P403 Therapeutic compliance in patients with chronic inflammatory bowel disease.
Hajlaoui, A.(1)*;Sabbah, M.(2);Bibani, N.(2);Jlassi, H.(2);Bellil , N.(2);Lassoued, K.(2);Trad, D.(2);Gargouri, D.(2);
(1)Habib Thameur Hospital, Department of gastroenterology., tunis, Tunisia;(2)Habib thameur hospital, Department of gastroenterology, tunis, Tunisia;
The World Health Organization estimates that half of all patients do not take their treatment as agreedwith the prescriber. Thus, the evaluation of compliance is essential in the management of patients withchronic diseases, particularly chronic inflammatory bowel diseases (IBD). This evaluation cansometimes be variable. Hence, it is of clinical significance to develop objective scales unifying compliance assessment methods.
The aim of our study was to assess therapeutic compliance in IBD patients and to identify predictivefactors of non compliance.
A cross-sectional study over a period of six months (from June to November 2022) including all IBD patients from our department was conducted.The data collection was carried out by one investigator. We used an analytical chart containingdemographic and clinical questions, the Perceived Stress Scale (PSS) questionnaire in its French version to evaluate the degree of stress and the "Morisky medication adherence scale -8 MMAS" and the "Girerd" questionnaires to evaluate compliance to treatment.
Forty-seven patients were included, with a mean age of 43 years [20-71 years] and a M/F sex ratio of0.59. Forty patients had Crohn's disease and seven had ulcerative colitis. Only 19 patients were recently (less than two years) diagnosed of IBD. Whereas, 20 patients were followed for more than 10years. All were undergoing maintainance therapy with azathioprine in 34%, anti TNF in 19%, combotherapy in 19%, 5 ASA in 8.5%. Among our population, 17% presented a flare and were under corticosteroids during our study.Most of our patients did not have a secondary or a university degree (n= 22). When it comes to patients’ perceptions of the disease, 14 patients showed a good understanding while seven showed poor knowledge. The remaining 26 patients had average knowledge about the disease and its management.Regarding the level of stress caused by their disease, 40% were able to cope with it, while 25.5% had major difficulty in stress management.Fifty-one patients were considered to be well compliant according to the MMAS-8, 32% were moderately compliant and 17% were not compliant. The results were comparable using both scores(Morisky and Girerd). The main predictors of poor compliance were level of education (p=0.042),degree of knowledge of the disease (p=0.011) and poor stress coping (p=0.001).
Adherence to treatment is the most important predictor of success or failure of therapeutic care. It isimportant to educate patients about the importance of compliance both at treatment initiation andduring periodic visits. It is also important to identify and act on the factors that lead to non-adherence.