scholarly journals A83 IMPACT OF TELEHEALTH ON MEDICATION ADHERENCE IN GASTROENTEROLOGY CHRONIC DISEASE MANAGEMENT

2021 ◽  
Vol 4 (Supplement_1) ◽  
pp. 52-53
Author(s):  
H Kim ◽  
M Tomaszewski ◽  
B Zhao ◽  
E Lam ◽  
R A Enns ◽  
...  
Keyword(s):  
Medication Adherence ◽  
Outpatient Care ◽  
Adherence Rate ◽  
Fill Rate ◽  
Medical Specialties ◽  
Funding Agencies ◽  
Adherence Assessment ◽  
Prescription Refill ◽  
Inflammatory Bowel ◽  
High Level

Abstract Background With the COVID-19 pandemic, the demand and availability of telehealth in outpatient care has increased. Although use of telehealth has been studied and validated for various medical specialties, relatively few studies have looked at its role in gastroenterology despite burden of chronic diseases such as inflammatory bowel disease (IBD). Aims To assess effectiveness of telehealth medicine in gastroenterology by comparing medication adherence rate for patients seen with telehealth and traditional in-person appointment for various GI conditions. Methods Retrospective chart analysis of patients seen in outpatient gastroenterology clinic was performed to identify patients who were given prescription to fill either through telehealth or in-person appointment. By using provincial pharmacy database, we determined the prescription fill rate. Results A total of 241 patients were identified who were provided prescriptions during visit with their gastroenterologists. 128 patients were seen through in-person visit during pre-pandemic period. 113 patients were seen through telehealth appointment during COVID pandemic. The mean age of patients in telehealth cohort was 42 years (57% male). On average patients had 10 prior visits with their gastroenterologists before index appointment, used for adherence assessment. 92% of patients were seen in follow-up, while 8% were seen in initial consultation. The majority of the patients in the telehealth cohort had IBD (89%), while the remaining 11% had various diagnoses, including functional GI disorder, gastroesophageal reflux disease, viral hepatitis, or hepatobiliary disorders. Biologic therapy was the most commonly prescribed medication (66.4%). 45 patients were provided either new medication or dose change, and 68 patients had prescription refill to continue their current medications. It took a mean of 18 days (SD = 16.2) for patients to fill their prescriptions. Prescription fill rate for patients seen through telehealth and in-person visit were 98.2% and 89.1% (P = 0.004) respectively. Patients seen through telehealth were 6.8 times more likely to fill their prescriptions compared to the in-person counterparts (OR 6.82, CI 1.51 – 30.68, P = 0.004). When we compared adherence rate while excluding biologic therapies, the prescription fill rate was 94.7% in telehealth group and 81.4% in in-person group (OR 4.11, CI 0.88 – 19.27, P = 0.056). Due to high level of adherence, statistical analysis comparing adherent and non-adherent groups was performed but yielded insignificant results. Conclusions Medication adherence rate for patients seen through telehealth was higher compared to patients seen through in-patient visit in this study. Telehealth is a viable alternative for outpatient care especially for patients with chronic GI conditions such as IBD. Funding Agencies None

scholarly journals Adherence and quality of life among diabetic patients with hypertension

2018 ◽  
Vol 8 (1) ◽  
pp. 14 ◽  
Author(s):  
Akrom Akrom ◽  
Wima Anggitasari
Keyword(s):  
Quality Of Life ◽  
Medication Adherence ◽  
Treatment Adherence ◽  
Average Score ◽  
Bivariate Analysis ◽  
Diabetic Patients ◽  
Adherence Assessment ◽  
High Level ◽  
College Educated

