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  • Title: Impact of a patient-support program on mesalamine adherence in patients with ulcerative colitis--a prospective study.
    Author: Moss AC, Chaudhary N, Tukey M, Junior J, Cury D, Falchuk KR, Cheifetz AS.
    Journal: J Crohns Colitis; 2010 Jun; 4(2):171-5. PubMed ID: 21122501.
    Abstract:
    BACKGROUND: Patient adherence to medications, particularly mesalamine, is reported to be low in patients with ulcerative colitis. We sought to determine whether a nurse-delivered patient-support program could improve medication adherence in these patients. METHODS: Patients prescribed mesalamine for ulcerative colitis prospectively received either a 23 week, nurse-delivered, patient support program (PSP) by phone, or standard care (SC). Medication adherence and quality of life were measured before and at 3 and 6 months after the program started. RESULTS: Eighty-one patients completed the study; 60 who received standard care, and 21 who received the PSP. Patients were in remission (mean SCAI score 3) at enrollment. Mean % of prescribed mesalamine refilled was 71% and 74% in the SC and PSP groups at 3 months (p=0.7), and 73% and 84% at 6 months (p=0.4). The proportion of adherent patients at 3 months (39% vs 44%, p=0.7) and 6 months (50% vs 67%, p=0.3) were similar between the SC and PSP groups. There was no association between use of the PSP and adherence at 3 (OR 1.2, 95% CI 0.4 to 3.8) or 6 months (OR 2, 95% CI 0.6 to 7). The change from baseline in SIBDQ scores were similar between SC and PSP groups at 3 months (+0.3 vs +0.2, p=0.8), and 6 months (+0.6 vs +0.2, p=0.2). CONCLUSIONS: This nurse-delivered patient-support program did not significantly improve medication adherence or quality-of-life beyond standard care at short and medium-term time-points. Simply discussing and measuring adherence improved mesalamine adherence in both groups in this study.
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