Factors associated with poor compliance amongst hospitalized, predominantly adolescent pediatric Crohn's disease

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Nathaniel A Cohen1, Dejan M Micic1, Atsushi Sakuraba1

  • 1Inflammatory Bowel Disease Center, University of Chicago Medicine, Chicago, IL, USA.

Annals of Medicine
|March 30, 2022
PubMed

Insights

Mental health disorders and smoking are key factors in medication non-compliance among adolescent Crohn's disease patients. A team-based approach is essential for improving adherence and managing underlying conditions in pediatric inflammatory bowel disease.

Area of Science:

  • Pediatric Gastroenterology
  • Adolescent Medicine
  • Mental Health Research

Background:

  • Medication compliance is crucial for managing pediatric inflammatory bowel disease (IBD) and preventing complications.
  • Non-compliance is a significant challenge in adolescent patients with Crohn's disease (CD).
  • This study investigated patient-related factors contributing to non-compliance in hospitalized pediatric CD patients.

Purpose of the Study:

  • To identify patient-related factors associated with medical treatment non-compliance in hospitalized pediatric Crohn's disease patients.
  • To analyze the prevalence and predictors of non-compliance in a predominantly adolescent cohort.
  • To inform strategies for improving medication adherence in pediatric IBD.

Main Methods:

  • Analysis of the Kids' Inpatient Database (KID), a large US all-payer pediatric inpatient database.
  • Inclusion of non-electively admitted pediatric Crohn's disease patients from 2016.
  • Extraction of data on non-compliance, comorbidities, and CD-related surgical procedures using ICD-10 codes.

Main Results:

  • Out of 2439 pediatric CD patients, 4.6% had a diagnosis of non-compliance.
  • Univariate analysis showed associations between non-compliance and smoking, cannabis use, depression, and schizoaffective disorder.
  • Multivariable analysis identified schizoaffective disorder (OR 11.6), depression (OR 1.9), and smoking (OR 2.2) as independent predictors of non-compliance.

Conclusions:

  • Mental health disorders (schizoaffective disorder, depression) and smoking are independently associated with medication non-compliance in hospitalized adolescent CD patients.
  • A multidisciplinary approach involving gastroenterologists, psychiatrists, and addiction specialists is necessary.
  • Addressing underlying mental health issues and substance use is critical for improving adherence in pediatric IBD patients.
Abstract

Keywords:
ComplianceCrohn’s diseaseinflammatory bowel diseasepaediatric gastroenterology

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