与溃疡性结肠炎患者口服 5-氨基水杨酸低依从性相关的因素。
Factors associated with low adherence to oral 5-aminosalicylic acid in patients with ulcerative colitis.
机构信息
Department of Gastroenterology, Haeundae Paik Hospital, Inje University College of Medicine, Busan, South Korea.
Department of Gastroenterology, Inje University Busan Paik Hospital, Inje University College of Medicine, Busan, South Korea.
出版信息
PLoS One. 2019 Mar 22;14(3):e0214129. doi: 10.1371/journal.pone.0214129. eCollection 2019.
BACKGROUND/AIMS: It is well known that 5-aminosalicylic acid (5-ASA) is the standard first-line treatment for ulcerative colitis (UC). Medication adherence is an important factor in the treatment of UC. We aimed to identify predictors of low adherence to oral 5-ASA in Koreans with UC.
METHODS
Between July 2017 and January 2018, we performed a multicenter, cross-sectional study across 6 University Hospitals in Korea. Medication adherence was assessed using the modified Morisky Medication Adherence Scale (MMAS-8) questionnaire. Our study included 264 patients with UC. Patients were requested to complete the self-reported MMAS-8 questionnaire and a survey assessing sociodemographic data. Adherence was categorized as low (scores<6), medium (scores 6-7), and high (score 8).
RESULTS
The mean age of patients was 44±14 years, women comprised 43.6% of the study population and 49.8% of the studied population showed low adherence to oral 5-ASA. Age <40 years, alcohol consumption, and current smoking were significantly associated with low adherence to oral 5-ASA (age <40 years: odds ratio [OR] 1.76, 95% confidence interval [CI] 1.04-2.96, p = .034; alcohol consumption: OR 1.66, 95% CI 1.00-2.74, p = .049; current smoking: OR 4.06, 95% CI 1.08-15.18, p = .038). When data were classified based on gender, we observed that only in men, alcohol consumption and current smoking showed a significant association with low adherence to oral 5-ASA (alcohol consumption: OR 2.14, 95% CI 1.08-4.23, p = .029; current smoking: OR 5.07, 95% CI 1.32-19.41, p = .018). In women, only age <40 years was significantly associated with low adherence to oral 5-ASA (age <40 years: OR 3.71, 95% CI 1.59-8.66, p = .002).
CONCLUSION
Approximately 50% of patients with UC showed low adherence to oral 5-ASA. Predictors of low adherence were age <40 years, alcohol consumption, and current smoking habits. In men, alcohol consumption and current smoking were significant predictors of low adherence, whereas in women only age <40 years was significantly associated with low adherence.
背景/目的：众所周知，5-氨基水杨酸（5-ASA）是溃疡性结肠炎（UC）的标准一线治疗药物。药物依从性是 UC 治疗的一个重要因素。我们旨在确定韩国 UC 患者口服 5-ASA 低依从性的预测因素。
方法
2017 年 7 月至 2018 年 1 月，我们在韩国的 6 所大学医院进行了一项多中心、横断面研究。使用改良 Morisky 药物依从性量表（MMAS-8）问卷评估药物依从性。我们的研究包括 264 例 UC 患者。患者被要求完成自我报告的 MMAS-8 问卷和一项评估社会人口统计学数据的调查。依从性分为低（评分<6）、中（评分 6-7）和高（评分 8）。
结果
患者的平均年龄为 44±14 岁，女性占研究人群的 43.6%，49.8%的研究人群对口服 5-ASA 的依从性较低。年龄<40 岁、饮酒和当前吸烟与口服 5-ASA 低依从性显著相关（年龄<40 岁：比值比[OR]1.76，95%置信区间[CI]1.04-2.96，p=0.034；饮酒：OR 1.66，95%CI 1.00-2.74，p=0.049；当前吸烟：OR 4.06，95%CI 1.08-15.18，p=0.038）。当根据性别对数据进行分类时，我们观察到仅在男性中，饮酒和当前吸烟与口服 5-ASA 的低依从性显著相关（饮酒：OR 2.14，95%CI 1.08-4.23，p=0.029；当前吸烟：OR 5.07，95%CI 1.32-19.41，p=0.018）。在女性中，仅年龄<40 岁与口服 5-ASA 低依从性显著相关（年龄<40 岁：OR 3.71，95%CI 1.59-8.66，p=0.002）。
结论
约 50%的 UC 患者口服 5-ASA 依从性较低。低依从性的预测因素是年龄<40 岁、饮酒和当前吸烟习惯。在男性中，饮酒和当前吸烟是低依从性的显著预测因素，而在女性中，仅年龄<40 岁与低依从性显著相关。
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