Author(s): Moss AC, Chaudhary N, Tukey M, Junior J, Cury D,
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Abstract BACKGROUND: Patient adherence to medications, particularly mesalamine, is reported to be low in patients with ulcerative colitis. We sought to determine whether a nurse-delivered patient-support program could improve medication adherence in these patients. METHODS: Patients prescribed mesalamine for ulcerative colitis prospectively received either a 23 week, nurse-delivered, patient support program (PSP) by phone, or standard care (SC). Medication adherence and quality of life were measured before and at 3 and 6 months after the program started. RESULTS: Eighty-one patients completed the study; 60 who received standard care, and 21 who received the PSP. Patients were in remission (mean SCAI score 3) at enrollment. Mean \% of prescribed mesalamine refilled was 71\% and 74\% in the SC and PSP groups at 3 months (p=0.7), and 73\% and 84\% at 6 months (p=0.4). The proportion of adherent patients at 3 months (39\% vs 44\%, p=0.7) and 6 months (50\% vs 67\%, p=0.3) were similar between the SC and PSP groups. There was no association between use of the PSP and adherence at 3 (OR 1.2, 95\% CI 0.4 to 3.8) or 6 months (OR 2, 95\% CI 0.6 to 7). The change from baseline in SIBDQ scores were similar between SC and PSP groups at 3 months (+0.3 vs +0.2, p=0.8), and 6 months (+0.6 vs +0.2, p=0.2). CONCLUSIONS: This nurse-delivered patient-support program did not significantly improve medication adherence or quality-of-life beyond standard care at short and medium-term time-points. Simply discussing and measuring adherence improved mesalamine adherence in both groups in this study. Copyright © 2009 European Crohn's and Colitis Organisation. Published by Elsevier B.V. All rights reserved.
This article was published in J Crohns Colitis
and referenced in Advances in Pharmacoepidemiology and Drug Safety