Insight into the widespread problem of nonadherence to therapy in ulcerative colitis patients

Abstract

Ulcerative colitis is a chronic condition that requires long-term treatment. The first-line therapy remains 5-aminosalicylic acid, which is available in several different formulations and dosing schedules. Several studies have demonstrated that adherence rates to prescribed 5-aminosalicylic acid products are below those expected for a drug that has significant consequences on important outcomes. Worse disease outcomes, higher medical costs and even potentially higher rates of colorectal cancer have been associated with nonadherence. Nonadherence is multifactorial, fluid in nature over time and is dependent on disease activity level. Interventions to improve adherence rates have to be individualized. With the advent of simpler dosing regimens it was assumed that adherence rates would improve, but this has not been the case. Despite our current knowledge about nonadherence, it remains difficult to manage long term.

Keywords::

• 5-ASA
• adherence
• compliance
• mesalamine
• persistence
• ulcerative colitis

Financial & competing interests disclosure

Sunanda Kane serves as a consultant to Kyorin, Shire and Warner Chilcott, and receives research support from Shire and Warner Chilcott. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

No writing assistance was utilized in the production of this manuscript.