Factors assoiated with non-adherence to oral IBD medication: a systematic review

What is it about?

Medication has been shown to be effective in treating symptoms and maintaining periods of remission in inflammatory bowel disease (IBD). However, it has been suggested that between one third and one half of all medicines are not taken as recommended; this can lead to reduced treatment effectiveness. A large number of studies have reported on factors associated with non-adherence to oral medication for IBD. In this review of the literature we found demographic and clinical factors are not reliable indicators of the likelihood of adherence. We also found the absence of a relationship between adherence and many of the factors previously thought to be relevant. The most consistent associations were with barriers to taking medications, and attitudes and beliefs. These findings imply that interventions aimed at adherence must be capable of being individualised, of addressing patient-specific barriers and of engaging with patients own personal beliefs about their condition and attitudes towards their treatment.

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Why is it important?

The World Health Organisation state that increasing adherence may have a greater effect on health than any individual improvement in medical treatment. It has been suggested that knowledge of factors associated with non-adherence may help clinicians identify ‘at risk’ groups.

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