Relationship between non-adherence to aminosalicylate medication and the risk of clinical relapse among Japanese patients with ulcerative colitis in clinical remission

A prospective cohort study

Aki Kawakami, Makoto Tanaka, Masakazu Nishigaki, Makoto Naganuma, Yasushi Iwao, Toshifumi Hibi, Hiromi Sanada, Noriko Yamamoto-Mitani, Keiko Kazuma

Research output: Contribution to journalArticle

19 Citations (Scopus)

Abstract

Background: Thirty to forty-five percent of ulcerative colitis (UC) patients show non-adherence to aminosalicylates, and non-adherence has been reported to increase the risk of clinical relapse. Because Japan differs from Western countries in terms of health care and drugs administered, adherence to aminosalicylates in Japan may differ from that elsewhere. Therefore, we examined aminosalicylate adherence and its relationship to the risk of clinical relapse of UC in Japan. Methods: A 1-year, prospective cohort study was conducted in 104 outpatients with UC in remission who had taken aminosalicylates >6 months. Aminosalicylate adherence was evaluated using data from a self-administered questionnaire and medical records. Non-adherence was defined as taking <80 % of the prescribed dose of aminosalicylates. The primary outcome was the record of clinical relapse in medical charts. Results: Twenty-nine patients (27.9 %) were evaluated as showing non-adherence. Among all subjects, 24 patients (23.1 %) relapsed. The non-adherence group had a higher rate of 1-year relapse than did the adherence group (41.3 vs. 16.0 %). Multiple Cox regression analysis showed that non-adherence increased the risk of clinical relapse 2.3-fold (hazard ratio 2.3, 95 % confidence interval 1.004-5.24, p = 0.04). Conclusions: Although the adherence rate in this study was slightly higher than that in previous studies, Japanese patients with UC who were not adherent to their medications had a twofold greater risk of relapse than those who were. These results indicate the importance of early identification of patients with non-adherence. A program to support medication taking behavior is needed to prevent UC relapse.

Original languageEnglish
Pages (from-to)1006-1015
Number of pages10
JournalJournal of Gastroenterology
Volume48
Issue number9
DOIs
Publication statusPublished - 2013

Fingerprint

Ulcerative Colitis
Cohort Studies
Prospective Studies
Recurrence
Japan
Patient Compliance
Medical Records
Outpatients
Regression Analysis
Confidence Intervals
Delivery of Health Care
Pharmaceutical Preparations

Keywords

  • Aminosalicylates
  • Maintenance therapy
  • Medication adherence
  • Relapse
  • Ulcerative colitis

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Relationship between non-adherence to aminosalicylate medication and the risk of clinical relapse among Japanese patients with ulcerative colitis in clinical remission : A prospective cohort study. / Kawakami, Aki; Tanaka, Makoto; Nishigaki, Masakazu; Naganuma, Makoto; Iwao, Yasushi; Hibi, Toshifumi; Sanada, Hiromi; Yamamoto-Mitani, Noriko; Kazuma, Keiko.

In: Journal of Gastroenterology, Vol. 48, No. 9, 2013, p. 1006-1015.

Research output: Contribution to journalArticle

Kawakami, Aki ; Tanaka, Makoto ; Nishigaki, Masakazu ; Naganuma, Makoto ; Iwao, Yasushi ; Hibi, Toshifumi ; Sanada, Hiromi ; Yamamoto-Mitani, Noriko ; Kazuma, Keiko. / Relationship between non-adherence to aminosalicylate medication and the risk of clinical relapse among Japanese patients with ulcerative colitis in clinical remission : A prospective cohort study. In: Journal of Gastroenterology. 2013 ; Vol. 48, No. 9. pp. 1006-1015.
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abstract = "Background: Thirty to forty-five percent of ulcerative colitis (UC) patients show non-adherence to aminosalicylates, and non-adherence has been reported to increase the risk of clinical relapse. Because Japan differs from Western countries in terms of health care and drugs administered, adherence to aminosalicylates in Japan may differ from that elsewhere. Therefore, we examined aminosalicylate adherence and its relationship to the risk of clinical relapse of UC in Japan. Methods: A 1-year, prospective cohort study was conducted in 104 outpatients with UC in remission who had taken aminosalicylates >6 months. Aminosalicylate adherence was evaluated using data from a self-administered questionnaire and medical records. Non-adherence was defined as taking <80 {\%} of the prescribed dose of aminosalicylates. The primary outcome was the record of clinical relapse in medical charts. Results: Twenty-nine patients (27.9 {\%}) were evaluated as showing non-adherence. Among all subjects, 24 patients (23.1 {\%}) relapsed. The non-adherence group had a higher rate of 1-year relapse than did the adherence group (41.3 vs. 16.0 {\%}). Multiple Cox regression analysis showed that non-adherence increased the risk of clinical relapse 2.3-fold (hazard ratio 2.3, 95 {\%} confidence interval 1.004-5.24, p = 0.04). Conclusions: Although the adherence rate in this study was slightly higher than that in previous studies, Japanese patients with UC who were not adherent to their medications had a twofold greater risk of relapse than those who were. These results indicate the importance of early identification of patients with non-adherence. A program to support medication taking behavior is needed to prevent UC relapse.",
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T1 - Relationship between non-adherence to aminosalicylate medication and the risk of clinical relapse among Japanese patients with ulcerative colitis in clinical remission

