1. Predictors of persistence with 5-aminosalicylic acid therapy for ulcerative colitis
- Author
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N. A. Accortt, Simon Magowan, Sunanda V. Kane, and Diana I. Brixner
- Subjects
Adult ,Male ,medicine.medical_specialty ,Adolescent ,Logistic regression ,Persistence (computer science) ,Medication Adherence ,Cohort Studies ,chemistry.chemical_compound ,Young Adult ,Mesalazine ,Internal medicine ,medicine ,Humans ,Pharmacology (medical) ,Medical prescription ,Young adult ,Aged ,Retrospective Studies ,Hepatology ,business.industry ,Anti-Inflammatory Agents, Non-Steroidal ,Gastroenterology ,Retrospective cohort study ,Middle Aged ,medicine.disease ,Ulcerative colitis ,Surgery ,Aminosalicylic Acids ,Logistic Models ,Prescriptions ,chemistry ,Colitis, Ulcerative ,Female ,business ,Cohort study - Abstract
Summary Background Individuals with ulcerative colitis (UC) are at risk for poor persistence with therapy. Aim To identify factors predicting persistence with 5-aminosalicylic acid (5-ASA) therapy after 3 and 12 months in subjects with UC. Methods In this retrospective cohort study, persistence with 5-ASA therapy was determined from prescription refill data from a commercial health insurance claims database. The analysis included subjects with UC who filled a prescription for any oral 5-ASA between October 2002 and September 2004. Persistence was defined as prescription refill at 3 and/or 12 months. Multivariate logistic regression modelling identified variables independently associated with persistence at 3 and 12 months. Results In all, 3574 subjects were identified. Fifty-seven per cent (2044) were persistent at 3 months. Glucocorticoid use before the index prescription predicted improved persistence at 3 months. Psychiatric diagnosis, mail order of the index prescription, female gender and co-pay predicted decreased persistence. At 12 months, 1124 (55%) remained persistent. Rectal 5-ASA use, older age and switching to a different 5-ASA predicted improved persistence at 12 months. Hospitalization for a gastrointestinal condition, mail order of the 3-month prescription and number of co-morbid illnesses predicted lower persistence. Conclusion Persistence with 5-ASA treatment in UC is complex and multifactorial, and differs by time period.
- Published
- 2009