in a nominal group meeting comprising a multidisciplinary committee of six gastroenterologists, one psychologist, one nurse, and one patient. Several overarching principles and recommendations were generated. A consensus procedure was implemented via a Delphi process, during which each committee member produced a score ranging from 0 = totally disagree to 10 = totally agree. Agreement was considered when at least 70 % of participants had voted ≥ 7. Results: the literature review included 75 articles. Non-adherence rates ranged from 7 % to 72 %. We found a great variability in the methods employed to assess adherence, associated factors, and interventions designed to improve adherence. Overall, eight overarching principles and six recommendations were generated, all of them achieving the pre-established agreement level, including, among others, the identification, classification, and management of non-adherence. Conclusions: Poor adherence/non-adherence are common in UC patients, this being a relevant clinical concern. Health professionals should address this issue and actively involve their patients in implementing effective, individualized interventions to improve adherence.
Share Button
New comment
Comments
No comments for this article
References
1. Dignass A, Lindsay JO, Sturm A, et al. Second European evidence-based consensus on the diagnosis and management of ulcerative colitis part 2: current management. J Crohns Colitis. Dec 2012;6(10):991-1030.
2. Reuken PA, Grunert PC, Lugering A, et al. Self-assessment of treatment targets in patients with inflammatory bowel disease using a survey. Therap Adv Gastroenterol 2020;13:1756284820971213.
3. Lopez-Sanroman A, Bermejo F. Review article: how to control and improve adherence to therapy in inflammatory bowel disease. Aliment Pharmacol Ther 2006;24(Suppl 3):45-9.
4. Lenti MV, Selinger CP. Medication non-adherence in adult patients affected by inflammatory bowel disease: a critical review and update of the determining factors, consequences and possible interventions. Expert Rev Gastroenterol Hepatol 2017;11(3):215-26.
5. Simpson SH, Eurich DT, Majumdar SR, et al. A meta-analysis of the association between adherence to drug therapy and mortality. BMJ 2006;333(7557):15.
6. Testa A, Castiglione F, Nardone OM, et al. Adherence in ulcerative colitis: an overview. Patient Prefer Adherence 2017;11:297-303.
7. Jackson CA, Clatworthy J, Robinson A, et al. Factors associated with non-adherence to oral medication for inflammatory bowel disease: a systematic review. Am J Gastroenterol 2010;105(3):525-39.
8. van Deen WK, van Oijen MG, Myers KD, et al. A nationwide 2010-2012 analysis of U.S. health care utilization in inflammatory bowel diseases. Inflamm Bowel Dis 2014;20(10):1747-53.
9. Watanabe C, Nagahori M, Fujii T, et al. Non-adherence to Medications in Pregnant Ulcerative Colitis Patients Contributes to Disease Flares and Adverse Pregnancy Outcomes. Dig Dis Sci 2021;66(2):577-86.
10. Tomar SK, Kedia S, Singh N, et al. Higher education, professional occupation, and upper socioeconomic status are associated with lower adherence to medications in patients with inflammatory bowel disease. JGH Open 2019;3(4):302-9.
11. Lopez A, Billioud V, Peyrin-Biroulet C, et al. Adherence to anti-TNF therapy in inflammatory bowel diseases: a systematic review. Inflamm Bowel Dis 2013;19(7):1528-33.
12. Khan S, Rupniewska E, Neighbors M, et al. Real-world evidence on adherence, persistence, switching and dose escalation with biologics in adult inflammatory bowel disease in the United States: A systematic review. J Clin Pharm Ther 2019;44(4):495-507.
13. Elkjaer M, Shuhaibar M, Burisch J, et al. E-health empowers patients with ulcerative colitis: a randomised controlled trial of the web-guided 'Constant-care' approach. Gut 2010;59(12):1652-61.
14. Elmaliklis IN, Liveri A, Ntelis B, et al. Increased Functional Foods' Consumption and Mediterranean Diet Adherence May Have a Protective Effect in the Appearance of Gastrointestinal Diseases: A Case(-)Control Study. Medicines (Basel) 2019;6(2).
15. Kluthe C, Tsui J, Spady D, et al. The Frequency of Clinic Visits Was Not Associated with Medication Adherence or Outcome in Children with Inflammatory Bowel Diseases. Can J Gastroenterol Hepatol 2018;2018:4687041.
16. Banerjee R, Pal P, Adigopula B, et al. Impact of Demographic, Clinical and Psychosocial Variables on Drug Adherence and Outcomes in Indian Patients With Inflammatory Bowel Disease: Cost is not the Only Factor! J Clin Gastroenterol 2021.
17. Bager P, Julsgaard M, Vestergaard T, et al. Adherence and quality of care in IBD. Scand J Gastroenterol 2016;51(11):1326-31.
18. Morisky DE, Ang A, Krousel-Wood M, et al. Predictive validity of a medication adherence measure in an outpatient setting. J Clin Hypertens (Greenwich) 2008;10(5):348-54.
19. Del Hoyo J, Nos P, Faubel R, et al. A Web-Based Telemanagement System for Improving Disease Activity and Quality of Life in Patients With Complex Inflammatory Bowel Disease: Pilot Randomized Controlled Trial. J Med Internet Res 2018;20(11):e11602.
