Socioeconomic and psychological factors associated with nonadherence to treatment in inflammatory bowel disease patients: Results of the ISSEO survey
Abstract
BACKGROUND: Adherence to treatment is a key condition in preventing relapses in inflammatory bowel disease (IBD). The aims of this study were specifically to study socioeconomic and psychological factors and adherence to treatment in a large cohort of patients. METHODS: A questionnaire concerning demographic, clinical, and psychosocial characteristics was mailed to 6000 IBD patients belonging to the French association of IBD patients (AFA). The questionnaire was also available on the Website of the AFA for nonmember patients to answer. Good adherence to treatment was defined as taking ≥ 80% of prescribed medication. Socioeconomic deprivation was assessed using the specific EPICES score (http://www.cetaf.asso.fr) developed in France. Anxiety and depression were assessed using the Hospital Anxiety and Depression scale. RESULTS: A total of 1069 women and 594 men (43.6 ± 15.4 years) completed the questionnaire; 1450 (87.2%) of them belonged to the AFA. In all, 1044 had Crohn's disease, 36 indeterminate colitis, and 583 ulcerative colitis. Adherence ≥ 80% was reported by 89.6% of patients. Factors associated with good adherence were: older age (P < 0.01), treatment with anti-tumor necrosis factor (TNF) (P < 0.0001), membership in the AFA (P = 0.006). Nonadherence increases with smoking (P = 0.02), constraints related to treatment (P < 10(-9) ), anxiety (P < 10(-6) ), and moodiness (P < 10(-5) ). There were no differences in adherence for the following: gender, type of IBD, activity and severity of the disease, socioeconomic deprivation, marital status, education level, and depression. CONCLUSIONS: In this large cohort of IBD patients, psychological distress and constraints related to treatment decrease adherence to treatment, while membership in a patients' association improves it.
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Stress may drive behavioural changes, such as medication nonadherence, poor diet and alcohol use which increase the risk of disease exacerbation.
“Stress may drive behavioural changes, such as medication nonadherence, 61 poor diet 62 and alcohol use 63 which increase the risk of disease exacerbation.”
From Systematic review: the role of psychological stress in inflammatory bowel disease (2022) · cites this paper as [61]
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- Authors
- Nahon, S., Lahmek, P., Saas, C., Durance, C., Olympie, A., Lesgourgues, B., & Gendre, J.-P.
- Affiliations
- Groupe Hospitalier Intercommunal Le Raincy Montfermeil (FR)
- Assistance Publique – Hôpitaux de Paris (FR)
- Association François Aupetit (FR)
- Corresponding author
- Nahon, Stéphane
- Lahmek, Pierre
- Saas, Catherine
- Durance, Christelle
- Olympie, Alain
- Lesgourgues, Bruno
- Gendre, Jean-Pierre
- ORCID
- Nahon, Stéphane
- Venue
- Inflammatory Bowel Diseases
- Publisher
- Oxford University Press (OUP)
- Published
- 2011-06
- Volume
- 17
- Issue
- 6
- Pages
- 1270-1276
- ISSN
- 1078-0998 (ISSN-L)
- OpenAlex
- W2103337130
- Cited by
- 102
- References
- 24
- Citations by year
- 2026: 1 · 2025: 3 · 2024: 12 · 2023: 8 · 2022: 8 · 2021: 8 · 2020: 12 · 2019: 4 · 2018: 2 · 2017: 4 · 2016: 6 · 2015: 12 · 2014: 8 · 2013: 5 · 2012: 8
- FWCI
- 4.11
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Inflammatory Bowel Diseases (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Family Practice › Medication Adherence and Compliance
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Inflammatory Bowel Disease
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Pregnancy and Medication Impact
- Keywords
- inflammatory bowel disease, medication adherence
- MeSH terms
- Assessment of Medication Adherence, Adult, Analysis of Variance, Colitis, Ulcerative, Crohn Disease, Depression, Educational Status, Female, Humans, Immunosuppressive Agents, Male, Psychiatric Status Rating Scales, Psychology, Surveys and Questionnaires, Severity of Illness Index, Sex Factors, Socioeconomic Factors, Inflammatory Bowel Diseases, Confidence Intervals, Chi-Square Distribution, Logistic Models, Odds Ratio, Drug Monitoring, Marital Status, Medication Adherence
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