Details

Autor(en) / Beteiligte

• van der Have, Mike
• Oldenburg, Bas
• Kaptein, Ad A
• Jansen, Jeroen M
• Scheffer, Robert C. H
• van Tuyl, Bas A
• van der Meulen-de Jong, Andrea E
• Pierik, Marieke
• Siersema, Peter D
• van Oijen, Martijn G. H
• Fidder, Herma H

Titel

Non-adherence to Anti-TNF Therapy is Associated with Illness Perceptions and Clinical Outcomes in Outpatients with Inflammatory Bowel Disease: Results from a Prospective Multicentre Study

Ist Teil von

• Journal of Crohn's and colitis, 2016-05, Vol.10 (5), p.549-555

Ort / Verlag

UK: Oxford University Press

Erscheinungsjahr

2016

Link zum Volltext

Quelle

Oxford Journals 2020 Medicine

Beschreibungen/Notizen

• Background and Aims: Non-adherence to anti-tumour necrosis factor [TNF] agents in patients with inflammatory bowel disease [IBD] is a serious problem. In this study, we assessed risk factors for non-adherence and examined the association between adherence to anti-TNF agents and loss of response [LOR]. Methods: In this multicentre, 12-month observational study, outpatients with IBD were included. Demographic and clinical characteristics were recorded. Adherence was measured with the Modified Morisky Adherence Scale-8 [MMAS-8] and 12-month pharmacy refills [medication possession ratio, MPR]. Risk factors included demographic and clinical characteristics, medication beliefs, and illness perceptions. Cox regression analysis was performed to determine the association between MPR and LOR to anti-TNF, IBD-related surgery or hospitalisation, dose intensification, or discontinuation of anti-TNF. Results: In total, 128 patients were included [67 infliximab, 61 adalimumab], mean age 37 ( ± standard deviation [SD] 14) years, 71 [56%] female. Median disease duration was 8 (interquartile range [IQR] 4–14) years. Clinical disease activity was present in 41/128 [32%] patients, 36/127 [28%] patients had an MMAS-8 < 6 [‘low adherence’], and 25/99 [25%] patients had an MPR < 80% [non-adherence]. Risk factors for non-adherence included adalimumab use (odds ratio [OR] 10.1, 95% confidence interval [CI] 2.62–40.00), stronger emotional response [OR 1.16, 95% CI 1.02–1.31], and shorter timeline perception, i.e. short perceived illness duration [OR 0.60, 95% CI 0.38–0.96]. Adherence is linearly and negatively [OR 0.14, 95% CI 0.03–0.63] associated with LOR. Conclusion: Non-adherence to anti-TNF agents is strongly associated with LOR to anti-TNF agents, adalimumab use, and illness perceptions. The latter may provide an important target for interventions aimed at improving adherence and health outcomes.