Tae Chung Hyun, Jung Sung-Ae, Moon Hye Sung, Seo Jung-A, Song Hye Kyung, Moon Chang Mo, Kim Seong-Eun, Shim Ki-Nam, Jung Hye-Kyung
Departments of *Health Promotion Medicine †Internal Medicine, Ewha Medical Research Institute, Ewha Womans University School of Medicine, Seoul, Korea.
J Clin Gastroenterol. 2016 Feb;50(2):157-62. doi: 10.1097/MCG.0000000000000431.
To investigate the association between treatment nonadherence and patients' knowledge of the prescribed medication among individuals with inflammatory bowel disease (IBD), and evaluate the impact of nonadherence on relapse.
The patient's knowledge of the prescribed medication has been identified as an important predictor of treatment adherence in chronic diseases. However, this association has not been examined in IBD.
In this prospective study, at baseline, 138 patients with IBD completed a self-reported survey on demographic data, knowledge of the prescribed medication, and candidate factors related to the degree of treatment adherence. To investigate the impact of nonadherence among patients in remission, relapse was analyzed for 18 months after enrollment.
Nonadherence was observed in 50 (36.2%) of the 138 subjects. In multivariate analysis, nonadherence was significantly associated with younger age (less than 30 y) at participation [odds ratio (OR), 5.88; 95% confidence interval (CI), 1.51-22.94; P=0.011], longer intervals between outpatient clinic visits (≥3 mo) (OR, 30.31; 95% CI, 3.06-300.17; P=0.004), and limited knowledge of the prescribed medication (OR, 5.61; 95% CI, 1.60-19.67; P=0.038). Nonadherent patients had a significantly greater risk of relapse of IBD than adherent patients (relative risk, 2.9; 95% CI, 2.25-3.79; P=0.045).
Younger age, longer intervals between outpatient clinic visits, and limited knowledge of the prescribed medication tended to be associated with nonadherence to treatment, which consequently also affects the risk of relapse.
调查炎症性肠病(IBD)患者中治疗不依从与患者对所开药物的了解之间的关联,并评估不依从对复发的影响。
患者对所开药物的了解已被确定为慢性病治疗依从性的重要预测因素。然而,这种关联尚未在IBD中进行研究。
在这项前瞻性研究中,在基线时,138例IBD患者完成了一项关于人口统计学数据、对所开药物的了解以及与治疗依从程度相关的候选因素的自我报告调查。为了调查缓解期患者不依从的影响,在入组后18个月分析复发情况。
138名受试者中有50名(36.2%)出现不依从。在多变量分析中,不依从与参与研究时年龄较小(小于30岁)[比值比(OR),5.88;95%置信区间(CI),1.51 - 22.94;P = 0.011]、门诊就诊间隔时间较长(≥3个月)(OR,30.31;95% CI,3.06 - 300.17;P = 0.004)以及对所开药物的了解有限(OR,5.61;95% CI,1.60 - 19.67;P = 0.038)显著相关。不依从的患者比依从的患者患IBD复发的风险显著更高(相对风险,2.9;95% CI,2.25 - 3.79;P = 0.045)。
年龄较小、门诊就诊间隔时间较长以及对所开药物的了解有限往往与治疗不依从相关,这进而也会影响复发风险。