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CC BY-NC-ND 4.0 · Journal of Coloproctology 2021; 41(01): 096-103
DOI: 10.1055/s-0041-1724053
Review Article

Researching Interventions to Improve Medication Adherence in Ulcerative Colitis Patients

Pesquisando intervenções para a melhoria da adesão à medicação em pacientes com colite ulcerativa
Mila Palma Pacheco 
1   Departament of Life Sciences, Programa de Pós-graduação em Ciências Farmacêuticas (PPGFARMA), Universidade do Estado da Bahia (UNEB), Salvador, Bahia, Brazil
,
Flora Maria Lorenzo Fortes 
1   Departament of Life Sciences, Programa de Pós-graduação em Ciências Farmacêuticas (PPGFARMA), Universidade do Estado da Bahia (UNEB), Salvador, Bahia, Brazil
,
Raquel Rocha dos Santos 
2   Escola de Nutrição, Universidade Federal da Bahia (UFBA), Salvador, Bahia, Brazil
,
Genoile Oliveira Santana Silva 
1   Departament of Life Sciences, Programa de Pós-graduação em Ciências Farmacêuticas (PPGFARMA), Universidade do Estado da Bahia (UNEB), Salvador, Bahia, Brazil
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Abstract

The purpose of this review was to identify interventions that improve adherence to medications in patients with ulcerative colitis (UC). The literature search was carried out between April and June 2020 in the PubMed/MEDLINE database, with the combination of MeSH terms medication adherence; intervention; ulcerative colitis; and inflammatory bowel disease. We restricted our search to articles published in English and Portuguese between March 2010 and March 2020. After the selection, recovery of full-text articles and analysis of the defined criteria, the interventions described in the studies were classified into four domains: educational; behavioral, cognitive behavioral, and multicomponent. In total, six clinical trials met the inclusion criteria and were analyzed. Half of the studies (3; 50%) used multicomponent interventions, 2 (33.3%) focused on behavioral interventions, and 1 (16.7%) applied isolated educational interventions. All studies used indirect methods to measure adherence, with an emphasis on scales and questionnaires. Half of the studies (3; 50%) showed a positive impact on adherence in patients with UC, with evidence that multicomponent interventions, when properly implemented in a clinical trial combining direct and indirect methods to measure medication adherence, appear to increase the chances of better results. We believe that future studies focusing on improving adherence in patients with UC are necessary.

Resumo

O objetivo desta revisão foi identificar intervenções para a melhoria da adesão a medicamentos em pacientes com colite ulcerativa (CU). A busca na literatura foi realizada entre abril e junho de 2020 na base de dados do PubMed/MEDLINE, com a combinação dos descritores medication adherence; intervention; ulcerative colitis; e inflammatory bowel disease. Restringimos a busca aos artigos publicados em inglês e português entre março de 2010 e março de 2020. Após a seleção, recuperação dos textos dos artigos, e análise dos critérios definidos, as intervenções descritas nos estudos foram classificadas em quatro domínios: educacional; comportamental, cognitivo comportamental, e multicomponente. No total, seis ensaios clínicos atenderam aos critérios de inclusão e foram analisados. Metade dos estudos (3; 50%) usaram intervenções do tipo multicomponente, 2 (33.3%) centraram-se em intervenções comportamentais, e 1 (16.7%) aplicou intervenções educacionais isoladamente. Todos os estudos utilizaram métodos indiretos para mensurar a adesão, com ênfase em escalas e questionários. Metade dos estudos (3; 50%) demonstraram impacto positivo na adesão em pacientes com CU, com indícios de que intervenções do tipo multicomponente, quando apropriadamente implementadas em ensaio clínicos que associam métodos diretos e indiretos para a mensuração da adesão a medicamentos, parecem aumentar as chances de melhores resultados. Consideramos que estudos futuros centrados na melhoria da adesão em pacientes com CU se fazem necessários.

Keywords

medication adherence - colitis - ulcerative - inflammatory bowel diseases - self-management - drug therapy

Palavras-chave

adesão à medicação - colita ulcerativa - doenças inflamatórias intestinais - automanejo - tratamento farmacológico


Publication History

Received: 19 July 2020

Accepted: 11 August 2020

Article published online:
19 March 2021

© 2021. Sociedade Brasileira de Coloproctologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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