Medication Non-Adherence in Inflammatory Bowel Disease: A Systematic Review Identifying Risk Factors and Opportunities for Intervention

Inflammatory bowel disease (IBD) is treated with medications to induce and maintain remission. However, many people with IBD do not take their prescribed treatment. Identifying factors associated with IBD medication adherence is crucial for supporting effective disease management and maintaining rem...

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Main Authors: Kathryn King, Wladyslawa Czuber-Dochan, Trudie Chalder, Christine Norton
Format: Article
Language:English
Published: MDPI AG 2025-02-01
Series:Pharmacy
Subjects:
Online Access:https://www.mdpi.com/2226-4787/13/1/21
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author Kathryn King
Wladyslawa Czuber-Dochan
Trudie Chalder
Christine Norton
author_facet Kathryn King
Wladyslawa Czuber-Dochan
Trudie Chalder
Christine Norton
author_sort Kathryn King
collection DOAJ
description Inflammatory bowel disease (IBD) is treated with medications to induce and maintain remission. However, many people with IBD do not take their prescribed treatment. Identifying factors associated with IBD medication adherence is crucial for supporting effective disease management and maintaining remission. Quantitative and qualitative studies researching IBD medication adherence between 2011 and 2023 were reviewed. In total, 36,589 participants were included in 79 studies. The associated non-adherence factors were contradictory across studies, with rates notably higher (72–79%) when measured via medication refill. Non-adherence was lower in high-quality studies using self-report measures (10.7–28.7%). The frequent modifiable non-adherence risks were a poor understanding of treatment or disease, medication accessibility and an individual’s organisation and planning. Clinical variables relating to non-adherence were the treatment type, drug regime and disease activity. Depression, negative treatment beliefs/mood and anxiety increased the non-adherence likelihood. The non-modifiable factors of limited finance, younger age and female sex were also risks. Side effects were the main reason cited for IBD non-adherence in interviews. A large, contradictory set of literature exists regarding the factors underpinning IBD non-adherence, influenced by the adherence measures used. Simpler medication regimes and improved accessibility would help to improve adherence. IBD education could enhance patient knowledge and beliefs. Reminders and cues might minimise forgetting medication. Modifying risks through an adherence support intervention could improve outcomes.
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spelling doaj-art-005e29edbdd148e4843a7b3dd535f1942025-08-20T02:44:43ZengMDPI AGPharmacy2226-47872025-02-011312110.3390/pharmacy13010021Medication Non-Adherence in Inflammatory Bowel Disease: A Systematic Review Identifying Risk Factors and Opportunities for InterventionKathryn King0Wladyslawa Czuber-Dochan1Trudie Chalder2Christine Norton3Florence Nightingale Faculty of Nursing Midwifery and Palliative Care, King’s College London, London SE1 8WA, UKFlorence Nightingale Faculty of Nursing Midwifery and Palliative Care, King’s College London, London SE1 8WA, UKDepartment of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London SE5 8AB, UKFlorence Nightingale Faculty of Nursing Midwifery and Palliative Care, King’s College London, London SE1 8WA, UKInflammatory bowel disease (IBD) is treated with medications to induce and maintain remission. However, many people with IBD do not take their prescribed treatment. Identifying factors associated with IBD medication adherence is crucial for supporting effective disease management and maintaining remission. Quantitative and qualitative studies researching IBD medication adherence between 2011 and 2023 were reviewed. In total, 36,589 participants were included in 79 studies. The associated non-adherence factors were contradictory across studies, with rates notably higher (72–79%) when measured via medication refill. Non-adherence was lower in high-quality studies using self-report measures (10.7–28.7%). The frequent modifiable non-adherence risks were a poor understanding of treatment or disease, medication accessibility and an individual’s organisation and planning. Clinical variables relating to non-adherence were the treatment type, drug regime and disease activity. Depression, negative treatment beliefs/mood and anxiety increased the non-adherence likelihood. The non-modifiable factors of limited finance, younger age and female sex were also risks. Side effects were the main reason cited for IBD non-adherence in interviews. A large, contradictory set of literature exists regarding the factors underpinning IBD non-adherence, influenced by the adherence measures used. Simpler medication regimes and improved accessibility would help to improve adherence. IBD education could enhance patient knowledge and beliefs. Reminders and cues might minimise forgetting medication. Modifying risks through an adherence support intervention could improve outcomes.https://www.mdpi.com/2226-4787/13/1/21inflammatory bowel diseasemedication non-adherencemedication non-concordancemedication non-compliancemedication non-persistencesystematic review
spellingShingle Kathryn King
Wladyslawa Czuber-Dochan
Trudie Chalder
Christine Norton
Medication Non-Adherence in Inflammatory Bowel Disease: A Systematic Review Identifying Risk Factors and Opportunities for Intervention
Pharmacy
inflammatory bowel disease
medication non-adherence
medication non-concordance
medication non-compliance
medication non-persistence
systematic review
title Medication Non-Adherence in Inflammatory Bowel Disease: A Systematic Review Identifying Risk Factors and Opportunities for Intervention
title_full Medication Non-Adherence in Inflammatory Bowel Disease: A Systematic Review Identifying Risk Factors and Opportunities for Intervention
title_fullStr Medication Non-Adherence in Inflammatory Bowel Disease: A Systematic Review Identifying Risk Factors and Opportunities for Intervention
title_full_unstemmed Medication Non-Adherence in Inflammatory Bowel Disease: A Systematic Review Identifying Risk Factors and Opportunities for Intervention
title_short Medication Non-Adherence in Inflammatory Bowel Disease: A Systematic Review Identifying Risk Factors and Opportunities for Intervention
title_sort medication non adherence in inflammatory bowel disease a systematic review identifying risk factors and opportunities for intervention
topic inflammatory bowel disease
medication non-adherence
medication non-concordance
medication non-compliance
medication non-persistence
systematic review
url https://www.mdpi.com/2226-4787/13/1/21
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