Abstract
Purpose
We conducted a prospective study to determine the effects of nonadherence with mesalamine
among patients with quiescent ulcerative colitis.
Methods
We followed a cohort of 99 consecutive patients who had ulcerative colitis in remission
for more than 6 months and who were taking maintenance mesalamine. Medication adherence
rates were calculated based on pharmacy records and a validated formula. Nonadherence
was defined as refilling less than 80% of prescribed medication. Patients were followed
prospectively and evaluated either in clinic or via telephone at 6, 12, and 24 months.
The primary outcome was clinical recurrence of ulcerative colitis. Proportional hazards
models were used to adjust for confounders.
Results
At 6 months, 12 patients (12%) had clinical recurrence of disease symptoms, all of
whom were nonadherent with medication. At 12 months, 19 of 86 patients had recurrent
disease, 13 (68%) of whom were nonadherent. Patients who were not adherent with medication
had more than a fivefold greater risk of recurrence than adherent patients (hazard
ratio = 5.5; 95% confidence interval: 2.3 to 13; P < 0.001).
Conclusion
Nonadherence with medication increases the risk of clinical relapse among patients
with quiescent ulcerative colitis. Future research should be directed at behavioral
interventions to improve adherence.
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Article info
Footnotes
☆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.
Identification
Copyright
© 2003 Excerpta Medica Inc. Published by Elsevier Inc. All rights reserved.
