Sunanda Kane, M. D., discusses recent articles published in the Journal of Pediatric Psychology and Inflammatory Bowel Disease Journal about medication adherence for children and adults with ulcerative colitis.
The first article focuses on pediatric patients and whether or not parents could predict how much medication their children were taking. This study looked for a correlation between what children and parents were saying in terms of how much medication they were taking and what electronic caps on the medicine were counting. Children in the study were sent home with medication that had an electronic cap on it that sent a signal every time it was opened to generally reflect pill taking behavior. The results from the study show that parents are pretty good at telling how much medication their child is taking but there needs to be a fudge factor to truly account for the amount of medicine being taken. Dr. Kane says by adding this fudge factor, a more accurate assessment can be made of how much medication is being taken.
The second study focuses on adults and was part of a clinical trial for asacol. The clinical trial was looking at once a day asacol versus three times a day asacol for patients who had ulcerative colitis and were in remission. The patients were asked to self-report when taking their medication, pills were counted, and some medication had electronic caps on it. Patients self-reported they took about 90% of their medicine and the electronic caps said they were taking about 86%. It turns out that the electronic caps were better at reporting how much medicine was being taken, but there was a good correlation between the electronic caps and self-reporting. The patients that took more of their medicine had a better chance at staying in remission. Over time, all patients started taking less medicine than they needed to. The authors concluded at the end of the study that patients aren't taking as much medicine as they need to and have a higher consequence for disease flare. They also found that once-a-day dosing is preferred and will lead to higher adherence.
Dr. Kane suggests that patients take their medicine on a fairly regular basis so they remain in remission and to think of the medicine as a vitamin for maintaining health. Dr. Kane says the two studies add to the importance of understanding how much medicine patients are taking and the consequences when they don't take it.
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Dr. Kane is a gastroenterologist at Mayo Clinic.