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P313. Adherence to treatment in Latvian patients with inflammatory bowel disease

E. Krustins, J. Pokrotnieks

Pauls Stradins Clinical University Hospital, Riga, Latvia

Background: Problems concerning patient compliance are common in many specialties, especially in those dealing with chronic illnesses, and seem to be independent of the graveness of the disease, as for example up to 20% of the patients with renal transplants have been found to have poor compliance. Gastroenterology and inflammatory bowel diseases in particular are no exception having compliance rates between 30%-60%.

The primary goal of this study was to determine the extent of patient deviation from their treatment plan. Additionally we wanted to determine their satisfaction with the existing treatment and to assess patients' willingness to participate in possible clinical studies as part of their treatment plan.

Methods: The study group consisted of 481 patient who between 2003. and 2008. had a colonoscopy at Pauls Stradins clinical university hospital and which had a diagnosis of an inflammatory bowel disease. To these patients a short questionnaire was mailed consisting of questions regarding their current health, the treatment (if any) they receive and their satisfaction with their health status. As well as the form contained questions whether the patient would be ready to participate in any future clinical trials. The study was approved by the ethics committee.

Results: From 481 questionnaires 202 (42%) were returned. 20 (4.1%) patients had indicated they do not wish answer. 44% of the patients responded that they occasionally change their dosing and 32.4% responded that they occasionally on their own account stop taking the medication. There was no connection between patients having complaints at the time of inquiry (23.7%) and the changing the treatment plan on their one's accord. About one half (53.3%) were ready to participate in clinical trials but strictly 22% denied such possibility. Remaining 24.7% weren't sure, mainly being concerned about the safety and possible side-effects of the new drugs. Statistical analysis also showed a significant (p = 0.01) connection between change of dosing and wilful discontinuation of the treatment. Patients who did not know what they were taking were more likely to stop taking medicines (p = 0.01). It was more likely that patients satisfied with their treatment were being supervised by a physician rather than a gastroenterologist, whose patients were more likely to be dissatisfied (p = 0.01). Satisfied patients more frequently noted that they were not interested in clinical trials (p = 0.04). Patients dissatisfied with their treatment tended to be interested, but the results were not significant (p = 0.1).

Conclusions: Patients who change their dosing regimen are also likely to discontinue their treatment; however, they are not necessarily the ones who still have complaints, what only partially agrees with data found in literature. The patients treated by physicians are more likely to be satisfied with their care than if supervised by a gastroenterologist. A finding that could most likely be explained with differences in the disease severity between these both groups. Patients satisfied with their treatment seem to more often refuse to participate in clinical trials.