Adherence and quality of care in IBD

Abstract

Objective: In inflammatory bowel disease (IBD), adherence to both medical treatment and other aspects of care has a substantial impact on the course of the disease. Most studies of medical adherence have reported that 30–45% of patients with IBD were non-adherent. Our study aimed to investigate the different aspects of adherence and to identify predictors of non-adherence, including the quality of care, for outpatients with IBD.

Materials and methods: An anonymous electronic questionnaire was used to investigate different aspects of adherence, the quality of care, patient involvement and shared decision making among 377 IBD outpatients.

Results: Three hundred (80%) filled in the questionnaire. The overall adherence rate was 93%. Young age (< 35 years old) and smoking were significantly associated with non-adherence (prevalence odds ratio (POR) 2.98, 95% CI 1.04–8.52, p < 0.05 and POR 3.88, 95% CI 1.36–11.05, p < 0.05, respectively). The lowest medical adherence rates were found for 5-ASA and topical treatments among patients with inactive disease. A large majority of patients stated that treatment strategies were agreed upon as a shared decision between the patient and the health care professionals.

Conclusions: Predictors for non-adherence were young age and smoking. High adherence rates could be explained by a high patient satisfaction and a high degree of shared decision making.

Keywords:

• Adherence
• Crohn’s disease
• decision making
• inflammatory bowel disease
• patient compliance
• quality of health care
• ulcerative colitis

Acknowledgements

A portion of this work was presented as a poster at the ECCO conference in 2015.

Disclosure statement

None of the authors has any competing interests to declare. No funding or financial assistance was received by the authors.