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Development of an Inflammatory Bowel Disease-Specific Medication Adherence Instrument and Reasons for Non-adherence

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Abstract

Background

Medication adherence impacts disease control in inflammatory bowel disease (IBD). Existing adherence measures such as the Morisky Medication Adherence Scale 8© are often costly, non-medication-specific, and time-consuming.

Aims

We aimed to develop a non-proprietary, IBD-specific medication adherence instrument and to assess reasons for suboptimal medication adherence.

Methods

We developed the IBD Medication Adherence Tool to assess frequency of adherence and indications for missed or delayed medication doses. We co-administered the IBD Medication Adherence Tool and the Morisky Medication Adherence Scale 8© (licensed for use) to participants enrolled in an internet-based cohort of adults with IBD and taking least one daily, oral IBD medication. We used Spearman’s correlation to evaluate associations between the IBD Medication Adherence Tool and Morisky Medication Adherence Scale 8©. We then categorized patients as sub-optimally adherent (IBD Medication Adherence Tool score 1–4) and highly adherent (score 5) and evaluated factors associated with and reasons for suboptimal adherence using multivariable analysis.

Results

We evaluated 514 patients (73% female, mean age 49), of whom 21.4% had suboptimal adherence. IBD Medication Adherence Tool scores were moderately correlated with Morisky Medication Adherence Scale 8© (r = 0.56, p < 0.001). The most commonly reported reasons for suboptimal adherence were forgetting, feeling well, and cost. Younger age and current smoking were associated with suboptimal adherence.

Conclusions

We developed a non-proprietary, IBD-specific tool to assess adherence to IBD medications, validated in a cohort of patients with IBD on daily, oral medications. Common reasons for suboptimal IBD medication adherence include forgetting, feeling well, and cost.

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Funding

This work was supported by the Crohn’s & Colitis Foundation. This work was supported by the National Institutes of Health [Grant Number T32 DK007634 to E.J.B and K23 DK127157-01 to E.L.B].

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Authors and Affiliations

  1. Department of Pediatric Gastroenterology, University of North Carolina, 333 S. Columbia Street, 247 MacNider Hall, CB# 7229, Chapel Hill, NC, 27599, USA

    Erica J. Brenner

  2. Department of Gastroenterology, University of North Carolina, 130 Mason Farm Rd, Bioinformatics Building, Suite 4143, Chapel Hill, NC, 27514, USA

    Millie D. Long, Xian Zhang, Robert S. Sandler & Edward L. Barnes

  3. Department of Pediatric Gastroenterology, University of North Carolina, 130 Mason Farm Rd, Bioinformatics Building, Suite 4143, Chapel Hill, NC, 27514, USA

    Michael D. Kappelman

Authors
  1. Erica J. Brenner
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  2. Millie D. Long
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  3. Michael D. Kappelman
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  4. Xian Zhang
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  5. Robert S. Sandler
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  6. Edward L. Barnes
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Corresponding author

Correspondence to Erica J. Brenner.

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Ethical approval

The IBD Partners protocol was reviewed and approved by the Institutional Review Board (IRB) of the University of North Carolina at Chapel Hill. Electronic consent was obtained at the time of cohort enrollment.

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Brenner, E.J., Long, M.D., Kappelman, M.D. et al. Development of an Inflammatory Bowel Disease-Specific Medication Adherence Instrument and Reasons for Non-adherence. Dig Dis Sci 68, 58–64 (2023). https://doi.org/10.1007/s10620-022-07517-5

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  • DOI: https://doi.org/10.1007/s10620-022-07517-5

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