P571 Beliefs about Medicines Questionnaire assessing medication adherence in patients with inflammatory bowel disease
M. L. De Castro*1, A. Martín2, L. Sanromán1, N. Martínez2, M. Figueira1, V. Hernández1, J. R. Pineda1, S. Pereira1, J. Martínez-Cadilla1, V. Del Campo3, J.-I. Rodríguez-Prada1
1Hospital Alvaro Cunqueiro. Complexo Hospitalario Universitario de Vigo. CHUVI, Gastroenterology, Vigo, Spain, 2Hospital Alvaro Cunqueiro. Complexo Hospitalario Universitario de Vigo. CHUVI, Hospital Pharmacy, Vigo, Spain, 3Hospital Alvaro Cunqueiro. Complexo Hospitalario Universitario de Vigo. CHUVI, Epidemiology, Vigo, Spain
Amongst the various factors associated with adherence behaviour, understanding patients’ health beliefs is key to improve adherence. The BMQ is a 17-item standardised scale assessing specific concerns about medication the person is taking and general beliefs about the importance of that medication. The objective of this study was to compare the beliefs and attitudes about these medications in patients who were classified as either adherent or nonadherent by a medication possession rate (MPR).
All consecutive patients with non-active Crohn’s disease (CD) or ulcerative colitis (UC) visited in the IBD outpatient clinic of the Hospital Universitary of Vigo (Spain) from October 2014 to April of 2015, were invited to participate in this prospective study. Patients who consented answered anonymously the scale BMQ, and their pharmacy refills were reviewed from the previous 3 months. The BMQ consists of 18 items organised into 2 main sections, whereas the BMQ-General assesses beliefs about medicines in general in 2 4-items scales: Harm and Overuse. The BMQ-Specific is further organised into 2 5-item scales. The Specific-Necessity scale identifies beliefs about the necessity of prescribed medication, and the Specific-Concerns scale identifies concerns about prescribed medications. Low adherence was defined as a medication possession ratio MPR (the proportion [or percentage] of day’s supply obtained during a specified period or over a period of refill intervals) < 0.8.
Enrolled were 203 patients, 121 UC and 82 CD; 50.7% were male, mean age was 46.3 (13.7), and time from diagnosis was 10.3 (7.6) years. Further, 149 (73.8%) were on monotherapy, and 53 (26.2%) on polytherapy for IBD. MPR identified 36% as low adherent patients. Altogether, 60.7% of patients reported some degree of worry about the long-term effects of their medication. Participants were prone to agree with statements suggesting that all medication is addictive (57.2%), poison (63.5%) or that medication typically does more harm than good (77.4%), and 59,8% of respondents endorsed the idea that stopping medications periodically was a good thing. Low adherence was related to higher scores in BMQ-Harm 9.4 (2.9) vus 8.5 (2.7) p = 0.03 with no differences in BMQ- Overuse or BMQ-Specific Necessity or Concerns.
These results suggest that low adherence of medical treatment in inflammatory bowel disease is not merely carelessness, but a response to patients’ beliefs. Interventions designed to increase adherence should provide patients with a clear rationale for the need for treatment and address their fears about medication.