University of Manitoba Department of Internal Medicine, Max Rady College of Medicine, Rady Faculty of Health Sciences, Winnipeg, Manitoba, Canada.
University of Manitoba Inflammatory Bowel Disease Clinical and Research Centre, Winnipeg, Manitoba, Canada.
Inflamm Bowel Dis. 2021 Feb 16;27(3):317-324. doi: 10.1093/ibd/izaa056.
We aimed to validate the Medication Adherence Report Scale-5 (MARS-5) as a tool for assessing medication adherence in inflammatory bowel disease (IBD) and to determine predictors of medication adherence.
One hundred twelve (N = 112) adults with confirmed IBD participating in the longitudinal Manitoba Living With IBD Study were eligible. Demographics, IBD type, surgeries, disease activity (using the Inflammatory Bowel Disease Symptom Inventory and fecal calprotectin levels), perceived stress, and medication use were collected biweekly through online surveys. The MARS-5 scores were obtained at baseline and at 1 year. Correlation between medication monitoring data and MARS-5 scores was performed and the optimal MARS-5 cutoff point for adherence assessment determined. Predictors of medication adherence were assessed at both ≥90% and ≥80%.
Participants were predominantly female (71.4%), mean age was 42.9 (SD = 12.8), and the majority (67.9%) had Crohn disease (CD). Almost half (46.4%) were taking more than 1 IBD medication, with thiopurines (41.9%) and biologics (36.6%) the most common. Only 17.9% (n = 20) were nonadherent at a <90% level; of those, 90% (n = 18) were using oral medications. The MARS-5 was significantly associated with adherence based on medication monitoring data at baseline (r = 0.48) and week 52 (r = 0.57). Sensitivity and specificity for adherence ≥80% and ≥90% were maximized at MARS-5 scores of >22 and >23, respectively. Having CD (OR = 4.62; 95% confidence interval, 1.36-15.7) was the only significant predictor of adherence.
MARS-5 is a useful measure to evaluate adherence in an IBD population. In this highly adherent sample, disease type (CD) was the only predictor of medication adherence.
本研究旨在验证 Medication Adherence Report Scale-5（MARS-5）作为评估炎症性肠病（IBD）患者药物依从性的工具，并确定药物依从性的预测因素。
112 名确诊为 IBD 的成年人符合参与这项纵向曼尼托巴生活在 IBD 研究的条件。通过在线调查每两周收集人口统计学资料、IBD 类型、手术、疾病活动（使用炎症性肠病症状量表和粪便钙卫蛋白水平）、感知压力和药物使用情况。在基线和 1 年时获得 MARS-5 评分。对药物监测数据和 MARS-5 评分进行相关性分析，并确定评估依从性的最佳 MARS-5 截断点。在≥90%和≥80%的水平上评估药物依从性的预测因素。
参与者主要为女性（71.4%），平均年龄为 42.9（SD=12.8），大多数（67.9%）患有克罗恩病（CD）。近一半（46.4%）正在服用 1 种以上的 IBD 药物，其中最常见的是硫唑嘌呤（41.9%）和生物制剂（36.6%）。只有 17.9%（n=20）在<90%的水平上不依从；其中 90%（n=18）使用口服药物。MARS-5 与基线（r=0.48）和第 52 周（r=0.57）的药物监测数据显著相关。MARS-5 得分>22 和>23 时，对依从性≥80%和≥90%的敏感性和特异性最大。CD（OR=4.62；95%置信区间，1.36-15.7）是唯一显著的药物依从性预测因素。
MARS-5 是评估 IBD 人群药物依从性的有用工具。在这个高度依从的样本中，疾病类型（CD）是药物依从性的唯一预测因素。
