Arquivos de Gastroenterologia
On-line version ISSN 1678-4219
DEWULF, Nathalie de Lourdes Souza et al. Compliance to drug therapy in inflammatory bowel diseases outpatients from an university hospital. Arq. Gastroenterol. [online]. 2007, vol.44, n.4, pp. 289-296. ISSN 1678-4219. http://dx.doi.org/10.1590/S0004-28032007000400003.
BACKGROUND: Compliance to drug therapy is important for a successful treatment. Although many studies have assessed compliance to treatment in patients with chronic diseases, few investigations have been carried out in inflammatory bowel diseases. AIM: To assess compliance to drug therapy in patients with inflammatory bowel diseases - Crohn's disease and ulcerative colitis -, followed at a university hospital, who had prescribed medication supplied by the Brazilian National Health System. METHODS: In a cross sectional study, a structured interview was applied to assess the compliance of 26 Crohn's disease patients, 26 ulcerative colitis patients and 4 cases with undetermined colitis. Patients were characterized as presenting higher or lower degree of compliance, based on the comparison of the information provided by the patient in the interview and data in the medical records. The Morisky test was also used to assess the behavioral pattern of the patient regarding the daily use of the medication. RESULTS: The interview showed that 15.4% of patients with Crohn's disease and 13.3% of those with ulcerative colitis could be regarded as less compliant. However, the Morisky test revealed lower compliance in 50% of patients with Crohn's disease and 63.3% of those with ulcerative colitis. Univariate analysis showed an association between low compliance and long disease duration, married status and colon involvement in Crohn's disease, and between low compliance and increased disease activity and greater number of medications in ulcerative colitis. However, multivariate analysis did not confirm any association between low compliance and any demographic or clinical factor. CONCLUSIONS: A high degree of noncompliance to treatment, linked to habitual behavior and hard to predict from demographic or clinical factor, was detected in inflammatory bowel disease patients, which suggests the need for investment in patient education regarding medication use.
Keywords : Inflammatory bowel diseases [drug therapy]; Crohn disease [drug therapy]; Colitis, ulcerative [drug therapy]; Drugs utilization; Patient compliance; Outpatients.