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P396 Monitoring adalimumab compliance using smart sharp bin technology

K. Hazel*1, C. Smyth1, O. Kelly1, R. J. Farrell1

1Connolly Hospital, Blanchardstown, Department of Gastroenterology, Dublin, Ireland

Background

Adalimumab is a patient-administered subcutaneous anti-TNF agent used in both Crohn’s disease and ulcerative colitis. It has previously been shown that there is significant non-compliance with patient-administered subcutaneous therapies. The aim of this study was to evaluate compliance with adalimumab among our patient cohort enrolled in the Health Beacon programme.

Methods

We collated data supplied by Health Beacon on a monthly basis to determine rates of non-compliance with adalimumab therapy including, early, late and missed dosing. A drop is counted as administration of adalimumab and placement of the pre-filled pen or syringe into the smart sharps bin.

Results

A total of 496 drops were counted among 26 patients. Fifteen males and 11 females are currently enrolled in the programme with an average age of 40.6 years. Seventeen patients have a diagnosis of Crohn’s disease and 9 with ulcerative colitis. 355 drops were recorded as being on-time, giving an overall compliance rate of 71.5%. Compliance among males is 76.8% and females 63.8%. Compliance is 71.7% and 70.6 in Crohn’s disease and ulcerative colitis, respectively. 46.2% of patients have missed at least two doses.

Conclusion

We have shown high rates of non-compliance with adalimumab therapy in patients who have agreed to have their compliance tracked. This may be attributed to the administration of the medication by the patient at home. In this case, infusion therapy may show benefit over subcutaneous therapy. Further correlation with inflammatory markers, endoscopic findings and faecal calprotectin may aid in deescalating therapy in those patients who are non-compliant, yielding significant savings for our department.