20. de Castro ML, Sanroman L, Martin A, et al. Assessing medication adherence in inflammatory bowel diseases. A comparison between a self-administered scale and a pharmacy refill index. Rev Esp Enferm Dig 2017;109(8):542-51.
21. Cook PF, Emiliozzi S, El-Hajj D, et al. Telephone nurse counseling for medication adherence in ulcerative colitis: a preliminary study. Patient Educ Couns 2010;81(2):182-6.
22. Quinn CC, Chard S, Roth EG, et al. The Telemedicine for Patients With Inflammatory Bowel Disease (TELE-IBD) Clinical Trial: Qualitative Assessment of Participants' Perceptions. J Med Internet Res 2019;21(6):e14165.
23. Devlen J, Beusterien K, Yen L, et al. Barriers to mesalamine adherence in patients with inflammatory bowel disease: a qualitative analysis. J Manag Care Spec Pharm 2014;20(3):309-14.
24. Kawakami A, Tanaka M, Nishigaki M, et al. A screening instrument to identify ulcerative colitis patients with the high possibility of current non-adherence to aminosalicylate medication based on the Health Belief Model: a cross-sectional study. BMC Gastroenterol 2014;14:220.
25. Calloway A, Dalal R, Beaulieu DB, et al. Depressive Symptoms Predict Anti-tumor Necrosis Factor Therapy Noncompliance in Patients with Inflammatory Bowel Disease. Dig Dis Sci 2017;62(12):3563-7.
26. Mountifield R, Andrews JM, Mikocka-Walus A, et al. Covert dose reduction is a distinct type of medication non-adherence observed across all care settings in inflammatory bowel disease. J Crohns Colitis 2014;8(12):1723-9.
27. Moss AC, Lillis Y, Edwards George JB, et al. Attitudes to mesalamine questionnaire: a novel tool to predict mesalamine nonadherence in patients with IBD. Am J Gastroenterol 2014;109(12):1850-5.
28. Cohen SB, Greenberg JD, Harnett J, et al. Real-World Evidence to Contextualize Clinical Trial Results and Inform Regulatory Decisions: Tofacitinib Modified-Release Once-Daily vs Immediate-Release Twice-Daily for Rheumatoid Arthritis. Adv Ther 2021;38(1):226-48.
29. Horne R, Parham R, Driscoll R, et al. Patients' attitudes to medicines and adherence to maintenance treatment in inflammatory bowel disease. Inflamm Bowel Dis 2009;15(6):837-44.
30. Alonso-Abreu I, Alarcón-Fernández O, Carrillo-Palau M, et al. Survey of adherence to treatment in inflammatory bowel disease. ENADEII study. Gastroenterol Hepatol 2020;43(6):285-92.
31. Beaulieu DB, Kane S. Inflammatory bowel disease in pregnancy. World J Gastroenterol 2011;17(22):2696-701.
32. Hueppe A, Langbrandtner J, Raspe H. Inviting patients with inflammatory bowel disease to active involvement in their own care: a randomized controlled trial. Inflamm Bowel Dis 2014;20(6):1057-69.
33. Coenen S, Weyts E, Vermeire S, et al. Effects of introduction of an inflammatory bowel disease nurse position on the quality of delivered care. Eur J Gastroenterol Hepatol 2017;29(6):646-50.
34. Cross RK, Cheevers N, Rustgi A, et al. Randomized, controlled trial of home telemanagement in patients with ulcerative colitis (UC HAT). Inflamm Bowel Dis 2012;18(6):1018-25.
35. de Jong MJ, van der Meulen-de Jong AE, Romberg-Camps MJ, et al. Telemedicine for management of inflammatory bowel disease (myIBDcoach): a pragmatic, multicentre, randomised controlled trial. Lancet 2017;390(10098):959-68.
36. Yin AL, Hachuel D, Pollak JP, et al. Digital Health Apps in the Clinical Care of Inflammatory Bowel Disease: Scoping Review. J Med Internet Res 2019;21(8):e14630.
37. Schultheiss JPD, Altena S, Clevers MR, et al. Adherence to Adalimumab Was Not Improved by a Reminder-Based Intervention with an Electronic Needle Container. Dig Dis Sci 2020.
38. Mocciaro F, Di Mitri R, Russo G, et al. Motivational interviewing in inflammatory bowel disease patients: a useful tool for outpatient counselling. Dig Liver Dis 2014;46(10):893-7.
39. Levensky ER, Forcehimes A, O'Donohue WT, et al. Motivational interviewing: an evidence-based approach to counseling helps patients follow treatment recommendations. Am J Nurs 2007;107(10):50-8.
40. McCombie AM, Mulder RT, Gearry RB. Psychotherapy for inflammatory bowel disease: a review and update. J Crohns Colitis 2013;7(12):935-49.
41. Casellas F, Guinard Vicens D, García-López S, et al. Consensus document on the management preferences of patients with ulcerative colitis: points to consider and recommendations. Eur J Gastroenterol Hepatol 2020;32(12):1514-22.
42. Lofland JH, Johnson PT, Ingham MP, et al. Shared decision-making for biologic treatment of autoimmune disease: influence on adherence, persistence, satisfaction, and health care costs. Patient Prefer Adherence 2017;11:947-58.
43. Actis GC, Pellicano R. Inflammatory bowel disease: Efficient remission maintenance is crucial for cost containment. World J Gastrointest Pharmacol Ther 2017;8(2):114-9.
44. Shale MJ, Riley SA. Studies of compliance with delayed-release mesalazine therapy in patients with inflammatory bowel disease. Aliment Pharmacol Ther 2003;18(2):191-8.
45. Marín L, Torrejón A, Oltra L, et al. Nursing resources and responsibilities according to hospital organizational model for management of inflammatory bowel disease in Spain. J Crohns Colitis 2011;5(3):211-7.
Related articles

