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P334 Medication adherence in diverse inner city pediatric patients with inflammatory bowel disease and comparison to physician perception of adherence

Ferreira J., Thomas S., Tomer G.

The Children's Hospital at Montefiore/ The University Hospital for Albert Einstein College of Medicine, Pediatric Gastroenterology and Nutrition, Bronx, United States

Background

Inflammatory bowel diseases (IBD) are chronic gastrointestinal diseases requiring medical therapy to maintain clinical remission. Adherence to medications is recognized to improve disease outcomes, yet it is a challenging task for patients, furthermore non-adherence is not well recognized by health care providers.

The aim of this study was to evaluate adherence in pediatric IBD patients using a recently validated adherence scale and to compare the results to physician perception of adherence.

Methods

IBD patients, ages 11 to 21 years were asked to fill 8-item Morisky Medication Adherence Scale (MMAS-8). Physicians who were blinded to the instrument results completed a routine electronic medical note that included their perception of patient's adherence recorded as adherent or non adherent. We retrospectively reviewed charts and compared physician adherence evaluation vs. patient's MMAS-8 results.

Results

Out of 64 patients, 41 had a diagnosis of Crohn's disease and 23 had ulcerative colitis with mean disease duration of 28.9 months. The mean age was 16.7; 46.8% were female. Hispanics comprised 51.4% of our patients and African Americans comprised 25% of our patients. Fifty-six patients had both MMAS-8 and a physician adherence evaluation. Using the MMAS-8, 26/56 (46%) of IBD patients were identified to have low adherence, 21 (36%) had medium adherence and only 11 (18%) had high adherence. Physicians classified correctly all patients with high adherence but only 50% of patients with low adherence and 25% of patients with medium adherence.

Conclusion

Adherence to medications is challenging for IBD patients. Screening for medication adherence is important in identifying patients at risk of non- adherence, who might benefit from interventions that will improve patient care and outcome. Identifying non-adherence is challenging for physicians and using MMAS-8 is a reliable validated survey that can be incorporated into routine use.