Medication adherence level and its predictors among inflammatory bowel disease sufferers in a resource-strained healthcare setting

Abstract

BACKGROUND: Despite novel breakthroughs in the inflammatory bowel disease (IBD) therapeutics armamentarium, nonadherence remains an invisible epidemic. However, its prevalence and determining features were unknown within resource-strained healthcare settings. METHODS: A hospital-based cross-sectional study was conducted on adults with IBD from December 2023 to July 2024. A standardized questionnaire and medical record review checklist were used to gather data. Multiple ordinal logistic regression analysis was used to adjudicate potential covariates. A variable was deemed statistically significant if its adjusted odds ratio had a P value of below 0.05 at 95% confidence interval. RESULTS: This study comprised 237 patient cohort (age: mean ± SD, 53.81 ± 6.71 years). Among them, 32.9, 29.96, and 37.14% were low, medium, and high adherents, respectively. Just under half (43.05%) of participants had a high medication regimen complexity score (mean ± SD, 19.46 ± 2.11). Health insurance status, active disease state, medication regimen complexity score, stigma, comorbidity status, adverse drug reactions, and polypharmacy were the potential predictors identified in the final model. CONCLUSION: Nearly two-thirds of the study's cohort exhibited suboptimal medication adherence, highlighting a significant clinical concern. Policymakers could consider developing key strategies such as integrating pharmacists and Medication Regimen Complexity Index-65 into IBD chronic care, and leveraging a validated, local-language adherence assessment tool offer a powerful approach to optimize treatment adherence among IBD sufferers.