<p><span>The level of treatment adherence and quality of life are not known in diabetic patients with hypertension. The study aim was to evaluate the level of adherence and quality of life of diabetic patients with hypertension in Bantul Public Hospital (BPH), Bantul, Indonesia.</span><span>This</span><span> study used a Cross-sectional method by conducting a survey through a direct interview with the patient. Participants of this study were 143 diabetic patients with hypertension in the internal disease clinic of BPH. Modified Morisky Medication Adherence Scale was used to measure the level of treatment adherence and SF36 questionnaires were used to measure the quality of life. Descriptive and analytical statistical was performed on data from the adherence assessment, quality of life, demographic characteristic and the clinical condition of the research participant. Bivariate analysis with </span><span lang="IN">C</span><span>hi-square was performed to assess the relationship between demographic and clinical factors to the high level of adherence. The majority of respondents had moderate and low levels of adherence. There were 34 patients (23.78%) with a high level of adherence, 56 patients (39.16%) with moderate level of adherence, and 53 patients (37.06%) with low level of adherence. Respondents also had low quality of life, in which the average score of quality of life was 61.96±12.48. Male and college-educated patients have higher adherence (OR&gt;1, p&lt;0.05) compared to other groups. Medication adherence and quality of life of diabetic patients with hypertension in BPH were relatively low. Male and high college-educated patients were associated with high levels of adherence</span></p>

scholarly journals Assessment of Anti-Diabetic Medications Adherence among Diabetic Patients in Sana’a City, Yemen: A Cross Sectional Study

2020 ◽  
pp. 114-122
Author(s):  
Gamil Othman ◽  
Faisal Ali ◽  
Mohamed Izham Mohamed Ibrahim ◽  
Yaser Mohammed Al-Worafi ◽  
Mukhtar Ansari ◽  
...  
Keyword(s):  
Medication Adherence ◽  
Descriptive Analysis ◽  
Cross Sectional Study ◽  
Adherence Rate ◽  
Diabetic Patients ◽  
Sectional Study ◽  
Structured Interviews ◽  
Cross Sectional ◽  
Public And Private ◽  
High Level

Background: Lack of adherence to anti-diabetic medications use is linked with suboptimal glycemic control which in turn leads to increase rate of diabetic complications. The adherence to anti-diabetic medications among adult diabetic patients in Sana'a city has not been yet evaluated. Objective: This study, therefore, assessed the extent to which diabetic patients are adherent to their antidiabetic medications and explored the factors underlying such adherence attitude in Sana’a City, Yemen. Methods: A cross-sectional method was conducted among a sample of 365 diabetic patients attending public and private hospitals from March to April 2017 in Sana'a City-Yemen. Random patients were selected and data regarding their treatment adherence were obtained using a questionnaire. Adherence to diabetes medications was measured using medication adherence index followed by structured interviews. Descriptive analysis was used to compare between different groups of diabetic patients. Bivariate analyses were conducted to evaluate the associations between clinical variables. Results: The cross-sectional study included 365 patients (263 males; 102 females). A high level of medication adherence rate to anti-diabetic drugs in the present study was (70%). The adherence rate was not similar in both genders where males were more adherent than females. The most common reason for non-adherence was forgetfulness (n= 67; 61%). While the lowest factor for non-adherence was associated with ineffective (n= 7; 6%). Adherence was strongly associated with diabetes duration, monthly income, blood sugar monitoring, communication with physician, and patient’s knowledge regarding importance of medication use (p <0.05). Conclusions: The degree of adherence in patients with diabetes in Sana’a to anti-diabetic medication was shown to be mostly suboptimal. The medication adherence levels are still crucial strategy for optimal treatment against diabetes. However, additional studies on strategies to improve adherence rate and health care should be carried out in the future.

scholarly journals Predictors of Medication Adherence in Pediatric Inflammatory Bowel Disease Patients at the Stollery Children’s Hospital

2009 ◽  
Vol 23 (12) ◽  
pp. 811-815 ◽  
Author(s):  
L Kitney ◽  
JM Turner ◽  
D Spady ◽  
B Malik ◽  
W El-Matary ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Medication Adherence ◽  
Bowel Disease ◽  
Chart Review ◽  
Disease Duration ◽  
Herbal Medicines ◽  
Adherence Rate ◽  
Children's Hospital ◽  
Children’S Hospital ◽  
Inflammatory Bowel

