Dewulf Nathalie de Lourdes Souza, Monteiro Rosane Aparecida, Passos Afonso Dinis Costa, Vieira Elisabeth Meloni, Troncon Luiz Ernesto de Almeida
Departamentos de Clínica Médica, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil.
Arq Gastroenterol. 2007 Oct-Dec;44(4):289-96. doi: 10.1590/s0004-28032007000400003.
Compliance to drug therapy is important for a successful treatment. Although many studies have assessed compliance to treatment in patients with chronic diseases, few investigations have been carried out in inflammatory bowel diseases.
To assess compliance to drug therapy in patients with inflammatory bowel diseases, Crohn's disease and ulcerative colitis, followed at a university hospital, who had prescribed medication supplied by the Brazilian National Health System.
In a cross sectional study, a structured interview was applied to assess the compliance of 26 Crohn's disease patients, 26 ulcerative colitis patients and 4 cases with undetermined colitis. Patients were characterized as presenting higher or lower degree of compliance, based on the comparison of the information provided by the patient in the interview and data in the medical records. The Morisky test was also used to assess the behavioral pattern of the patient regarding the daily use of the medication.
The interview showed that 15.4% of patients with Crohn's disease and 13.3% of those with ulcerative colitis could be regarded as less compliant. However, the Morisky test revealed lower compliance in 50% of patients with Crohn's disease and 63.3% of those with ulcerative colitis. Univariate analysis showed an association between low compliance and long disease duration, married status and colon involvement in Crohn's disease, and between low compliance and increased disease activity and greater number of medications in ulcerative colitis. However, multivariate analysis did not confirm any association between low compliance and any demographic or clinical factor.
A high degree of noncompliance to treatment, linked to habitual behavior and hard to predict from demographic or clinical factor, was detected in inflammatory bowel disease patients, which suggests the need for investment in patient education regarding medication use.
药物治疗的依从性对于成功治疗至关重要。尽管许多研究评估了慢性病患者的治疗依从性，但针对炎症性肠病的相关研究较少。
评估在大学医院随访的、使用巴西国家卫生系统提供药物治疗的炎症性肠病（包括克罗恩病和溃疡性结肠炎）患者的药物治疗依从性。
在一项横断面研究中，采用结构化访谈评估26例克罗恩病患者、26例溃疡性结肠炎患者和4例未定型结肠炎患者的依从性。根据访谈中患者提供的信息与病历数据的比较，将患者分为依从性高或低两类。还使用了莫利斯基测试来评估患者日常用药的行为模式。
访谈显示，15.4%的克罗恩病患者和13.3%的溃疡性结肠炎患者可被视为依从性较低。然而，莫利斯基测试显示，50%的克罗恩病患者和63.3%的溃疡性结肠炎患者依从性较低。单因素分析显示，克罗恩病患者依从性低与病程长、已婚状态和结肠受累有关，溃疡性结肠炎患者依从性低与疾病活动度增加和用药数量增多有关。然而，多因素分析未证实依从性低与任何人口统计学或临床因素之间存在关联。
在炎症性肠病患者中检测到高度的治疗不依从性，这与习惯行为有关，且难以从人口统计学或临床因素预测，这表明需要在患者药物使用教育方面进行投入。
