Li Shuyan, Ma Yan, Sun Hongling, Ni Zijun, Hu Shurong, Chen Yan, Lan Meijuan
Department of Nursing, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
Center for Inflammatory Bowel Diseases, Department of Gastroenterology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
Front Pharmacol. 2023 Aug 14;14:1185026. doi: 10.3389/fphar.2023.1185026. eCollection 2023.
Crohn's disease (CD) is an incurable chronic disease that requires long-term treatment. As an anti-tumor necrosis factor (TNF) agent, Infliximab (IFX) is widely used in the treatment of Crohn's disease, while the adherence is not high. The purpose of this study was to investigate the adherence to IFX among CD patients in China and evaluate the association between medication belief and IFX adherence. Demographic data, clinical information and patients' medication beliefs were collected using an online questionnaire and reviewing electronic medical records (EMRs). The Beliefs about Medicines Questionnaire (BMQ)-specific was used to assess medication beliefs which contains the BMQ-specific concern score and the BMQ-specific necessity score. An evaluation of adherence factors was conducted using univariate and multidimensional logistic regression analyses. In all, 166 CD patients responded the online questionnaire among which 77 (46.39%) patients had high adherence. The BMQ-specific concern score in patients in low adherence was 30.00 and in high adherence patients was 27.50, and patients with lower BMQ-specific concern score had higher adherence ( = 0.013). The multiple regression analysis showed that the BMQ-specific concern score (OR = 0.940, 95% CI: 0.888-0.996) significantly affected the IFX adherence in CD patients. Otherwise, gender, marital status, time spent on the way (including the waiting time in infusion center) and accommodation to the center were also the influencing factors of adherence. The IFX adherence to CD in China was not high. Medicine concerns may be predictive factor of adherence. Education, the duration of IFX therapy and experience of adverse effects were not significantly associated with IFX adherence. By enhancing knowledge and relieving medicine concerns, we may increase patients' adherence to IFX.
克罗恩病（CD）是一种无法治愈的慢性病，需要长期治疗。英夫利昔单抗（IFX）作为一种抗肿瘤坏死因子（TNF）药物，广泛应用于克罗恩病的治疗，但患者的依从性不高。本研究旨在调查中国克罗恩病患者对IFX的依从性，并评估用药信念与IFX依从性之间的关联。通过在线问卷和查阅电子病历（EMR）收集人口统计学数据、临床信息及患者的用药信念。使用特定的药物信念问卷（BMQ）来评估用药信念，该问卷包含BMQ特定关注得分和BMQ特定必要性得分。采用单因素和多因素逻辑回归分析对依从性因素进行评估。共有166例克罗恩病患者回复了在线问卷，其中77例（46.39%）患者依从性高。低依从性患者的BMQ特定关注得分为30.00，高依从性患者为27.50，BMQ特定关注得分较低的患者依从性较高（P = 0.013）。多因素回归分析显示，BMQ特定关注得分（OR = 0.940，95%CI：0.888 - 0.996）显著影响克罗恩病患者对IFX的依从性。此外，性别、婚姻状况、在路上花费的时间（包括在输液中心的等待时间）以及对治疗中心的适应情况也是依从性的影响因素。中国克罗恩病患者对IFX的依从性不高。对药物的关注可能是依从性的预测因素。教育程度、IFX治疗时长及不良反应经历与IFX依从性无显著关联。通过增强知识和减轻对药物的关注，我们可能会提高患者对IFX的依从性。
