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P526 Survey of adherence to treatment in inflammatory bowel disease: ENADEII STUDY

I. Alonso Abreu*1, O. Alarcón-Fernández1, M. Carrillo-Palau1, L. Ramos López1, J. P. Gisbert2, M. Chaparro2, P. Nos3, A. Jiménez Sosa4, E. Quintero Carrión1, GETECCU1

1Hospital Universitario de Canarias, Gastroenterology, Santa Cruz de Tenerife, Spain, 2Hospital Universitario La Princesa. IIS-IP, CIBEREHD, Gastroenterology, Madrid, Spain, 3Hospital Universitario La Fe, Gastroenterology, Valencia, Spain, 4Hospital Universitario de Canarias, Statistics, Santa Cruz de Tenerife, Spain


INTRODUCTION: The rate of non-adherence to medical treatment in inflammatory bowel disease (IBD) stands at around 50%, which worsens the treatment outcomes and increases morbidity and costs. Any action that increases adherence would enhance the quality of healthcare provided. The various strategies that have been tested out have been primarily targeted to patient; however, only one previous study is partially addressed to know what is being done by the doctor to improve patients' adherence.


To determine through an on-line survey among Spanish gastroenterologists: (1) The knowledge about treatment adherence of patients with IBD. (2) The methods in routine clinical practice to improve treatment adherence.


METHODS: The Technical Secretariat of GETECCU sent an invitation e-mail to partners with a link to the survey (via the on-line system Survey Monkey). An anonymous questionnaire made up of 2 types of items was used to gather data: demographic ones and those specifically targeted to determine the attitude on adherence. The time for response was extended up to 2 months, and during this time interval a second and a third survey were sent.


RESULTS: 760 partners were invited to participate, with an estimated participation of 646. The data were derived from 184 surveys (28.5%), women (63.2%) and 81% belonging to a university hospital. 68% of respondents had publications about IBD indexed on Medline, but only 13% dealt with adherence. Despite the fact that nearly 99% regarded treatment adherence as very important or important, 25% of doctors did not measure it during their practice; out of 77% of the doctors that did analysed treatment adherence, three-quarters did in all patients (regardless of severity). This measurement, however, was more likely among patients taking thiopurines or under treatment based on biological agents. Even though 100% of the doctors believed that improving adherence confers the best prognosis, 47% did not do a great deal to enhance it. The most widely used method for assessing and improving adherence was the yes/no question and the personal interview, used by 75% of doctors. Factors associated with measurement and treatment adherence improvement were: type of hospital in which the doctor practices; type of patient’s treatment; doctor’s gender; weekly time spent on IBD, having publications about IBD and about IBD adherence indexed on Medline and how relevant is adherence for the doctor.


CONCLUSIONS: Taking into account the impact of good adherence to treatment in patients with IBD, it is very important to apply an objective grading system to quantify and improve it.