Is there any association between impaired health-related quality of life and non-adherence to medical therapy in inflammatory bowel disease?

Scand J Gastroenterol. 2012 Nov;47(11):1298-303. doi: 10.3109/00365521.2012.703233. Epub 2012 Aug 31.

Abstract

Objectives: Inflammatory bowel diseases (IBD) have a huge impact on the patients' lives and require continuous medication and long-term medical follow-up. The Short Form Health Survey (SF-36) is a commonly used questionnaire measuring health-related quality of life (HRQOL). Our aim was to evaluate whether HRQOL influences medication adherence and vice versa in IBD patients, and to find relationships between demographic parameters, therapeutic modalities and non-adherence or HRQOL.

Patients and methods: Five hundred ninety-two IBD patients treated at six Hungarian tertiary centers were enrolled. Patients completed the SF-36 questionnaire and a medication adherence report scale during their visits. The associations between demographic parameters, HRQOL, different kinds of therapies and non-adherence were analyzed.

Results: The most affected dimension was physical functioning and least affected were the social functions. About 42.7% of the patients revealed their HRQOL to be acceptable. About 74.6% of the patients believed that the prescribed medications actually improved their HRQOL. Diarrhea was the most common and most severe symptom during the course of the disease. Non-adherence was reported in 13.4% of the patients. 'Forgetting to take the medication' was the main reason for non-adherence in 67.6% of the cases. Medication adherence was significantly higher among nonsmoker patients, and also in the case of immunomodulator therapy. There was no association between the sum of HRQOL and different subscores and non-adherence.

Conclusion: Inflammatory bowel disease is associated with low HRQOL, which is not affected by drug therapy. The impaired quality of life in IBD is mainly influenced by the disease itself.

MeSH terms

  • Adolescent
  • Adrenal Cortex Hormones / therapeutic use
  • Adult
  • Aged
  • Aged, 80 and over
  • Aminosalicylic Acids / therapeutic use
  • Anti-Bacterial Agents / therapeutic use
  • Anti-Inflammatory Agents, Non-Steroidal / therapeutic use
  • Antibodies, Monoclonal / therapeutic use
  • Chi-Square Distribution
  • Colitis, Ulcerative / complications
  • Colitis, Ulcerative / drug therapy*
  • Colitis, Ulcerative / psychology
  • Crohn Disease / complications
  • Crohn Disease / drug therapy*
  • Crohn Disease / psychology
  • Diarrhea / etiology
  • Female
  • Health Status*
  • Humans
  • Immunologic Factors / therapeutic use
  • Male
  • Mental Health
  • Middle Aged
  • Motor Activity
  • Patient Compliance / psychology*
  • Quality of Life / psychology*
  • Smoking
  • Social Participation
  • Surveys and Questionnaires
  • Young Adult

Substances

  • Adrenal Cortex Hormones
  • Aminosalicylic Acids
  • Anti-Bacterial Agents
  • Anti-Inflammatory Agents, Non-Steroidal
  • Antibodies, Monoclonal
  • Immunologic Factors