Self-reported treatment adherence in inflammatory bowel disease in Indian patients

Non-adherence to medical therapy is emerging as an important determinant of relapse in patients with inflammatory bowel disease (IBD).

To find the prevalence of and reasons for nonadherence to medical therapy in Indian patients with IBD and its correlation with disease outcome.

In this cross-sectional study, we checked for adherence to treatment in 127 patients with IBD (117 ulcerative colitis and 10 Crohn's disease) using a questionnaire that inquired into frequency of missed doses, causes for missed doses, and its relation to relapse of disease.

Of the 127 patients (mean age 42.8 years; 68 women), 103 (81%) were non-adherent to treatment, defined as taking 80% or less of the dose advised. The reasons for non-adherence (not mutually exclusive) were: forgetfulness-98 patients (77%), felt better-18 (14.2 %), high frequency of doses-13 (10.1%), no effect of medications-10 (7.87%), non-availability of medications-3 (2.3%). Non-adherent patients were three times more likely to develop a relapse as compared to those with adherence (OR 3.389, 95% CI 1.29-8.88, p=0.012).

Over 80% of patients with IBD in this survey were non-adherent to medical treatment; forgetfulness was mentioned as the most common cause. Non-adherent patients were more likely to relapse. Patients need to be educated regarding the need for adherence to treatment in IBD.