Cited by 127Medication Adherence and ComplianceInflammatory Bowel DiseasePharmacy and Medical Practices

Objective versus subjective assessment of oral medication adherence in pediatric inflammatory bowel disease

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Hommel, Kevin A., Davis, Christine M., Baldassano, Robert N.·2009·Inflammatory Bowel Diseases

Abstract

BACKGROUND: The objective was to examine the prevalence and frequency of oral medication nonadherence using a multimethod assessment approach consisting of objective, subjective, and biological data in adolescents with inflammatory bowel disease (IBD). METHODS: Medication adherence was assessed via pill counts, patient/parent interview, and 6-thioguanine nucleotide (6-TGN)/6-methylmercaptopurine nucleotide (6-MMPN) metabolite bioassay in 42 adolescents with IBD. Pediatric gastroenterologists provided disease severity assessments. RESULTS: The objective nonadherence prevalence was 64% for 6-MP/azathioprine (AZA) and 88% for 5-aminosalicylate (5-ASA) medications, whereas subjective nonadherence prevalence was 10% for 6-MP/AZA and 2% for 5-ASA. The objective nonadherence frequency was 38% for 6-MP/AZA and 49% for 5-ASA medications, and subjective nonadherence frequency was 6% for 6-MP/AZA and 3% for 5-ASA. The bioassay data revealed that only 14% of patients had therapeutic 6-TGN levels. CONCLUSIONS: The results indicate that objectively measured medication nonadherence prevalence is consistent with that observed in other pediatric chronic illness populations, and that objective nonadherence frequency is considerable, with 40%-50% of doses missed by patients. Subjective assessments appeared to overestimate adherence. Bioassay adherence data, while compromised by pharmacokinetic variation, might be useful as a cursory screener for nonadherence with follow-up objective assessment. Nonadherence in 1 medication might also indicate nonadherence in other medications. Clinical implications and future research directions are provided.

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  1. [20]Zelikovsky N Medical Adherence Measure Unpublished data 2007 18543839

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Authors
Hommel, K. A., Davis, C. M., & Baldassano, R. N.
Affiliations
  • Cincinnati Children's Hospital Medical Center (US)
  • Children's Hospital of Philadelphia (US)
Venue
Inflammatory Bowel Diseases
Published
2009-04
Volume
15
Issue
4
Pages
589-593
ISSN
1078-0998 (ISSN-L)
OpenAlex
W2007722541
Cited by
127
References
25
Citations by year
2026: 1 · 2025: 1 · 2024: 3 · 2023: 7 · 2022: 7 · 2021: 13 · 2020: 12 · 2019: 9 · 2018: 8 · 2017: 11 · 2016: 6 · 2015: 8 · 2014: 7 · 2013: 11 · 2012: 5
FWCI
4.27
Type
journal article
Language
en
Open access
Locations
  • Inflammatory Bowel Diseases (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
Funders
National Institute of Diabetes and Digestive and Kidney Diseases (P30 DK0789392, K23DK079037)
Topics
  • Health Sciences › Medicine › Family Practice › Medication Adherence and Compliance
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Inflammatory Bowel Disease
  • Life Sciences › Pharmacology, Toxicology and Pharmaceutics › Pharmacology › Pharmacy and Medical Practices
Keywords
medication adherence, pediatric inflammatory bowel disease
MeSH terms
Assessment of Medication Adherence, Administration, Oral, Adolescent, Psychology, Adolescent, Female, Gastrointestinal Agents, Humans, Male, Severity of Illness Index, Inflammatory Bowel Diseases, Prevalence, Drug Monitoring, Medication Adherence

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