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Just over half of NZ Patients with Inflammatory Bowel Disease have ‘Good’ Medication Adherence: a look at how well patients take their medication

As former US Surgeon General, Dr C. Everett Koop, said: “Drugs don't work in patients who don't take them.” Hence, it is very important for patients to take their medications as prescribed i.e. practice medication adherence (MA). This is essential particularly for patients with Inflammatory Bowel Disease (IBD) as IBD has no cure; so, it is mainly managed using life-long medication therapy with disease monitoring, besides other interventions.

IBD is a chronic gut disease made up of Crohn’s Disease, Ulcerative Colitis and IBD-unclassified. Patients with IBD may experience periods of active disease with ‘flare-ups’ and ‘quiescent’ periods at other times. They may also have symptoms including (bloody) diarrhoea, urgency, constipation, abdominal pain, weight loss amongst others; all of which limit their quality of life and productivity.

Researchers at the University of Otago, Department of Medicine, investigated the nationwide MA levels of patients with IBD using national pharmacy dispensing claims and hospitalisation data. They found that the average MA over three years, for 4654 patients, was moderately high at 77.4%. Likewise, average MA over five years was also moderately high at 74.9% for 3148 patients. These were measured using a novel formular called daily polypharmacy possession ratio (DPPR) which calculates MA to multiple medications taken at the same time.

The picture was a bit different when they calculated how many patients had ‘good adherence’ i.e. patients whose MA was at least 80%. Only 54% and 51% of patients over three and five years, respectively, met this threshold. These findings suggest that a closer look needs to be paid into the long-term MA patterns and, importantly, the factors impacting how patients with IBD take their medications.