Clinical studyMedication nonadherence and the outcomes of patients with quiescent ulcerative colitis☆
Section snippets
Patients
Patients followed at the University of Chicago Adult Gastroenterology Outpatient Clinic were enrolled. Patients were recruited consecutively from May 1998 through October 1998, either during a clinic visit or via telephone after a patient-initiated request for a medication refill. Eligibility criteria included a history of quiescent ulcerative colitis for at least the preceding 6 months and maintenance treatment with mesalamine (Asacol, Procter and Gamble, Cincinnati, Ohio). The diagnosis of
Results
Ninety-nine consecutive patients with ulcerative colitis in remission and who were being treated with mesalamine were recruited during an 8-month period (Table 1). Thirty-nine patients developed recurrent symptoms during follow-up. The annual incidence of relapse was about 20%.
By 6 months, 12 patients (12%) had clinical recurrence of their disease, all of whom were nonadherent with medication. The median percentage of prescribed mesalamine refilled was 51% (range, 0% to 76%), compared with 77%
Discussion
In this prospective study, we found that clinical recurrence of ulcerative colitis was associated with nonadherence to prescribed mesalamine. A previous study, which followed patients for 48 weeks to identify risk factors for recurrent ulcerative colitis, did not find any association between medication adherence and clinical relapse (20). However, medication adherence was measured by asking patients and was greater than 95% for all participants. Direct patient inquiry is inaccurate as patients
References (27)
- et al.
Cigarette smoking and ulcerative colitis: a case-control study
Mayo Clin Proc
(1994) - et al.
Stress and exacerbation in ulcerative colitisa prospective study of patients enrolled in remission
Am J Gastroenterol
(2000) - et al.
Effects of nonsteroidal antiinflammatory drugs on inflammatory bowel diseasea case-control study
Am J Gastroenterol
(2000) - et al.
Telephoning the patient’s pharmacy to assess adherence with asthma medications by measuring refill rate for prescriptions
J Pediatr
(2000) - et al.
The assessment of refill compliance using pharmacy recordsmethods, validity, and applications
J Clin Epidemiol
(1997) - et al.
Clinical, biological, and histological parameters as predictors of relapse in ulcerative colitis
Gastroenterology
(2001) - et al.
Course of ulcerative colitisanalysis of changes in disease activity over years
Gastroenterology
(1994) - et al.
Increasing patient adherence to gastroenterology treatment and prevention regimens
Am J Gastroenterol
(1999) - et al.
Effects of smoking on the presentation and clinical course of inflammatory bowel disease
Eur J Gastroenterol Hepatol
(1997) - et al.
Non-steroidal anti-inflammatory drugs are associated with emergency admission to hospital for colitis due to inflammatory bowel disease
Gut
(1997)
An oral preparation of mesalamine as long-term maintenance therapy for ulcerative colitis. A randomized, placebo-controlled trial
Ann Intern Med
Coated oral 5-aminosalicylic acid (Claversal) is equivalent to sulfasalazine for remission maintenance in ulcerative colitisa double-blind study
J Clin Gastroenterol
Comparison of the efficacy and safety of 1.5 compared with 3.0 g oral slow-release mesalazine (Pentasa) in the maintenance treatment of ulcerative colitis
Eur J Gastroenterol Hepatol
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This research was funded by grants from Procter and Gamble Pharmaceuticals, Cincinnati, Ohio, and the David and Reva Logan Center for Gastrointestinal Research, Chicago, Illinois.