Gastroenterology, Salford Royal Hospital, Salford, UK.
Expert Opin Drug Saf. 2011 Nov;10(6):863-70. doi: 10.1517/14740338.2011.583915. Epub 2011 May 9.
Inflammatory bowel diseases (IBDs) require maintenance medication to sustain remission and as a prophylaxis against the development of colorectal dysplasia. Non-adherence can compromise the effectiveness of treatment plans.
Depending on study cohort and country, 7 - 72% of IBD patients do not adhere to maintenance medication plans. Non-adherence is associated with an increased number of flares and increased healthcare utilization costs. Several factors, such as experiencing side effects and demographic, socioeconomic, disease-specific and psychological variables have been associated with non-adherence in IBD. Data on demographic, socioeconomic and disease-specific variables are inconsistent, while data on psychological distress, patients' beliefs about medication and discordant doctor-patient relationships are more consistently associated with non-adherence. There has been a change towards investigation of modifiable factors for non-adherence in the recent literature.
Currently, there is no simple and effective intervention to improve adherence to IBD maintenance medication. Anxiety, beliefs about medicines and the doctor-patient relationship are promising targets for interventions, but require further study.
炎症性肠病（IBD）需要维持药物治疗以维持缓解，并预防结直肠异型增生的发生。不遵医嘱会影响治疗计划的效果。
根据研究队列和国家的不同，7%-72%的 IBD 患者不遵守维持药物治疗计划。不遵医嘱与更多的发作次数和增加的医疗保健利用成本有关。一些因素，如经历副作用以及人口统计学、社会经济学、疾病特异性和心理变量，与 IBD 中的不遵医嘱有关。关于人口统计学、社会经济学和疾病特异性变量的数据不一致，而关于心理困扰、患者对药物的信念和医患关系不一致的数据与不遵医嘱更相关。最近的文献中已经出现了针对可改变的不遵医嘱因素进行研究的趋势。
目前，尚无简单有效的干预措施来提高 IBD 维持药物治疗的依从性。焦虑、对药物的信念和医患关系是有前途的干预靶点，但需要进一步研究。
