Context: Non-adherence to therapy, in any degree is a common event and occurs in several circumstances. It is one of most common cause of fail in therapy of chronic diseases and Crohn's disease is not an exception.
Objective: To evaluate in patients with Crohn's disease the prevalence and the risk factors to non-adherence to therapy.
Methods: From July 2006, for 12 months, were included prospectively, for non-adhesion to therapy 100 patients with Crohn's disease that were assisted in a Center for Inflammatory Bowel Diseases of University Hospital of Federal University of Juiz de Fora, MG, in Brazil. A modified Morisky & Green Test for Measure of Adherence to Therapy was answered by all of them. According to test the patients were classified in two groups defined as adherence and non-adherence, respectively, and the last one was separated in intentional and non-intentional adhesion. Clinical, psychological and pharmacotherapeutics variables were sought to find the factors related to non-adherence.
Results: Sixty four percent of total group were noticed to have a score of non-adherence to therapy according to used test and non-intentional was the most common type of behavior in such patients, and they demonstrated to be conscious of therapy. The comparison of adherent and non-adherent patients displayed a significant tendency to occurrence of non-adherence in younger (P = 0.07) and in non-white patients (P = 0.06). No correlation was observed in comparison of psychological and pharmacotherapeutics variables and non-adherence.
Conclusions: In patients with Crohn's disease the prevalence of non-adherence to therapy is high (64%). The younger and non-white patients have higher propensity to non-adherence. In such circumstances efforts should be made to look for strategies to deal with this sort of people suffering from Crohn's disease, trying to increase the degree of adherence in this sort of patients.
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http://dx.doi.org/10.1590/s0004-28032009000300008 | DOI Listing |
Annu Rev Med
January 2025
Department of Medicine, University of California San Diego, La Jolla, California, USA.
Chronic pouchitis (CP) occurs in approximately 20% of patients with ulcerative colitis after total proctocolectomy with ileal pouch anal anastomosis and is categorized as antibiotic dependent, antibiotic refractory, or Crohn's disease-like. The management of CP is challenging because of limited evidence and few randomized controlled trials. In this review, we discuss the medical management of CP and its supporting data delineated by type of therapy.
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January 2025
Department of Anorectal Surgery, Shuguang Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China.
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Department of Epidemiology and Preventive Medicine, School of Public Health, Faculty of Medicine, Tel Aviv University, Ramat Aviv, Tel Aviv, 6997801, Israel.
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Crohns Colitis 360
January 2025
Division of Digestive Diseases and Nutrition, Department of Medicine, University of Kentucky College of Medicine, Lexington, KY, USA.
Background: Despite advancements in the therapeutic armamentarium for Crohn's disease (CD), biologic and small molecule monotherapies are associated with sub-optimal response and remission rates. Utilizing dual biologic therapy (DBT) holds the potential to increase efficacy in the treatment of refractory or partially responsive CD. Evidence pertaining to this strategy remains limited.
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