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P243. Inflammatory bowel disease itself is a more important risk factor for impaired health-related quality of life than non-adherence to medical therapy

G. Horvath1, K. Farkas2, R. Hollósi2, F. Nagy3, Z. Szepes2, M. Papp4, K. Palatka4, P. Miheller5, L. Lakatos6, T. Nyari7, T. Wittmann4, T. Molnar3

1Health Centre of Miskolc, Miskolc, Hungary; 21st Department of Medicine, University of Szeged, Szeged, Hungary; 31st Department of Medicine, Szeged, Hungary; 42nd Department of Medicine, University of Debrecen, Debrecen, Hungary; 52nd Department of Medicine, Semmelweiss University, Budapest, Hungary; 61st Department of Medicine, Csolnoky F. Hospital, Veszprém, Hungary; 7Department of Medical Informatics, Szeged, Hungary

Introduction: Current treatment goals in IBD are directed not only towards the management of digestive and systemic symptoms, but also to improve general well-being. Appropriate medication adherence is crucial for successful IBD therapy, although studies have revealed medication non-adherence prevalence rates ranging from 35% to 72% in normal clinical practice.

The aim of study was to evaluate whether health-related quality of life (HRQOL) influences medication adherence and vice versa in patients with IBD and to find relation between different demographic parameter, therapeutic modalities and non-adherence or HRQOL.

Patients and Methods: A total of 531 patients (CD: 57.3%, UC: 42.7%; female/male ratio: 54.1/45.9%, mean present age: 38 years, mean age at the diagnosis: 28.6 years, mean disease duration: 8.9 years) were enrolled in the study treated at four Hungarian tertiary centers. Diagnosis was established based on clinical, endoscopic, radiological and histological criteria. Patients were asked to complete SF-36 questionnaire and a medication adherence report scale at the hospitals during medical visits. We evaluated the association between demographic parameters, different dimensions of HRQOL, different kind of therapies and non-adherence and between demographic parameters, different kind of therapies and HRQOL. The answers of the questions were analyzed using Pearson chi-square test, one sided Fisher's exact test and factor analysis.

Results: 33% of the patients have been operated on previously. Only 2.7% of the patients assessed their general well-being to be excellent, while 42.7% revealed it to be very poor. Overall non-adherence was reported by only 11.9% of patients. ‘Forgot to take medication’ occurred in 46.5%. Complementary and alternative medicine was used in 37% of the patients. There were no differences in adherence between the type of IBD, gender, disease activity, disability grade, educational level, complementary and alternative medicine use, the number of previous surgery, and the need for psychologist. Factor analysis proved that adherence increased significantly in non-smoker patients (61.1% p = 0.004), and in case of 5-aminosalycilate (p = 0.05) and immunomodulator (p = 0.024) use.

Discussion: The majority of the patients assessed their general well-being to be very poor; however, the overall nonadherence with medical therapy in our cohort was lower than reported in the literature suggesting that impaired quality of life in IBD is mainly influenced by the disease itself and it is not clearly associated with medication non-adherence.