Adherence improvement in patients with ulcerative colitis: a multidisciplinary consensus document

• Francesc Casellas ^[1] ; Yago González-Lama ^[2] ; Daniel Ginard Vicens ^[3] ; Santiago García-López ^[4] ; Fernando Muñoz ^[7] ; Laura Marín Sánchez ^[5] ; Laura Camacho ^[6] ; Ana Cabez ^[8] ; Pilar Fortes ^[8] ; Susana Gómez ^[8] ; Pablo Bella Castillo ^[9] ; Manuel Barreiro-de Acosta ^[10]
  1. [1] Hospital Vall d'Hebron

     Hospital Vall d'Hebron

     Barcelona, España

     
  2. [2] Hospital Universitario Puerta de Hierro

     Hospital Universitario Puerta de Hierro

     Madrid, España

     
  3. [3] Hospital Universitario Son Espases

     Hospital Universitario Son Espases

     Palma de Mallorca, España

     
  4. [4] Hospital Miguel Servet

     Hospital Miguel Servet

     Zaragoza, España

     
  5. [5] Hospital Universitari Germans Trias i Pujol

     Hospital Universitari Germans Trias i Pujol

     Barcelona, España

     
  6. [6] Hospital Universitario Virgen de la Victoria

     Hospital Universitario Virgen de la Victoria

     Málaga, España

     
  7. [7] Complejo Asistencial de Salamanca. Salamanca, Spain
  8. [8] Medical Department. Pfizer España. Madrid, Spain
  9. [9] Confederación ACCU. Madrid, Spain
  10. [10] Hospital Clínico Universitario de Santiago de Compostela. Santiago de Compostela, A Coruña. Spain

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• Localización: Revista Española de Enfermedades Digestivas, ISSN-e 2340-4167, ISSN 1130-0108, Vol. 114, Nº. 3, 2022, págs. 156-165
• Idioma: inglés
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  • Objectives: a) to analyze the evidence available about poor adherence/non-adherence, including prevalences, associated factors, and interventions in ulcerative colitis (UC) patients; b) to provide a framework to improve poor adherence/non-adherence. Methods: a qualitative approach was used. A literature review was performed using Medline. Primary searches were performed with Mesh and free texts to identify articles that analyzed prevalence, causes, associated factors, and interventions designed to improve poor adherence/non-adherence in UC patients. Study quality was evaluated using the Oxford scale. The results were presented and discussed in a nominal group meeting comprising a multidisciplinary committee of six gastroenterologists, one psychologist, one nurse, and one patient. Several overarching principles and recommendations were generated. A consensus procedure was implemented via a Delphi process, during which each committee member produced a score ranging from 0 = totally disagree to 10 = totally agree. Agreement was considered when at least 70 % of participants had voted ≥ 7. Results: the literature review included 75 articles. Non-adherence rates ranged from 7 % to 72 %. We found a great variability in the methods employed to assess adherence, associated factors, and interventions designed to improve adherence. Overall, eight overarching principles and six recommendations were generated, all of them achieving the pre-established agreement level, including, among others, the identification, classification, and management of non-adherence. Conclusions: Poor adherence/non-adherence are common in UC patients, this being a relevant clinical concern. Health professionals should address this issue and actively involve their patients in implementing effective, individualized interventions to improve adherence