BACKGROUND: Patients with inflammatory bowel disease (IBD) often do not take their medications as prescribed.OBJECTIVE: To examine self-reported adherence rates in IBD patients at the Stollery Children’s Hospital (Edmonton, Alberta) and to determine predictors of medication adherence.METHODS: A survey was mailed to 212 pediatric IBD patients of the Stollery Children’s Hospital. A chart review was completed for those who returned the survey.RESULTS: A total of 119 patients completed the survey. The nonresponders were significantly older than responders (14.5 years versus 13.2 years; P=0.032). The overall adherence rate was 80%. Nonadherence was associated with older age (14.6 years versus 13.0 years; P=0.04), longer disease duration (5.0 years versus 3.1 years; P=0.004) and reported use of herbal medications (40.0% versus 13.6%; P=0.029). The most common reasons reported for missing medications were forgetfulness, feeling better and too many medications. In addition, patients reported being more likely to take anti-inflammatory medications and less likely to take herbal medicines.CONCLUSION: Identified predictors of nonadherence such as age, disease duration and use of herbal treatments may enable the development of specific strategies to improve adherence in adolescents with IBD.

scholarly journals The Frequency of Clinic Visits Was Not Associated with Medication Adherence or Outcome in Children with Inflammatory Bowel Diseases

2018 ◽  
Vol 2018 ◽  
pp. 1-10 ◽  
Author(s):  
Cheryl Kluthe ◽  
Jenkin Tsui ◽  
Donald Spady ◽  
Matthew Carroll ◽  
Eytan Wine ◽  
...  
Keyword(s):  
Medication Adherence ◽  
Inflammatory Bowel Diseases ◽  
Chart Review ◽  
Patient Adherence ◽  
Retrospective Chart Review ◽  
Clinic Visit ◽  
Adherence Rate ◽  
Visit Frequency ◽  
Bowel Diseases ◽  
Inflammatory Bowel

Background. Medication nonadherence is a challenge in pediatric patients with inflammatory bowel diseases (IBD). Poor adherence can result in disease flare-ups, disease complicationstherapy escalation, and the need for corticosteroids. The aim was to determine if clinic visit frequency was associated with treatment adherence. Methods. A retrospective chart review of patients attending the Edmonton Pediatric IBD Clinic (EPIC) at the Stollery Children’s Hospital from January 2012 to December 2013 was completed. Correlations were made between frequency of clinic visit, percentage of prescriptions filled, percentage of requisitioned blood work completed, rural or urban residence, and steroid-free remission status of patients for the 6 months after the chart review. Results. 127 patients were reviewed with 82 patients diagnosed with Crohn’s disease (CD) and 46 with ulcerative colitis (UC) which included one IBD-Unclassified. Mean age at diagnosis is 9.17 years and median duration of follow-up is 3.2 years. Almost all patients on infliximab infusions received them “within window.” Immunomodulator median adherence rate was 88%. 5-ASA adherence was 82%. A median of 67% of patients had blood work completed as requested. Clinic visit frequency was not associated with adherence to blood work or to medications. Duration of disease was the only independent factor found to be associated with a reduction in blood work and immunomodulator adherence (“OR 0.86 and 95% CI: 0.74–0.99” and “OR 0.82 and 95% CI: 0.71–0.97”) per year, respectively. Patients who remained corticosteroid-free in the 6 months after the 2 years’ adherence review had an overall median medication adherence rate of 86% compared to only 53% for those who relapsed and required corticosteroids (p=0.01). Conclusion. Clinic visit frequency was not associated with patient adherence to medications or blood work. However, disease duration was found to be associated with medication adherence. Adherent patients were more likely to remain in steroid-free remission.

scholarly journals Utility of the MARS-5 in Assessing Medication Adherence in IBD

2020 ◽  
Author(s):  
James K Stone ◽  
Leigh Anne Shafer ◽  
Lesley A Graff ◽  
Lisa Lix ◽  
Kelcie Witges ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Medication Adherence ◽  
Bowel Disease ◽  
Fecal Calprotectin ◽  
Monitoring Data ◽  
Oral Medications ◽  
Medication Monitoring ◽  
Adherence Assessment ◽  
Inflammatory Bowel ◽  
Predominantly Female

