It is possible that non-compliance with maintenance mesalazine therapy may be a risk factor for relapse in inflammatory bowel disease.
However, the prevalence and determinants of non-compliance are unknown.
In this study, investigators from Sheffield, England, assessed the prevalence and determinants of non-compliance in patients with inflammatory bowel disease.
The team evaluated 98 out-patients receiving delayed-release mesalazine.
They determined compliance using both direct enquiry and urine analysis to detect 5-aminosalicylic acid/N-acetyl-5-aminosalicylic acid.
|43% of patients reported taking less than 80% of their prescribed dose.|
|Alimentary Pharmacology and Therapeutics|
The team also assessed potential determinants of compliance.
Overall, the physicians found that 43% of patients reported taking less than 80% of their prescribed dose.
The team determined that independent predictors of non-compliance were 3-times daily dosing and full-time employment.
In addition, urine from 12% of patients contained no detectable 5-aminosalicylic acid/N-acetyl-5-aminosalicylic acid. A further 18% had levels below those expected by the team.
They found that depression was the only independent predictor of complete non-compliance, and 3-times daily dosing was the only independent predictor of partial non-compliance.
The researchers determined that self-reporting correctly identified 66% of patients judged to be non-compliant on urinary drug measurement.
Drs Shale and Riley concluded, "Non-compliance with maintenance mesalazine therapy is common in patients with inflammatory bowel disease".
"Three-times daily dosing and full-time employment are predictors of partial non-compliance, whilst depression is associated with complete non-compliance".
"Self-reporting detects most non-compliant patients".