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Overcoming Adherence Issues in Ulcerative Colitis

Overview
Specialty Gastroenterology
Date 2011 Oct 1
PMID 21960790
Citations 7
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Abstract

Ulcerative colitis (UC) is a chronic condition requiring lifelong medication to minimize the incidence of symptomatic flares. Nevertheless, studies have shown that a large proportion of patients are nonadherent to their prescribed therapeutic regimen. This review examines studies of patient adherence to 5-aminosalicylic acid (5-ASA) therapy in real world settings and considers the reasons that patients do not adhere to medication. Patients offer numerous reasons for not taking medication as prescribed; however, neither clinical nor community studies have consistently identified the same groups of patients as being high risk for poor adherence. Indeed, the problem of nonadherence is complex and requires a combination of strategies to be improved. Physicians, physician assistants, and nurse practitioners need to take the time to explain the importance of continual therapy, even when patients feel well, and should engage patients in a discussion to aid in the understanding of their nonadherence. Then, healthcare providers can determine how to best amend the regimen to improve adherence. As taking several tablets several times daily may be confusing or difficult for patients, higher strength 5-ASA formulations that require fewer daily doses have the potential to enhance patient adherence as part of an overall management strategy.

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References
1.
Brunner M, Assandri R, Kletter K, Tschurlovits M, Corrado M, Villa R . Gastrointestinal transit and 5-ASA release from a new mesalazine extended-release formulation. Aliment Pharmacol Ther. 2003; 17(3):395-402. DOI: 10.1046/j.1365-2036.2003.01445.x. View

2.
Kane S, Cohen R, Aikens J, Hanauer S . Prevalence of nonadherence with maintenance mesalamine in quiescent ulcerative colitis. Am J Gastroenterol. 2001; 96(10):2929-33. DOI: 10.1111/j.1572-0241.2001.04683.x. View

3.
Loftus Jr E, Silverstein M, Sandborn W, Tremaine W, Harmsen W, Zinsmeister A . Ulcerative colitis in Olmsted County, Minnesota, 1940-1993: incidence, prevalence, and survival. Gut. 2000; 46(3):336-43. PMC: 1727835. DOI: 10.1136/gut.46.3.336. View

4.
Lichtenstein G, Kamm M, Boddu P, Gubergrits N, Lyne A, Butler T . Effect of once- or twice-daily MMX mesalamine (SPD476) for the induction of remission of mild to moderately active ulcerative colitis. Clin Gastroenterol Hepatol. 2007; 5(1):95-102. DOI: 10.1016/j.cgh.2006.10.025. View

5.
Kripalani S, Yao X, Haynes R . Interventions to enhance medication adherence in chronic medical conditions: a systematic review. Arch Intern Med. 2007; 167(6):540-50. DOI: 10.1001/archinte.167.6.540. View