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P464. Investigation of adherence to adalimumab self-injection treatment – a multicenter patient questionnaire Pearl survey

F. Hirai1, K. Watanabe2, N. Kubokura3, M. Iimuro4, Y. Yano1, N. Kamata2, M. Esaki3, H. Yamagami2, S. Nakamura4, T. Matsumoto3, T. Matsumoto4, T. Matsui1, 1Fukuoka University Chikushi Hospital, Department of Gastroenterology, Fukuoka, Japan, 2Osaka City University Graduate School of Medicine, Department of Gastroenterology, Osaka, Japan, 3Kyushu University, Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Fukuoka, Japan, 4Hyogo College of Medicine, Department of Lower Gastroenterology, Hyogo, Japan


Adalimumab (ADA), a self-injectable subcutaneous injection drug is expected to be highly convenient. However, good treatment adherence is required. Reports on adherence to ADA self-injection treatment are few. The objective of this survey was to elucidate this adherence and the relating factors in Japan.


CD patients on ADA 40 mg/eow self-injection treatment at 4 university hospitals were the subjects of a questionnaire survey. The survey was approved by the ethics committee of each institution and informed consent was obtained from the patients prior to the questionnaire survey.


A questionnaire was distributed and the responses collected from 124 patients (except for one patient who dissent the survey). The mean age was 36.3 years, and males accounted for 69%. Those with a history of IFX treatment were 53%, and the mean ADA treatment duration was 11.4 months. Of these ADA self-injection patients, 85% complied with the treatment dates, and responded that they followed the treatment schedule strictly (good adherence). However, 15% responded that they forgot to take the treatment or were late in taking the treatment (poor adherence). Apart from a cessation of symptoms for one patient, the reason for most of the patients was that they forgot the date of treatment. In addition, one subject personally decided to discontinue the treatment. Moreover, 37% of the patients entered the date of treatment in their calendars or schedule diaries, and registered the treatment date in the alarm of their mobile phones (schedule registration). Of the patients that performed the “schedule registration”, 94% had good adherence, which was significantly high (P = 0.039) compared to that of 79% for the patients that did not perform the “schedule registration”. In a multivariate analysis using multiple factors (age, gender, duration of illness, working status, status of satisfaction of the self-injection treatment, status of satisfaction with the treatment efficacy, and status of “schedule registration”), duration of illness (odds ratio, OR:0.99), status of satisfaction with the treatment efficacy (OR:13.42) and status of “schedule registration” (OR:7.95) were significant factors relating to good adherence (P < 0.05 for all).


ADA adherence was comparatively good, however, there were also patients with a poor adherence due to reasons such as forgetting the date of treatment. Registration of the treatment schedule in advance can improve the adherence.