Premium
Predictors of persistence with 5‐aminosalicylic acid therapy for ulcerative colitis
Author(s) -
KANE S. V.,
ACCORTT N. A.,
MAGOWAN S.,
BRIXNER D.
Publication year - 2009
Publication title -
alimentary pharmacology and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.308
H-Index - 177
eISSN - 1365-2036
pISSN - 0269-2813
DOI - 10.1111/j.1365-2036.2009.03941.x
Subject(s) - medicine , persistence (discontinuity) , medical prescription , logistic regression , ulcerative colitis , retrospective cohort study , multivariate analysis , pediatrics , disease , pharmacology , geotechnical engineering , engineering
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.