Rectal treatment in ulcerative colitis; a qualitative study exploring reasons for under utilisation

Area of Science:

• Gastroenterology
• Pharmacology
• Patient Adherence Research

Background:

• Ulcerative colitis (UC) is a chronic inflammatory bowel disease (IBD) affecting the colon.
• First-line UC treatment often involves rectal therapies (suppositories, foam, enema).
• Adherence to rectal UC treatments is notably low, impacting therapeutic efficacy.

Purpose of the Study:

• To investigate modifiable factors influencing adherence to rectal UC treatments.
• To explore perspectives of patients, healthcare providers (HCPs), and pharmaceutical companies.
• To identify strategies for improving adherence to rectal medications in UC.

Main Methods:

• Semi-structured interviews were conducted with UC patients, gastroenterologists, IBD nurses, community pharmacists, and pharmaceutical company representatives.
• Interviews focused on knowledge and beliefs, product characteristics, and communication regarding rectal therapies.
• Thematic analysis, employing inductive and deductive approaches, was used to analyze interview data.

Main Results:

• Patients with UC often feel unsupported in managing their rectal therapies.
• Pre-treatment concerns and initial application difficulties are inadequately addressed by HCPs.
• Enhanced training, patient-focused materials, visual aids, and practical tips can improve rectal medication use.

Conclusions:

• Detailed knowledge of proper rectal treatment application and open communication are vital for UC patient adherence.
• These factors are a shared priority among all stakeholders involved in UC care.
• The study proposes solutions for future development and tailored interventions to boost adherence.