T2 - A prospective cohort study

AU - Kawakami, Aki

AU - Tanaka, Makoto

AU - Nishigaki, Masakazu

AU - Naganuma, Makoto

AU - Iwao, Yasushi

AU - Hibi, Toshifumi

AU - Sanada, Hiromi

AU - Yamamoto-Mitani, Noriko

AU - Kazuma, Keiko

PY - 2013

Y1 - 2013

N2 - Background: Thirty to forty-five percent of ulcerative colitis (UC) patients show non-adherence to aminosalicylates, and non-adherence has been reported to increase the risk of clinical relapse. Because Japan differs from Western countries in terms of health care and drugs administered, adherence to aminosalicylates in Japan may differ from that elsewhere. Therefore, we examined aminosalicylate adherence and its relationship to the risk of clinical relapse of UC in Japan. Methods: A 1-year, prospective cohort study was conducted in 104 outpatients with UC in remission who had taken aminosalicylates >6 months. Aminosalicylate adherence was evaluated using data from a self-administered questionnaire and medical records. Non-adherence was defined as taking <80 % of the prescribed dose of aminosalicylates. The primary outcome was the record of clinical relapse in medical charts. Results: Twenty-nine patients (27.9 %) were evaluated as showing non-adherence. Among all subjects, 24 patients (23.1 %) relapsed. The non-adherence group had a higher rate of 1-year relapse than did the adherence group (41.3 vs. 16.0 %). Multiple Cox regression analysis showed that non-adherence increased the risk of clinical relapse 2.3-fold (hazard ratio 2.3, 95 % confidence interval 1.004-5.24, p = 0.04). Conclusions: Although the adherence rate in this study was slightly higher than that in previous studies, Japanese patients with UC who were not adherent to their medications had a twofold greater risk of relapse than those who were. These results indicate the importance of early identification of patients with non-adherence. A program to support medication taking behavior is needed to prevent UC relapse.

AB - Background: Thirty to forty-five percent of ulcerative colitis (UC) patients show non-adherence to aminosalicylates, and non-adherence has been reported to increase the risk of clinical relapse. Because Japan differs from Western countries in terms of health care and drugs administered, adherence to aminosalicylates in Japan may differ from that elsewhere. Therefore, we examined aminosalicylate adherence and its relationship to the risk of clinical relapse of UC in Japan. Methods: A 1-year, prospective cohort study was conducted in 104 outpatients with UC in remission who had taken aminosalicylates >6 months. Aminosalicylate adherence was evaluated using data from a self-administered questionnaire and medical records. Non-adherence was defined as taking <80 % of the prescribed dose of aminosalicylates. The primary outcome was the record of clinical relapse in medical charts. Results: Twenty-nine patients (27.9 %) were evaluated as showing non-adherence. Among all subjects, 24 patients (23.1 %) relapsed. The non-adherence group had a higher rate of 1-year relapse than did the adherence group (41.3 vs. 16.0 %). Multiple Cox regression analysis showed that non-adherence increased the risk of clinical relapse 2.3-fold (hazard ratio 2.3, 95 % confidence interval 1.004-5.24, p = 0.04). Conclusions: Although the adherence rate in this study was slightly higher than that in previous studies, Japanese patients with UC who were not adherent to their medications had a twofold greater risk of relapse than those who were. These results indicate the importance of early identification of patients with non-adherence. A program to support medication taking behavior is needed to prevent UC relapse.

KW - Aminosalicylates

KW - Maintenance therapy

KW - Medication adherence

KW - Relapse

KW - Ulcerative colitis

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U2 - 10.1007/s00535-012-0721-x

DO - 10.1007/s00535-012-0721-x

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JF - Journal of Gastroenterology

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