• T Moshkovska, M A Stone, J Clatworthy, R M Smith, J Bankart, R Baker, J Wang, R Horne, and J F Mayberry.
• Department of Gastroenterology, Leicester General Hospital, UHL NHS Trust, Leicester, UK. tm111@le.ac.uk
• Aliment. Pharmacol. Ther. 2009 Dec 1; 30 (11-12): 1118-27.

BackgroundNon-adherence to 5-aminosalicylic acid (5-ASA) medication can limit the established benefits of this therapy in ulcerative colitis (UC).AimTo determine rates and predictors of non-adherence to 5-ASA therapy in UC patients.MethodsMedication adherence was assessed using self-report data and urinary drug excretion measurements. Participants completed a study-specific questionnaire and two validated questionnaires: Beliefs about Medicine Questionnaire (BMQ)-Specific and Satisfaction with Information about Medicines Scale.ResultsA total of 169 participants provided self-report adherence data; 151 also provided urine samples. Adherence rates were 111/151 (68%) according to self-report and 90/151 (60%) according to urine analysis, but the two measures were not correlated (chi(2) = 0.12, P = 0.725). Logistic regression identified a significant association between self-reported non-adherence and younger age [odds ratio (OR) for increased age 0.954, 95% confidence interval (CI) 0.932-0.976] and also doubts about personal need for medication (OR for BMQ - Specific Necessity scores 0.578, 95% CI 0.366-0.913). For non-adherence based on urine analysis, only South Asian ethnicity was independently associated with non-adherence (OR 2.940, 95% CI 1.303-6.638).ConclusionsOur observations confirm the difficulty of accurately assessing medication adherence. Nonmodifiable (younger age, South Asian ethnicity) and potentially modifiable (medication beliefs) predictors of non-adherence were identified.

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