Adherence in ulcerative colitis: an overview

Anna Testa,1 Fabiana Castiglione,1 Olga Maria Nardone,1 Giorgio L Colombo2 1Gastroenterology, University of Naples Federico II, Naples, 2Department of Drug Sciences, University of Pavia, Pavia, Italy Abstract: Medication adherence is an important challenge while treating chronic illnesses, such as...

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Main Authors: Testa A, Castiglione F, Nardone OM, Colombo GL
Format: Article
Language:English
Published: Dove Medical Press 2017-02-01
Series:Patient Preference and Adherence
Subjects:
Online Access:https://www.dovepress.com/adherence-in-ulcerative-colitis-an-overview-peer-reviewed-article-PPA
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author Testa A
Castiglione F
Nardone OM
Colombo GL
author_facet Testa A
Castiglione F
Nardone OM
Colombo GL
author_sort Testa A
collection DOAJ
description Anna Testa,1 Fabiana Castiglione,1 Olga Maria Nardone,1 Giorgio L Colombo2 1Gastroenterology, University of Naples Federico II, Naples, 2Department of Drug Sciences, University of Pavia, Pavia, Italy Abstract: Medication adherence is an important challenge while treating chronic illnesses, such as ulcerative colitis (UC), that require a long-term management to induce and maintain clinical remission. This review provides an overview of the role that medication adherence plays in the routine management of UC, with a focus on the results of a recent Italian study reporting the perception of patients with UC regarding adherence to treatment. A literature analysis was conducted on topics, such as measurement of adherence in real practice, causes, risk factors and consequences of non-adherence and strategies, to raise patients’ adherence. Most of the data refer to adherence to 5-aminosalicylic acid, and standard of care for the induction and maintenance of remission in UC. The adherence rate to 5-aminosalicylic acid is low in clinical practice, thus resulting in fivefold higher risk of relapse, likely increased risk of colorectal cancer, reduced quality of life and higher health care costs for in- and outpatient settings. There are various causes affecting non-adherence to therapy: forgetfulness, high cost of drugs, lack of understanding of the drug regimen – which are sometimes due to insufficient explanation by the specialist – anxiety created by possible adverse events, lack of confidence in physicians’ judgment and complex dosing regimen. The last aspect negatively influences adherence to medication both in clinical trial settings and in real-world practice. Regarding this feature, mesalamine in once-daily dosage may be preferable to medications with multiple doses per day because the simplification of treatment regimens improves adherence. Keywords: adherence, ulcerative colitis, 5-ASA, mesalamine, once-daily
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spelling doaj.art-a885101a38e04447bdb812eee5b1552e2022-12-21T17:34:32ZengDove Medical PressPatient Preference and Adherence1177-889X2017-02-01Volume 1129730331501Adherence in ulcerative colitis: an overviewTesta ACastiglione FNardone OMColombo GLAnna Testa,1 Fabiana Castiglione,1 Olga Maria Nardone,1 Giorgio L Colombo2 1Gastroenterology, University of Naples Federico II, Naples, 2Department of Drug Sciences, University of Pavia, Pavia, Italy Abstract: Medication adherence is an important challenge while treating chronic illnesses, such as ulcerative colitis (UC), that require a long-term management to induce and maintain clinical remission. This review provides an overview of the role that medication adherence plays in the routine management of UC, with a focus on the results of a recent Italian study reporting the perception of patients with UC regarding adherence to treatment. A literature analysis was conducted on topics, such as measurement of adherence in real practice, causes, risk factors and consequences of non-adherence and strategies, to raise patients’ adherence. Most of the data refer to adherence to 5-aminosalicylic acid, and standard of care for the induction and maintenance of remission in UC. The adherence rate to 5-aminosalicylic acid is low in clinical practice, thus resulting in fivefold higher risk of relapse, likely increased risk of colorectal cancer, reduced quality of life and higher health care costs for in- and outpatient settings. There are various causes affecting non-adherence to therapy: forgetfulness, high cost of drugs, lack of understanding of the drug regimen – which are sometimes due to insufficient explanation by the specialist – anxiety created by possible adverse events, lack of confidence in physicians’ judgment and complex dosing regimen. The last aspect negatively influences adherence to medication both in clinical trial settings and in real-world practice. Regarding this feature, mesalamine in once-daily dosage may be preferable to medications with multiple doses per day because the simplification of treatment regimens improves adherence. Keywords: adherence, ulcerative colitis, 5-ASA, mesalamine, once-dailyhttps://www.dovepress.com/adherence-in-ulcerative-colitis-an-overview-peer-reviewed-article-PPAAdherenceulcerative colitis5-ASAmesalamineonce-daily
spellingShingle Testa A
Castiglione F
Nardone OM
Colombo GL
Adherence in ulcerative colitis: an overview
Patient Preference and Adherence
Adherence
ulcerative colitis
5-ASA
mesalamine
once-daily
title Adherence in ulcerative colitis: an overview
title_full Adherence in ulcerative colitis: an overview
title_fullStr Adherence in ulcerative colitis: an overview
title_full_unstemmed Adherence in ulcerative colitis: an overview
title_short Adherence in ulcerative colitis: an overview
title_sort adherence in ulcerative colitis an overview
topic Adherence
ulcerative colitis
5-ASA
mesalamine
once-daily
url https://www.dovepress.com/adherence-in-ulcerative-colitis-an-overview-peer-reviewed-article-PPA
work_keys_str_mv AT testaa adherenceinulcerativecolitisanoverview
AT castiglionef adherenceinulcerativecolitisanoverview
AT nardoneom adherenceinulcerativecolitisanoverview
AT colombogl adherenceinulcerativecolitisanoverview