Clinical and Experimental Gastroenterology (Aug 2021)
Patient Preference and Adherence to Aminosalicylates for the Treatment of Ulcerative Colitis
Abstract
Kartikeya Tripathi,1 Jeffrey Dong,2 Brooke F Mishkin,2 Joseph D Feuerstein2 1Department of Gastroenterology, University of Massachusetts Medical School - Baystate Campus, Springfield, MA, USA; 2Division of Gastroenterology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USACorrespondence: Joseph D FeuersteinDivision of Gastroenterology, Beth Israel Deaconess Medical Center, Harvard Medical School, 110 Francis St 8e Gastroenterology, Boston, MA, 02215, USATel +1 617 632 8623Fax +1 617 632 9199Email [email protected]: Ulcerative colitis (UC) is a chronic inflammatory disorder that requires sustained treatment for optimal outcomes. The 5-aminosalicylate (5-ASA) class of medications are first-line for the treatment of mild-to-moderate UC but suffer from suboptimal adherence rates in real-world settings. This review summarizes the literature on adherence and patient preference to 5-ASA in patients with UC. We begin by highlighting key studies that measure real-world adherence rates, as well as some of the pitfalls associated with certain techniques. We examine the data on the consequences of non-adherence, which range from decreased quality of life and higher risk of colorectal cancer at the individual level to increased costs to the overall healthcare system. We then turn to the reasons and risk factors for non-adherence and summarize the current understanding of the barriers towards adherence. Afterwards, we describe the research on patient preferences between 5-ASA formulations and dosing regimen. Finally, we summarize the evidence regarding interventions to improve 5-ASA adherence. While adherence remains a challenge in practice, understanding the current state of the field can better inform future efforts towards increasing adherence, and thus clinical outcomes, in UC.Keywords: UC, 5-ASA, ulcerative colitis, adherence, compliance
