Long-term oral mesalazine adherence and the risk of disease flare in ulcerative colitis: nationwide 10-year retrospective cohort from the veterans affairs healthcare system

Summary Background Adherence is a major factor in determining disease activity in ulcerative colitis (UC). There are limited data on long‐term nationwide adherence levels among patients with UC. Aim To evaluate the long‐term adherence levels to oral mesalazine (mesalamine) in the Veterans Affairs (V...

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Bibliographic Details
Published in:Alimentary pharmacology & therapeutics 2012-10, Vol.36 (8), p.755-764
Main Authors: Khan, N., Abbas, A. M., Bazzano, L. A., Koleva, Y. N., Krousel-Wood, M.
Format: Article
Language:English
Subjects:
Administration, Oral
Adolescent
Adult
Aged
Aged, 80 and over
Anti-Inflammatory Agents, Non-Steroidal - therapeutic use
Biological and medical sciences
Child
Child, Preschool
Cohort Studies
Colitis, Ulcerative - drug therapy
Delivery of Health Care
Digestive system
Female
Gastroenterology. Liver. Pancreas. Abdomen
Humans
Male
Medical sciences
Medication Adherence - statistics & numerical data
Mesalamine - therapeutic use
Middle Aged
Other diseases. Semiology
Pharmacology. Drug treatments
Proportional Hazards Models
Regression Analysis
Retrospective Studies
Stomach. Duodenum. Small intestine. Colon. Rectum. Anus
Time Factors
United States
Veterans
Young Adult
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Summary:Summary Background Adherence is a major factor in determining disease activity in ulcerative colitis (UC). There are limited data on long‐term nationwide adherence levels among patients with UC. Aim To evaluate the long‐term adherence levels to oral mesalazine (mesalamine) in the Veterans Affairs (VA) healthcare system, to determine the impact of non‐adherence on the risk of flares, and to evaluate the different pharmacy data‐based adherence indicators. Methods Nationwide data were obtained from the VA for the period 2001–2011. UC patients who started mesalazine maintenance during the inclusion period were included. Level of adherence was assessed using three different indicators: medication possession ratio (MPR), continuous single‐interval medication availability (CSA) and continuous multiple‐interval medication gaps (CMG). Cox regression modelling was used to predict disease flares and assess the predictive value of each adherence indicator. Results We included 13 062 patients into the analysis with median follow‐up time of 6.1 years. Percentage of patients with high adherence was 47%, 43%, 31% as identified by CSA, MPR and CMG respectively. Low adherers had a significant increase in the risk of flares compared with high adherers (Hazard ratio: 2.8, 1.7 and 1.8, P 
ISSN:0269-2813
1365-2036
DOI:10.1111/apt.12013