Adherencia al tratamiento con adalimumab, golimumab y ustekinumab en pacientes con enfermedad inflamatoria intestinal

Objective: Inflammatory bowel disease comprises a group of chronic relapsing inflammatory disorders affecting the bowel. In the last  decade, the advent of biological drugs brought about a drastic change in the treatment of the disease. Adalimumab, golimumab and ustekinumab are three biologic agents that patients can self-administer  subcutaneously after collecting them from the pharmacy department.  However, for the treatment to be effective, adherence is paramount.  The purpose of the present study is to evaluate adherence in patients  who collected all three drugs from the dispensary of a tertiary care  hospital. Method: A cross-sectional observational analysis was carried out of patients who had been receiving treatment with adalimumab,  golimumab and ustekinumab for at least four months. The medication  possession ratio was calculated based on information extracted from the  pharmacy dispensing records. Patients with a ratio ≤ 85% were  enrolled in the study and asked to respond to Morisky-Green Medication  Adherence Questionnaire.  Results: One-hundred and seventy-eight patients were included, of whom 60.1% (107) were male and 30.9% (55) had been treated  previously with other biologics. According to the pharmacy dispensing  records, mean adherence was 91.79%, with 45 patients (25.28%)  classified as scarcely compliant (≤ 85%). The Morisky-Green Medication  Adherence Questionnaire revealed that carelessness about administering the drug at the right time and forgetfulness were the main reasons for  therapeutic non-adherence. Female sex (odds ratio 0.42; p = 0.013)  and lengthy treatments (p = 0.002) were associated to lower adherence rates. Conclusions: Although most patients in the studied population were seen to be compliant, low levels of adherence were observed in a  number of patients who would benefit from interventions aimed at  boosting their adherence. It must be said, however, that the statistical  power of this study should be enhanced in order to increase the  significance of the results obtained.