Adherence to ursodeoxycholic acid therapy in patients with cholestatic and autoimmune liver disease - 07/02/19
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Highlights |
• | Adherence to medication is often suboptimal, especially during long-term therapy. In this prospective study in 75 patients with cholestatic and autoimmune liver disease, adherence to ursodeoxycholic acid was measured both with real time medication monitoring and patient reported adherence. |
• | Eighty-nine percent of the patients exhibited good adherence and 11% poor adherence according to real time medication monitoring. |
• | Poor adherence was associated with young age and male gender. |
• | Despite the excellent safety profile of ursodeoxycholic acid, only 42% of all patients were accepting, whereas 50% ambivalent, and 8% indifferent to therapy. |
• | Of all patients, 92% had a strong belief that UDCA is highly necessary for their health, but at the same time 50% were worried about the possibility to become addicted to this medication and/or to experience adverse events. |
Summary |
Background |
Ursodeoxycholic acid (UDCA) is used for treatment of cholestatic liver diseases and may improve long-term outcome. Although treatment with this hydrophilic bile acid is virtually without side effects, medication adherence might be suboptimal due to patient misconceptions, compromising clinical outcome. Our aim was to evaluate adherence to UDCA in relation to patient beliefs about medicine and to identify potential predictors of poor adherence.
Methods |
Prospective open-label study recruiting patients in treatment with UDCA from April 2016 to March 2017. Adherence was assessed both by the Sensemedic dispenser and by patient-reported adherence, during 12 weeks. Good adherence was defined as ≥ 80% intake. Quality of life (by SF-36) and beliefs about medicine (by BMQ) were also assessed.
Results |
A total of 75 patients were enrolled (32% primary biliary cholangitis, 31% autoimmune hepatitis, 29% primary sclerosing cholangitis and 8% other conditions). Average adherence according to the medication dispenser was 92 ± 16% (range: 17–100). Eighty-nine percent of the patients exhibited good adherence and 11% poor adherence. According to the BMQ, 42% of all patients were accepting, 50% ambivalent, 8% indifferent and 0% skeptical to UDCA treatment. Poor adherence was associated with young age (P = 0.029) and male gender (P = 0.021).
Conclusions |
Despite the excellent safety profile of UDCA, still a significant number of patients are poorly adherent. Young age and male sex are associated with poor adherence. Efforts should be made to identify patients with poor adherence and to improve their compliance to therapy.
Le texte complet de cet article est disponible en PDF.Keywords : Attitude to health, Behavioral medicine, Adherence, Ursodeoxycholic acid
Plan
Vol 43 - N° 1
P. 37-44 - février 2019 Retour au numéro
Article précédent
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