The symptoms of inflammatory bowel disease (IBD) often require intensive, complex treatment regimens. Patients might take drugs orally, rectally, intravenously, or by infusion, or could use a combination of these delivery systems. To manage IBD successfully, it’s important to adhere to a treatment plan, but many patients struggle to comply.
A recent study published in Inflammatory Bowel Disease discusses practical strategies for enhancing adherence to medications for patients who have IBDs such as Crohn’s disease and ulcerative colitis.1 Statistics show that between 43-60% of adults with IBD do not take their medications as prescribed, and these patients are 5.5 times more likely to experience a disease flare-up than those who are adherent!
Let’s look at what you can do to make it easier to stick with your medicine routine.
Figuring out why you aren’t taking your meds properly is the first step to improving adherence. Here are some common patient concerns:
- a lack of information about what each drug is for and how and why you’re taking them
- difficulty staying organized and remembering to integrate the dosing schedule into your daily routine
- being disinterested in the illness itself
- tending to want to avoid thinking about administering some of the non-oral treatments
- not being able to afford to fill prescriptions on time
Responding to these varied reasons requires different strategies, and since most patients have more than one of these blocks, a multifaceted approach is likely to give the best results.
If you’re an IBD patient, you will benefit from learning about the symptoms and complications of your illness, so you know why a treatment is important. Resources such as our patient information pamphlets, newsletters, videos, website, and BadGut® lectures can be a helpful starting point. It’s also important for you to ask your physician and/or pharmacist exactly when/how you should take your medicine and if you need to be aware of possible side effects.
Making it Easier
Research shows that individuals who only have to take medicine once a day tend to adhere better than patients who have multiple doses a day, and that improving adherence may result in subsequent decreases in health care costs.2 If you find it too complicated to take medicine as frequently as prescribed, talk to your physician because you might have better luck with a different formulation or type of product.
If you find remembering to take your meds difficult, you might like to try using visual or auditory reminder systems. These include using post-it notes, putting your pill bottles in certain locations, setting alarms, or using any other cues that work for you.
Using weekly or daily pillboxes (dosettes) stocked with your medication might help you stick to a routine when taking oral medications.
Some patients don’t take their meds as directed because they feel it isn’t important or don’t have confidence in their treatment. Some patients are discouraged or feel overwhelmed by the disease itself and others haven’t made an effort to get on board with a particular treatment. If this is how you feel, research shows that a type of counselling called Motivational Interviewing helps individuals find their own reasons to want to adhere to their medication; reminder systems can help you stay on track.
If you are having trouble sticking to your medication routine because you can’t afford it, then talk to your physician about any available alternatives. Getting on to a drug plan that covers your medication or perhaps applying to a government plan might ease some of the burden. If you are unable to obtain any financial assistance, your physician might recommend a different treatment that is less expensive or better covered by your particular drug plan.
The GI Society continues to advocate collectively on behalf of GI patients within the health care system, working toward having the right medication available for the right patient at the right time, without it being a financial burden. Unfortunately, we’re not there yet!