Therapeutic adherence in inflammatory bowel disease: User guide from a multidisciplinary modified Delphi consensus
- PMID: 40414777
- DOI: 10.1016/j.dld.2025.04.032
Therapeutic adherence in inflammatory bowel disease: User guide from a multidisciplinary modified Delphi consensus
Abstract
Background: Therapeutic non-adherence can significantly impair the quality of life of patients affected by inflammatory bowel disease (IBD), leading to worse treatment outcomes, more frequent hospitalizations, and increased healthcare expenses. Identifying and enhancing treatment adherence is a key goal in managing IBD.
Aim: To establish a consensus on the definition of therapeutic adherence, determination of risk factors, and identify patients with IBD at higher risk of non-adherence.
Methods: A modified Delphi method was employed to develop consensus statements. Initially, an extensive literature review was conducted on therapeutic adherence in patients affected by IBD, leading to the formulation of 13 statements. These statements were assessed and approved after two rounds of voting (level of agreement 1 to 9; cut-off ≥7 for approval).
Results: In the first voting round, all 13 statements achieved a mean score of ≥7. During a subsequent plenary session, 12 of the 13 statements reached positive consensus, with final cumulative agreement ranging from 80 % to 100 %.
Conclusion: The 12 statements are intended to offer practical guidance to enhance therapeutic adherence in patients with IBD. Patients' profiles at higher risk of non-adherence need prompt recognition and implementation of appropriate strategies by dedicated physicians.
Keywords: Adherence; Biological therapy; Clinical outcomes; Conventional therapy; Inflammatory bowel disease.
Copyright © 2025. Published by Elsevier Ltd.
Conflict of interest statement
Declaration of competing interest Silvio Danese reports consultancy fees from AbbVie, Alimentiv, Allergan, Amgen, Applied Molecular Transport, AstraZeneca, Athos Therapeutics, Biogen, Boehringer Ingelheim, Bristol Myers Squibb, Celgene, Celltrion, Dr Falk Pharma, Eli Lilly, Enthera, Ferring Pharmaceuticals Inc., Gilead, Hospira, Inotrem, Janssen, Johnson & Johnson, Morphic, MSD, Mundipharma, Mylan, Pfizer, Roche, Sandoz, Sublimity Therapeutics, Takeda, Teladoc Health, TiGenix, UCB Inc., Vial, Vifor. Dr. Silvio Danese reports lecture fees from Abbvie, Amgen, Ferring Pharmaceuticals Inc., Gilead, Janssen, Mylan, Pfizer, Takeda Flavio Caprioli served as consultant to Abbvie, MSD, Takeda, Janssen, Roche, Celgene, Bristol-Meyers Squibb, Galapagos, Gllead, Pfizer, Mundipharma, Biogen, Ferring, Eli-Lilly, Nestlè, Lionhealth, AlfaSigma, Dr Falk. He received lecture fees from Abbvie, Ferring, Takeda, Allergy Therapeutics, Janssen, Pfizer, Biogen, Sandoz, Tillotts Pharma, Vifor Pharma, AlfaSigma, and unrestricted research grants from Giuliani, Sofar, MSD, Takeda, Abbvie, Celltrion, Pfizer, Actial. Arianna Dal Buono declares speaker’s fees from AbbVie, Galapagos, Janssen, Eli Lilly, Ferring and Celltrion. Alessandro Armuzzi declares consulting fees from AbbVie, Allergan, Amgen, Arena, Biogen, Boehringer Ingelheim, Bristol-Myers Squibb, Celgene, Celltrion, Eli-Lilly, Ferring, Galapagos, Gilead, Janssen, MSD, Mylan, Pfizer, Protagonist Therapeutics, Roche, Samsung Bioepis, Sandoz and Takeda; speaker’s fees from AbbVie, Amgen, Arena, Biogen, Bristol-Myers Squibb, Eli-Lilly, Ferring, Galapagos, Gilead, Janssen, MSD, Novartis, Pfizer, Roche, Samsung Bioepis, Sandoz, Takeda, and Tigenix; and research support from Biogen, MSD, Takeda, and Pfizer. Fabiana Castiglione declares lecture fees/advisory board: AbbVie, Takeda, Pfizer, Janssen, Johnson and Johnson, Eli Lilly, Cadigroup, AlfaSigma, Galapagos, Lionhealth, Biogen, Sandoz. Paolo Gionchetti received honoraria or consultation fees from Janssen, Abbvie, Pfizer, Takeda, Ferring, MSD, Alfa-Sigma, Galapagos, Celltrion, Biogen, Sandoz, Eli-Lilly. PG participated in a company sponsored speaker’s bureau: Abbvie, Janssen, Takeda, Ferring, Msd, Sofar, Chiesi, Sandoz, Eli-Lilly David Lazzari has no conflict of interest to declare. |Salvo Leone received payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events from Galapagos and Ferring. Ambrogio Orlando declares consulting fees from AbbVie, Alfa-Sigma, Amgen, Biogen, Celltrion, Eli-Lilly, Ferring, Galapagos, Giuliani, Janssen, Jhonson&Jhonson, Lionhealth, MSD, Nestlè, Pfizer Sandoz, Takeda; speaker’s fees from AbbVie, Alfa-Sigma, Amgen, Celltrion, Eli-Lilly, Jhonson &Jhonson, MSD, Pfizer, Sandoz, and Takeda. aurizio Vecchi served as consultant for Abbvie, Takeda, Johnson and Johnson, Galapagos, Pfizer, Mundipharma, Biogen, Ferring, Giuliani, Sofar, NTC, Alfa Sigma. He received lecture fees from Abbvie, Ferring, Takeda, Eli-Lilly, Johnson & Johnson, Pfizer, Biogen, Sandoz, Vifor Pharma, AlfaSigma, and unrestricted research grants from Giuliani, Sofar, Takeda, Abbvie, Celltrion, Pfizer.
