P629 Adherence - does patient involvement and satisfaction matter?
P. Bager*, M. Julsgaard, T. Vestergaard, L. Ambrosius Christensen, J. Frederik Dahlerup
Aarhus University Hospital, Department of Hepatology and Gastroenterology, Aarhus , Denmark
Adherence to treatment for inflammatory bowel diseases (IBD) is important to achieve remission of the disease. Previous studies report that approximately a third of patients are non-adherent to medical treatment. In Denmark, the National Health Service provides tax-supported health care for all inhabitants including refunds of a major part of the costs of all prescription drugs for IBD. This might be associated with high adherence. The aims of the present study were to investigate adherence rate and identify predictors of non-adherence for outpatients with IBD in a tertiary university hospital.
An anonymous electronic questionnaire was prospectively distributed to 20% of the IBD-cohort at Aarhus University Hospital, Denmark. Patients were recruited consecutively in the outpatient clinic. Patients could either complete the survey in the clinic or at home.
Among 377 patients, 300 (80%) completed the survey. 117 (39%) were males; median age was 35 years (range 15-79 years); Type of IBD were equally distributed among Crohn's disease (CD) (46%) and ulcerative colitis (UC) (51%). A total of 268 patients (90%) ranked their overall adherence rate (medication, appointments kept, blood and stool sample collection) > 7 on a Likert scale (1-10; 10=best). Of those who received medication, 254 patients (93%) stated adherence to medical treatment greater than 80%. IBD diagnosis, gender and disease duration did not influence adherence. Young age and smoking were associated with non-adherence (p<0.05). All (100%) adherent patients reported that they informed the health care professionals about their actual intake of medication. However, the proportion was only 74% for non-adherent patients (p<0.01). Adherence rates between 78-99% were found when stratified by type of medication and disease activity. Of note, patients in remission on topical treatment had a lower adherence rate (60%) compared with patients with disease activity on topical treatment (p< 0.01). On Likert scales (1-10; 10=best) the following proportions reported a score > 7: 'satisfaction with treatment' (85%); 'continuity in the treatment' (72%); 'contact to the clinic' (76%); 'accessibility over the telephone' (60%); 'quality of the information provided by the clinic' (60%). Furthermore, 77% stated involvement in the decision making regarding the treatment plan.
Self reported adherence rates, patients' satisfaction and involvement in treatment plan were very high. This may indicate coherence between adherence and the quality of care provided. Apart from young age and smoking, no clear indicators of non-adherence could be identified. This was probably due to the high percentage of adherent patients in the present study.