Non-adherence to Medications in Pregnant Ulcerative Colitis Patients Contributes to Disease Flares and Adverse Pregnancy Outcomes
- 06.04.2020
- Original Article
Erschienen in:
- Verfasst von
- Chikako Watanabe
- Masakazu Nagahori
- Toshimitsu Fujii
- Kaoru Yokoyama
- Naoki Yoshimura
- Taku Kobayashi
- Hirokazu Yamagami
- Kazuya Kitamura
- Kagaya Takashi
- Shiro Nakamura
- Makoto Naganuma
- Shunji Ishihara
- Motohiro Esaki
- Maria Yonezawa
- Reiko Kunisaki
- Atsushi Sakuraba
- Naoaki Kuji
- Soichiro Miura
- Toshifumi Hibi
- Yasuo Suzuki
- Ryota Hokari
- Erschienen in
- Digestive Diseases and Sciences | Ausgabe 2/2021
Abstract
Background
Adherence to medications is important to maintain disease under control and to prevent complications in pregnant patients with ulcerative colitis (UC). To evaluate the incidence of non-adherence during pregnancy and its effect on relapse and pregnancy outcomes, we conducted a multicenter prospective study using a patient self-reporting system without physician interference.
Methods
Sixty-eight pregnant UC women were recruited from 17 institutions between 2013 and 2019. During the course of pregnancy, questionnaires were collected separately from patients and physicians, to investigate the true adherence to medications, disease activity, and birth outcomes. Multivariable logistic regression analysis was performed to identify the risk factors for the relapse or adverse pregnancy outcomes.
Results
Of 68 pregnancy, 15 adverse pregnancy outcomes occurred in 13 patients. The rate of self-reported non-adherence was the greatest to mesalamines in the first trimester, which was significantly higher than physicians’ estimate (p = 0.0116), and discontinuation was observed in 42.1% of non-adherent group. Logistic regression analysis revealed non-adherence as an independent risk factor for relapse [odds ratio (OR) 7.659, 95% CI 1.928–30.427, p = 0.038], and possibly for adverse pregnancy outcome (OR 8.378, 95% CI 1.350–51.994, p = 0.023). Among the subgroup of patients treated with oral mesalamine alone, the non-adherence was confirmed to be an independent risk factor for relapse (p = 0.002).
Conclusion
Non-adherence to mesalamine was underestimated by physicians in pregnant UC patients and contributed to disease relapse and possibly on pregnancy outcomes. Preconceptional education regarding safety of medications and risk of self-discontinuation is warranted.
Anzeige
- Titel
- Non-adherence to Medications in Pregnant Ulcerative Colitis Patients Contributes to Disease Flares and Adverse Pregnancy Outcomes
- Verfasst von
-
Chikako Watanabe
Masakazu Nagahori
Toshimitsu Fujii
Kaoru Yokoyama
Naoki Yoshimura
Taku Kobayashi
Hirokazu Yamagami
Kazuya Kitamura
Kagaya Takashi
Shiro Nakamura
Makoto Naganuma
Shunji Ishihara
Motohiro Esaki
Maria Yonezawa
Reiko Kunisaki
Atsushi Sakuraba
Naoaki Kuji
Soichiro Miura
Toshifumi Hibi
Yasuo Suzuki
Ryota Hokari
- Publikationsdatum
- 06.04.2020
- Verlag
- Springer US
- Erschienen in
-
Digestive Diseases and Sciences / Ausgabe 2/2021
Print ISSN: 0163-2116
Elektronische ISSN: 1573-2568 - DOI
- https://doi.org/10.1007/s10620-020-06221-6
Dieser Inhalt ist nur sichtbar, wenn du eingeloggt bist und die entsprechende Berechtigung hast.
