Multicenter Study of Nonadherence to Self-Injectable Biologic Therapy in Patients With Inflammatory Bowel Disease:...

Area of Science:

• Gastroenterology
• Pharmacology
• Health Services Research

Background:

• Subcutaneous biologic therapies are crucial for managing inflammatory bowel disease (IBD).
• Adherence to these therapies impacts treatment outcomes.
• Integrated specialty pharmacies in academic centers may influence adherence rates.

Purpose of the Study:

• To evaluate adherence to subcutaneous biologic therapy in IBD patients within academic centers.
• To identify risk factors associated with nonadherence.
• To assess the impact of nonadherence on health outcomes, including emergency department visits and hospitalizations.

Main Methods:

• Multicenter, retrospective cohort analysis of adult IBD patients on injectable anti-TNF or anti-IL 12/23 therapies.
• Primary outcomes included medication possession ratio (MPR) and optimal adherence (MPR > 0.86).
• Risk factors (smoking, narcotic use, psychiatric history, prior biologic use) and secondary outcomes (ED visits, hospitalizations) were analyzed using statistical tests and logistic regression.

Main Results:

• High overall adherence (68%-70%) with a median MPR of 0.95 observed in 608 patients.
• Increased risk factors for nonadherence correlated with a higher likelihood of nonadherence (P < .05).
• Nonadherence significantly increased the likelihood of emergency department visits (RR 1.45) and hospitalizations (RR 1.60).

Conclusions:

• Academic centers with integrated pharmacies demonstrate high adherence rates for subcutaneous biologic therapy in IBD.
• Identified risk factors remain significant predictors of nonadherence.
• Nonadherence to biologic therapy is associated with increased healthcare utilization, including hospitalizations and ED visits.