Letter

Tofacitinib-induced eosinophilia

DOI: 10.17235/reed.2023.9831/2023

Letter

Perianal Paget’s disease

DOI: 10.17235/reed.2022.9304/2022

Letter

Chinese dragon sign of ulcerative colitis

DOI: 10.17235/reed.2022.9154/2022

Letter

Ulcerative colitis exacerbated by strongyloidiasis

DOI: 10.17235/reed.2022.9044/2022

Letter

Mesalazine induced interstitial pneumonitis in the COVID era

DOI: 10.17235/reed.2022.8635/2021

Letter

The effect of Adacolumn® on ulcerative colitis with COVID-19

DOI: 10.17235/reed.2020.7156/2020

Letter

Sweet syndrome in severe ulcerative flare

DOI: 10.17235/reed.2020.6995/2020

Letter

Dyspepsia, functional dyspepsia and Rome IV criteria

DOI: 10.17235/reed.2018.5599/2018

Letter to the Editor

Ulcerative colitis with gastric and duodenal involvement

DOI: 10.17235/reed.2017.4685/2016

Editorial

Specialist care in the management of inflammatory bowel disease

DOI: 10.17235/reed.2016.4628/2016

Original

Mercaptopurine and inflammatory bowel disease: the other thiopurine

DOI: 10.17235/reed.2016.4546/2016

Case Report

Mesalamine-induced myopericarditis - A case report

DOI: 10.17235/reed.2016.4016/2015

Citation tools
Casellas F, González-Lama Y, Ginard Vicens D, García-López S, Muñoz F, Marín Sánchez L, et all. Adherence improvement in patients with ulcerative colitis: a multidisciplinary consensus document. 8130/2021


Download to a citation manager

Download the citation for this article by clicking on one of the following citation managers:

Metrics
This article has received 942 visits.
This article has been downloaded 265 times.

Statistics from Dimensions


Statistics from Plum Analytics

Publication history

Received: 02/06/2021

Accepted: 06/07/2021

Online First: 13/07/2021

Published: 07/03/2022

Article revision time: 33 days

Article Online First time: 41 days

Article editing time: 278 days


Share
This article has been rated by 3 readers.
Reader rating:
Valora este artículo:




Asociación Española de Ecografía Digestiva Sociedad Española de Endoscopia Digestiva Sociedad Española de Patología Digestiva
The Spanish Journal of Gastroenterology is the official organ of the Sociedad Española de Patología Digestiva, the Sociedad Española de Endoscopia Digestiva and the Asociación Española de Ecografía Digestiva
Cookie policy Privacy Policy Legal Notice © Copyright 2023 y Creative Commons. The Spanish Journal of Gastroenterology