P572 The influence of beliefs about medication in therapeutic adherence among patients with inflammatory bowel disease.
De Castro Parga, M.L.(1,2);Alvarez-Smith, C.(1);Sanroman, L.(1);Figueira, M.(1);Hernández, V.(1);Pineda, J.(1);Martinez-Cadilla, J.(1);Pereira, S.(1);Rodriguez-Prada, I.(1);
(1)University Hospital Complex of Vigo, Department of Gastroenterology, Vigo, Spain;(2)Instituto de Investigación Sanitaria Galicia Sur IIS Galicia Sur., Sergas, Vigo, Spain
Background
Medication nonadherence in inflammatory bowel disease (IBD) is common and has a negative impact on disease outcome. It is currently not clear whether in patients with IBD, the opinions, beliefs and attitudes towards medicines determine an adequate therapeutic adherence. Our aim was to assess what the real influence of medication opinions is on IBD patients adherence.
Methods
Patients attending a tertiary hospital IBD outpatient clinic were enrolled. They filled the BMQ (Beliefs about Medication Questionnaire): a 18-item standardized scale assessing specific opinions about medication that a person is taking and beliefs about the potential for harm and overuse of medication in general. Pharmacy refill data were checked for the previous 3 months and their medication possession ratios (MPR) were calculated. Nonadherence was defined as MPR<0.8.Ethical approval was obtained.
Results
We analyzed 193 IBD patients: 96 women and 97 men with average age 46.1 years. Ulcerative colitis 109 (56.6%) and 84 Crohn´s disease (43.5%). Oral mesalazine was used for IBD control in 48%, immunosuppressnat in 43.5% and targeted therapies, 28.5%. MPR detected non-adherence in 57 patients (29.5%). Patients with CD had a higher adherence than those with UC (78.6 vs 64.2% p=0.03). Non-adherence was higher in patients with mesalazine 41.3% (p=0.001) and lower with targeted therapies 15% (p=0.007). BMQ classified our IBD patients in 60% "ambivalent", 36% " accepting", 7% "indifferent" with no "sceptical": Females had a higher puntuation in BMQ harm about medication scale (p= 0.006). Surgical patients scored higher about the necessity of their IBD medication (0.005) and patients with a low educational level showed many concerns about IBD medication (0.002). Nevertheless there were neither significant differences in BMQ general (abuse/harm) or specific (need/concern) scores nor in attitude profiles between patients with adequate adherence and non-adherent patients.
Conclusion
Non-adherence behaviour in IBD patients was not associated with beliefs about medication. Ulcerative colitis and oral mesalazine were related to lower adherence, meanwhile patients on directed therapies showed high adherence,