Shared decision-making improves adherence to mesalamine in ulcerative colitis: A prospective, multicenter,...

Area of Science:

• Gastroenterology
• Pharmacology
• Patient Adherence Research

Background:

• Mesalamine is a first-line treatment for mild-to-moderate ulcerative colitis (UC).
• Suboptimal adherence to mesalamine is common in real-world settings.
• Collaborative patient-provider relationships may improve adherence and outcomes.

Purpose of the Study:

• To quantify the association between patient participation in treatment decision-making and adherence to oral mesalamine in UC.
• To investigate the impact of medication preference on mesalamine adherence.

Main Methods:

• A 12-month prospective, non-interventional cohort study involving 520 patients with UC across 113 German gastroenterology practices.
• Data collected included demographics, clinical characteristics, mesalamine formulation preference, disease knowledge, self-reported adherence, and disease activity.
• Correlation and logistic regression analyses were used to assess associations.

Main Results:

• Approximately 75% of patients reported good adherence throughout the study.
• Patient participation in treatment decisions was significantly associated with better adherence (P=0.04).
• This association was particularly strong for patients preferring and receiving prolonged-release mesalamine granules (OR=2.73, P=0.001).
• Good adherence correlated with significant improvements in disease activity over 12 months (P<0.001).

Conclusions:

• Facilitating patient involvement in treatment decisions can enhance mesalamine adherence in UC patients.
• Accommodating patient preferences for medication formulation is crucial for improving adherence.
• These strategies hold potential for improved long-term ulcerative colitis management.