Abstract Introduction We aimed to validate the Medication Adherence Report Scale-5 (MARS-5) as a tool for assessing medication adherence in inflammatory bowel disease (IBD) and to determine predictors of medication adherence. Methods One hundred twelve (N = 112) adults with confirmed IBD participating in the longitudinal Manitoba Living With IBD Study were eligible. Demographics, IBD type, surgeries, disease activity (using the Inflammatory Bowel Disease Symptom Inventory and fecal calprotectin levels), perceived stress, and medication use were collected biweekly through online surveys. The MARS-5 scores were obtained at baseline and at 1 year. Correlation between medication monitoring data and MARS-5 scores was performed and the optimal MARS-5 cutoff point for adherence assessment determined. Predictors of medication adherence were assessed at both ≥90% and ≥80%. Results Participants were predominantly female (71.4%), mean age was 42.9 (SD = 12.8), and the majority (67.9%) had Crohn disease (CD). Almost half (46.4%) were taking more than 1 IBD medication, with thiopurines (41.9%) and biologics (36.6%) the most common. Only 17.9% (n = 20) were nonadherent at a &lt;90% level; of those, 90% (n = 18) were using oral medications. The MARS-5 was significantly associated with adherence based on medication monitoring data at baseline (r = 0.48) and week 52 (r = 0.57). Sensitivity and specificity for adherence ≥80% and ≥90% were maximized at MARS-5 scores of &gt;22 and &gt;23, respectively. Having CD (OR = 4.62; 95% confidence interval, 1.36-15.7) was the only significant predictor of adherence. Conclusion MARS-5 is a useful measure to evaluate adherence in an IBD population. In this highly adherent sample, disease type (CD) was the only predictor of medication adherence.

scholarly journals Benefit of a pharmacist-led intervention for medication management of renal transplant patients: a controlled before-and-after study

2021 ◽  
Vol 12 ◽  
pp. 204062232110052
Author(s):  
Jeremy Chambord ◽  
Lionel Couzi ◽  
Pierre Merville ◽  
Karine Moreau ◽  
Fabien Xuereb ◽  
...  
Keyword(s):  
Medication Adherence ◽  
Immunosuppressive Therapy ◽  
Medication Management ◽  
Intervention Group ◽  
Knowledge Score ◽  
Control Group ◽  
Patient Knowledge ◽  
Transplant Patients ◽  
Before And After ◽  
High Level

Aims: To assess the effect of a pharmacist-led intervention, using Barrows cards method, during the first year after renal transplantation, on patient knowledge about their treatment, medication adherence and exposure to treatment in a French cohort. Methods: We conducted a before-and-after comparative study between two groups of patients: those who benefited from a complementary pharmacist-led intervention [intervention group (IG), n = 44] versus those who did not [control group (CG), n = 48]. The pharmacist-led intervention consisted of a behavioral and educational interview at the first visit (visit 1). The intervention was assessed 4 months later at the second visit (visit 2), using the following endpoints: treatment knowledge, medication adherence [proportion of days covered (PDC) by immunosuppressive therapy] and tacrolimus exposure. Results: At visit 2, IG patients achieved a significantly higher knowledge score than CG patients (83.3% versus 72.2%, p = 0.001). We did not find any differences in treatment exposure or medication adherence; however, the intervention tended to reduce the proportion of non-adherent patients with low knowledge scores. Using the PDC by immunosuppressive therapy, we identified 10 non-adherent patients (10.9%) at visit 1 and six at visit 2. Conclusions: Our intervention showed a positive effect on patient knowledge about their treatment. However, our results did not show any improvement in overall medication adherence, which was likely to be because of the initially high level of adherence in our study population. Nevertheless, the intervention appears to have improved adherence in non-adherent patients with low knowledge scores.

scholarly journals A200 VEDOLIZUMAB IS AN EFFECTIVE TREATMENT OPTION FOR NON INFLAMMATORY BOWEL DISEASE RELATED ENTEROPATHY

