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The influence of self-care-related constructs on medication adherence in inflammatory bowel disease: a scoping review
Piergiorgio Martella1, Elisa Schiavoni2, Daniele Napolitano3,4
1Department of Care Management, IRCCS A. Gemelli University Polyclinic Foundation, Rome, Italy - piergiorgio.martella@policlinicogemelli.it.
Background:
Self-care is increasingly recognized as a key determinant of outcomes in inflammatory bowel disease (IBD), yet its relationship with medication adherence remains inconsistently mapped. This scoping review aimed to explore how self-care-related constructs, including self-efficacy and patient activation are associated with medication adherence.
Methods:
A scoping review was conducted according to Joanna Briggs Institute methodology and PRISMA-ScR guidelines. PubMed, Scopus, Web of Science, and CINAHL were searched using terms related to IBD, self-care or self-management, including self-efficacy, patient activation and medication adherence. Primary studies involving adult outpatients were included. Study selection and data charting were performed by two reviewers, with discrepancies resolved through discussion with a third supervisor.
Results:
The search identified 699 records; after removing 164 duplicates, 535 records were screened. Eleven full texts were assessed, and five studies were included. Evidence was heterogeneous and included interventional and observational designs. Interventions supporting self-management, such as nurse-led counselling and practical tools, were associated with improved adherence. Telemedicine monitoring improved patient activation but not self-efficacy. Observational evidence suggested that higher self-efficacy and lower regimen complexity were associated with better adherence.
Conclusions:
Available evidence suggests that self-care-related constructs, particularly self-efficacy and patient activation, may be associated with medication adherence in IBD outpatients. However, the literature remains limited and heterogeneous. Further theory-informed and adequately powered studies are needed.
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