Assessing medication adherence in inflammatory bowel diseases: a comparison between a self-administered scale and a pharmacy refill index
Background: Medication non-adherence in inflammatory bowel disease (IBD) has a negative impact on disease outcome. Different tools have been proposed to assess non-adherence. We aimed to compare a self-administered scale and a pharmacy refill index as a reliable measure of medication adherence and t...
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| Format: | Article |
| Language: | English |
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Aran Ediciones
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| Series: | Revista Espanola de Enfermedades Digestivas |
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| Online Access: | http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S1130-01082017000800002&lng=en&tlng=en |
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| author | María-Luisa de-Castro Luciano Sanromán Alicia Martín Montserrat Figueira Noemí Martínez Vicent Hernández Víctor del-Campo Juan-Ramón Pineda Jesús Martínez-Cadilla Santos Pereira Ignacio Rodríguez-Prada |
| author_facet | María-Luisa de-Castro Luciano Sanromán Alicia Martín Montserrat Figueira Noemí Martínez Vicent Hernández Víctor del-Campo Juan-Ramón Pineda Jesús Martínez-Cadilla Santos Pereira Ignacio Rodríguez-Prada |
| author_sort | María-Luisa de-Castro |
| collection | DOAJ |
| description | Background: Medication non-adherence in inflammatory bowel disease (IBD) has a negative impact on disease outcome. Different tools have been proposed to assess non-adherence. We aimed to compare a self-administered scale and a pharmacy refill index as a reliable measure of medication adherence and to determine what factors are related to adherence. Methods: Consecutive non-active IBD outpatients were asked to fill in the self-reported Morisky Medication Adherence Scale (MMAS-8) and the Beliefs about Medication Questionnaire (BMQ). Pharmacy refill data were reviewed from the previous three or six months and the medication possession ratio (MPR) was calculated. Non-adherence was defined as MMAS-8 scores < 6 or MPR < 0.8. Results: Two-hundred and three patients were enrolled (60% ulcerative colitis, 40% Crohn's disease); 51% were men, and the mean age was 46.3 (14) years. Seventy-four per cent of patients were on monotherapy and 26% on combination therapy; altogether, 65% received mesalazine, 46% thiopurines and 16% anti-tumor necrosis factor alfa. Non-adherence rate assessed by MPR was 37% and 22.4% by MMAS-8. Receiver operator curve analysis using a MMAS-8 cut-off of six gave an area under the curve of 0.6 (95% CI 0.5-0.7), p = 0.001. This score had an 85% sensitivity and 34% specificity to predict medication non-adherence, with negative and positive predictive values of 57% and 70% respectively. High scores in the BMQ potential for harm of medication were significantly associated with MPR non-adherence (p = 0.01). Conclusion: The accuracy of MMAS-8 to identify medication non-adherence in inactive IBD outpatients in our setting is poor due to a low specificity and a negative predictive value. Psychosocial factors such as beliefs about medication seem to be related to IBD non-adherence. |
| first_indexed | 2024-12-17T10:42:12Z |
| format | Article |
| id | doaj.art-7530622f026c4b2b9d0c801044a61f3b |
| institution | Directory Open Access Journal |
| issn | 1130-0108 |
| language | English |
| last_indexed | 2024-12-17T10:42:12Z |
| publisher | Aran Ediciones |
| record_format | Article |
| series | Revista Espanola de Enfermedades Digestivas |
