P462 A single factor of compliance may not be sufficient to improve outcomes in Ulcerative Colitis
Evangelisches Krankenhaus Kalk, University of Cologne, Köln, Germany
While some factors, such as once-daily dosing of mesalazine (OD), have indicated better compliance, in real-life healthcare, it is still unclear if a single factor of compliance can improve the patient outcome.
A total of 520 patients (47 % females) aged between 16 and 82 years with ulcerative colitis (UC) were included in a prospective study which was conducted in 113 private gastroenterology specialist practices throughout Germany. All patients were treated with mesalazine. Compliance was rated by the patients using a visual analogue scale (VAG) ranging from 0 (I have taken all medication correctly) to 10 (I have taken no medication).
The severity of UC was rated according to the UCDAI; follow-up took place for up to 12 months and included several patient visits. Results are given as median/range and differences were calculated using chi²-testing.
In active UC, compliance improved during the study and was better at the end in the OD group compared to divided dosing (DD) (90.5 % vs. 79.9 %).
Patients in remission reported very good compliance at the start of the observation (OD: 84.1 % vs. DD: 82.4 %), which slightly improved with OD (88.9 %) but not with DD (82.1 %).
The UCDAI was 6 in patients with active disease in both groups (OD, DD) and dropped to 2 with OD as well as with DD. In the remission group, the UCDAI dropped from 3 to 2 with DD, while it increased from 2 to 3 with OD. The average UCDAI at visits A, B and C in patients with bad compliance (<=70 %) was 5.7 (4.8 - 6.7) (median/range) in comparison to 5.3 (5.0 - 5.5) (median/range) in patients with good compliance.
In real-life healthcare, a single factor such as daily dosing has only modest effects on compliance and no significant effects on outcome. Better compliance improves outcomes in patients with active disease and in those in remission.