Medication adherence in inflammatory bowel disease

Abstract

Inflammatory bowel disease (IBD) is a chronic idiopathic inflammatory condition with intestinal and extraintestinal manifestations. Medications are the cornerstone of treatment of IBD. However, patients often adhere to medication poorly. Adherence to medications is defined as the process by which patients take their medications as prescribed. Treatment non-adherence is a common problem among chronic diseases, averaging 50% in developed countries and is even poorer in developing countries. In this review, we will examine the adherence data in IBD which vary greatly depending on the study population, route of administration, and methods of adherence measurement used. We will also discuss the adverse clinical outcomes related to non-adherence to medical treatment including increased disease activity, flares, loss of response to anti-tumor necrosis factor therapy, and so forth. There are many methods to measure medication adherence namely direct and indirect methods, each with their advantages and drawbacks. Finally, we will explore different intervention strategies to improve adherence to medications.

Keywords: Colitis, ulcerative; Crohn disease; Inflammatory bowel disease; Medication adherence.

Fig. 1. Visual Analogue Scale.

Fig. 2. Attitudinal analysis. Horne et al. showed that compared to those who were “accepting” of maintenance therapies prescribed for IBD, participants in all 3 other attitudinal groups were significantly more likely to be non-adherent.