| spelling | doaj.art-7530622f026c4b2b9d0c801044a61f3b2022-12-21T21:52:13ZengAran EdicionesRevista Espanola de Enfermedades Digestivas1130-0108109854255110.17235/reed.2017.5137/2017S1130-01082017000800002Assessing medication adherence in inflammatory bowel diseases: a comparison between a self-administered scale and a pharmacy refill indexMaría-Luisa de-Castro0Luciano Sanromán1Alicia Martín2Montserrat Figueira3Noemí Martínez4Vicent Hernández5Víctor del-Campo6Juan-Ramón Pineda7Jesús Martínez-Cadilla8Santos Pereira9Ignacio Rodríguez-Prada10Complexo Hospitalario de VigoComplexo Hospitalario de VigoComplexo Hospitalario de VigoComplexo Hospitalario de VigoComplexo Hospitalario de VigoComplexo Hospitalario de VigoComplexo Hospitalario de VigoComplexo Hospitalario de VigoComplexo Hospitalario de VigoComplexo Hospitalario de VigoComplexo Hospitalario de VigoBackground: Medication non-adherence in inflammatory bowel disease (IBD) has a negative impact on disease outcome. Different tools have been proposed to assess non-adherence. We aimed to compare a self-administered scale and a pharmacy refill index as a reliable measure of medication adherence and to determine what factors are related to adherence. Methods: Consecutive non-active IBD outpatients were asked to fill in the self-reported Morisky Medication Adherence Scale (MMAS-8) and the Beliefs about Medication Questionnaire (BMQ). Pharmacy refill data were reviewed from the previous three or six months and the medication possession ratio (MPR) was calculated. Non-adherence was defined as MMAS-8 scores < 6 or MPR < 0.8. Results: Two-hundred and three patients were enrolled (60% ulcerative colitis, 40% Crohn's disease); 51% were men, and the mean age was 46.3 (14) years. Seventy-four per cent of patients were on monotherapy and 26% on combination therapy; altogether, 65% received mesalazine, 46% thiopurines and 16% anti-tumor necrosis factor alfa. Non-adherence rate assessed by MPR was 37% and 22.4% by MMAS-8. Receiver operator curve analysis using a MMAS-8 cut-off of six gave an area under the curve of 0.6 (95% CI 0.5-0.7), p = 0.001. This score had an 85% sensitivity and 34% specificity to predict medication non-adherence, with negative and positive predictive values of 57% and 70% respectively. High scores in the BMQ potential for harm of medication were significantly associated with MPR non-adherence (p = 0.01). Conclusion: The accuracy of MMAS-8 to identify medication non-adherence in inactive IBD outpatients in our setting is poor due to a low specificity and a negative predictive value. Psychosocial factors such as beliefs about medication seem to be related to IBD non-adherence.http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S1130-01082017000800002&lng=en&tlng=enInflammatory bowel diseaseMedication adherencePatient complianceSurveys and questionnairesReproducibility of resultsPharmacy |
| spellingShingle | María-Luisa de-Castro Luciano Sanromán Alicia Martín Montserrat Figueira Noemí Martínez Vicent Hernández Víctor del-Campo Juan-Ramón Pineda Jesús Martínez-Cadilla Santos Pereira Ignacio Rodríguez-Prada Assessing medication adherence in inflammatory bowel diseases: a comparison between a self-administered scale and a pharmacy refill index Revista Espanola de Enfermedades Digestivas Inflammatory bowel disease Medication adherence Patient compliance Surveys and questionnaires Reproducibility of results Pharmacy |
| title | Assessing medication adherence in inflammatory bowel diseases: a comparison between a self-administered scale and a pharmacy refill index |
| title_full | Assessing medication adherence in inflammatory bowel diseases: a comparison between a self-administered scale and a pharmacy refill index |
| title_fullStr | Assessing medication adherence in inflammatory bowel diseases: a comparison between a self-administered scale and a pharmacy refill index |
| title_full_unstemmed | Assessing medication adherence in inflammatory bowel diseases: a comparison between a self-administered scale and a pharmacy refill index |
| title_short | Assessing medication adherence in inflammatory bowel diseases: a comparison between a self-administered scale and a pharmacy refill index |
| title_sort | assessing medication adherence in inflammatory bowel diseases a comparison between a self administered scale and a pharmacy refill index |
| topic | Inflammatory bowel disease Medication adherence Patient compliance Surveys and questionnaires Reproducibility of results Pharmacy |
| url | http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S1130-01082017000800002&lng=en&tlng=en |
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