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P430. Non-adherence to treatment in inflammatory bowel disease – prevalence and risk factors

J. Magalhães1, F. Dias de Castro1, M.J. Moreira1, S. Leite1, J. Cotter1, 1Alto Ave Hospital Center, Gastroenterology, Guimarães, Portugal

Background

Adherence to therapy is a key factor when analyzing the efficacy of a given treatment in clinical practice. Inflammatory bowel disease (IBD) is associated with high rates of non-compliance to therapy. The aim of our study was to assess the prevalence of non-adherence to treatment among patients with IBD and evaluate which factors could be related.

Methods

One hundred consecutive IBD outpatients (60% with Crohn's disease and 40% with Ulcerative Colitis) filled in an anonymous questionnaire, which included information about demography, duration of the disease, specific therapy for IBD, and data possibly related to extent of non-adherence to treatment. Statistics were performed with SPSS v.18.0. For continuous variables, mean and standard deviation were calculated and for categorical variables percentages were provided. Categorical variables were compared with Fisher's exact test. A p value <0.05 was considered statistically significant.

Results

Overall non-adherence was reported by 38% (n = 38) of patients. 78.9% (n = 30) of patients reported unintentional non-adherence and 55.3% (n = 21) forgot at least one dose per week. Non-adherence was statistically associated with: high educational level (p < 0.001); the perception that medical therapy isn't effective enough (p < 0.001); therapy with corticosteroids (p = 0.019); recent diagnosis (p = 0.020); and young age (p = 0.007). On the other hand, different factors such as gender (p = 0.668), disease type (p = 0.211), smoker status (p = 0.626), occurrence of minor side effects (p = 0.217), use of alternative medicine (p = 1.000), previous IBD-related admissions (p = 0.676) or previous surgeries (p = 0.794) did not correlate with the degree of adherence.

Conclusion

The overall non-adherence is relatively high among IBD patients and gastroenterologist's attention should be focused on it. Risk factors of non-compliance must be evaluated at each follow-up visit to improve adherence to therapy.