2021 ◽  
Vol 4 (Supplement_1) ◽  
pp. 224-225
Author(s):  
H Akhtar ◽  
T Nguyen ◽  
V Jairath
Keyword(s):  
Clinical Response ◽  
Case Series ◽  
Duration Of Treatment ◽  
Effective Treatment Option ◽  
Histologic Response ◽  
Funding Agencies ◽  
Full Text Review ◽  
Language Restriction ◽  
Inflammatory Bowel ◽  
Cell Adhesion Molecule 1

Abstract Background Vedolizumab is an α4β7 integrin antagonist which inhibits intestinal T-cell translocation by blocking integrin interactions with mucosal vascular addressin cell adhesion molecule 1, reducing lymphocyte mediated inflammation. Its gut selective mode of action and safety profile have lead to reports of off-label use of vedolizumab for non-IBD related inflammatory intestinal disorders. Aims We conducted a literature review to assess clinical, endoscopic and histologic improvement in patients treated with Vedolizumab for non-IBD enteropathies refractory to conventional therapy. Methods EMBASE, Medline, Clinicaltrials.gov and Cochrane CENTRAL were searched on September 12, 2019 for case studies, case series and cohort studies without language restriction yielding 356 studies with 164 duplicates, 74 non-applicable studies, leaving 118 studies. After full text review, 98 studies were excluded, leaving 20 included studies. Results 65% of patients (51/79) achieved clinical response. 40.5% (15/37) of patients experienced endoscopic improvement and 33% (17/51) of patients experienced histologic improvement. The duration of treatment varied from patients receiving only induction doses to up to 70 months for maintenance therapy. There were four reported cases of withdrawal due to adverse events from Vedolizumab. Conclusions In a treatment refractory population, over 60% of patients reported to have a clinical response and one-third endoscopic/histologic response, indicating that Vedolizumab is a viable option for patients with refractory non-IBD enteropathy. Funding Agencies None

scholarly journals High level of IgG4 as a biomarker for a new subset of inflammatory bowel disease

2018 ◽  
Vol 8 (1) ◽  
Author(s):  
Zhujun Wang ◽  
Min Zhu ◽  
Chengxin Luo ◽  
Yu zhen ◽  
Jingxi Mu ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Inflammatory Bowel ◽  
High Level

Su1801 One Simple Question Is Sufficient for Measuring Medication Adherence in Inflammatory Bowel Disease Patients Using Self-Report

2016 ◽  
Vol 150 (4) ◽  
pp. S556
Author(s):  
Mirjam Severs ◽  
Marie-Josée J. Mangen ◽  
Herma H. Fidder ◽  
Mirthe E. Van Der Valk ◽  
Mike Van Der Have ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Medication Adherence ◽  
Bowel Disease ◽  
Self Report ◽  
Simple Question ◽  
Inflammatory Bowel

scholarly journals Management of Acute Severe Ulcerative Colitis in a Pregnant Woman With COVID-19 Infection: A Case Report and Review of the Literature

2020 ◽  
Vol 26 (7) ◽  
pp. 971-973 ◽  
Author(s):  
Melissa H Rosen ◽  
Jordan Axelrad ◽  
David Hudesman ◽  
David T Rubin ◽  
Shannon Chang
Keyword(s):  
Ulcerative Colitis ◽  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
First Trimester ◽  
Review Of The Literature ◽  
Severe Ulcerative Colitis ◽  
Immune Mediated ◽  
First Trimester Of Pregnancy ◽  
Inflammatory Bowel ◽  
High Level

Abstract First detected in Wuhan, China, the novel 2019 severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is an enveloped RNA beta-coronavirus responsible for an unprecedented, worldwide pandemic caused by COVID-19. Optimal management of immunosuppression in inflammatory bowel disease (IBD) patients with COVID-19 infection currently is based on expert opinion, given the novelty of the infection and the corresponding lack of high-level evidence in patients with immune-mediated conditions. There are limited data regarding IBD patients with COVID-19 and no data regarding early pregnancy in the era of COVID-19. This article describes a patient with acute severe ulcerative colitis (UC) during her first trimester of pregnancy who also has COVID-19. The case presentation is followed by a review of the literature to date on COVID-19 in regard to inflammatory bowel disease and pregnancy, respectively.

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