Higher education, professional occupation, and upper socioeconomic status are associated with lower adherence to medications in patients with inflammatory bowel disease

• Published in: JGH open Vol. 3; no. 4; pp. 302 - 309
• Main Authors: Tomar, Sanjeevani K, Kedia, Saurabh, Singh, Namrata, Upadhyay, Ashish D, Kamat, Nagesh, Bopanna, Sawan, Yadav, Dawesh P, Goyal, Sandeep, Jain, Saransh, Makharia, Govind, Ahuja, Vineet
• Format: Journal Article
• Language: English
• Published: Melbourne Wiley Publishing Asia Pty Ltd 01.08.2019; John Wiley & Sons, Inc; Wiley
• Subjects: adherence; Age; Crohn's disease; Crohns disease; Diabetes; Drug dosages; Education; Gender; Illnesses; Inflammatory bowel disease; mesalamine; Original; Patient compliance; Patients; Questionnaires; Researchers; Sociodemographics; Socioeconomic factors; Socioeconomic status; Studies; ulcerative colitis; India; mesalamine; Crohn's disease; ulcerative colitis; adherence; inflammatory bowel disease
• ISSN: 2397-9070; 2397-9070
• DOI: 10.1002/jgh3.12160

Background and Aim The literature on medication adherence in patients with inflammatory bowel disease (IBD) is heterogeneous. The present study aimed to identify the rates and predictors of nonadherence to medications in IBD. Methods This cross‐sectional study included patients of IBD (ulcerative colitis [UC] and Crohn's disease [CD]) recruited between November 2016 and March 2017. Adherence was assessed with a questionnaire (interview based) that evaluated patients' sociodemographic and disease profile and rates and predictors of medication adherence. Results A total of 266 patients (204 UC, 62 CD) were included (mean age: 38.5 ± 12.7 years, males: 142 [53.4%], mean disease duration: 6.4 ± 5.2 years). The overall adherence rate was 82.3%, with the lowest for topical therapy (67.3%) and the highest for steroids (95.9%). Predominant reasons for nonadherence were forgetting dose (18.8%), unavailability of medications (13.2%), felt better (11.7%), adverse effects (6.8%), and cost of treatment (6.0%). Patients' education (P < 0.001), occupation (P = 0.097), and socioeconomic status (P = 0.021) had a negative association with adherence. Patients in upper socioeconomic strata with professional education/occupation were the least adherent (47%), whereas patients from lower socioeconomic strata who were illiterate and unemployed had the highest adherence (100%). Conclusion More than 80% of patients were adherent to their medications; adherence was the lowest for topical therapy. Higher education, occupation, and upper socioeconomic status were negatively associated with adherence. Current literature on medication adherence in patients with inflammatory bowel disease is heterogeneous. Adherence rates were least among patients in upper socio‐economic strata with professional education/occupation whereas patients from the lower socioeconomic strata who were illiterate and unemployed had the highest adherence rates.