Intest Res  
Medication adherence in inflammatory bowel disease
Webber Chan1,2, Andy Chen3, Darren Tiao4, Christian Selinger5, Rupert Leong1
1Gastroenterology and Liver Services, Concord Repatriation General Hospital, Sydney, Australia, 2Department of Gastroenterology and Hepatology, Singapore General Hospital, Singapore, 3South Western Sydney Clinical School, University of New South Wales, 4Sydney Medical School, the University of Sydney, Sydney, Australia, 5IBD Unit, Leeds Gastroenterology Institute, Leeds Teaching Hospitals NHS Trust, St James University Hospital, Leeds, UK
Correspondence to: Webber Chan, Gastroenterology and Liver Services, Concord Repatriation General Hospital, ACE Unit, Level 1 West, Hospital Road Concord NSW 2139, Australia. Tel: +61-2-9767-6111, Fax: +61-2-97676767, E-mail: webber.chan.p.w@singhealth.com.sg
Received: May 17, 2017; Revised: May 28, 2017; Accepted: May 29, 2017; Published online: August 2, 2017.
© Korean Association for the Study of Intestinal Diseases. All rights reserved.

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Inflammatory bowel disease (IBD) is a chronic idiopathic inflammatory condition with intestinal and extraintestinal manifestations. Medications are the cornerstone of treatment of IBD. However, patients often adhere to medication poorly. Adherence to medications is defined as the process by which patients take their medications as prescribed. Treatment non-adherence is a common problem among chronic diseases, averaging 50% in developed countries and is even poorer in developing countries. In this review, we will examine the adherence data in IBD which vary greatly depending on the study population, route of administration, and methods of adherence measurement used. We will also discuss the adverse clinical outcomes related to non-adherence to medical treatment including increased disease activity, flares, loss of response to anti-tumor necrosis factor therapy, and so forth. There are many methods to measure medication adherence namely direct and indirect methods, each with their advantages and drawbacks. Finally, we will explore different intervention strategies to improve adherence to medications.
Keywords: Medication adherence; Colitis, ulcerative; Crohn disease; Inflammatory bowel disease


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