Socioeconomic and psychological factors associated with non-adherence to treatment in IBD patients: Results of the isseo survey

  • Nahon S
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Background and aims Adherence to treatment is a key condition in preventing relapses in IBD. Among factors influencing adherence, patient-related determinants such as socioeconomic status, demographic, psychological, cognitive and behavioral characteristics are very important. The aims of this study were to study in a large cohort of IBD patients, factors influencing adherence especially those related to patients ie socioeconomic and psychological factors (ISSEO for Impact de la Situation Socio Economique sur l'Observance). Patients and methods A questionnaire about demographic, clinical and psycho-social characteristics was sent by mail to 6000 IBD patients belonging to the French association of IBD patients (AFA). The questionnaire was also available on the website of the AFA for non-member patients to answer the questionnaire. A good adherence to treatment was defined as taking (greater-than or equal to)80% of prescribed medication. Socioeconomic deprivation was assessed using a specific score; the EPICES score ( developed in France. Anxiety and depression were assessed using the HAD (Hospitality Anxiety and Depression) scale and by a visual analogic scale. Results 1069 women and 594 men (43.6(plus or minus)15.4 yrs) completed the questionnaire, 1450 (87.2%) of them belonged to the AFA. 1044 had a Crohn's disease, 36 an indeterminate colitis and 583 an ulcerative colitis. An adherence (greater-than or equal to)80% was reported by 89.6% of patients. Factors associated with good adherence were: older age (p10 (OR: 0.2; CI: 0.36-0.67; p<10(-6)) and a bad mood felt by the patient (OR: 0.43; CI: 0.3-0.62; p<10(-5)). There were no differences in adherence for the following: gender, type of IBD, characteristics of the disease (especially activity and severity), deprivation evaluated by the EPICES score, marital status, education level and depression. Conclusion This survey shows a high adherence to treatment in French IBD patients belonging to a patients' association. Psychological support, adaptation of treatment to patient's lifestyle and membership of a patients' association may improve adherence to treatment.




Nahon, S. (2011). Socioeconomic and psychological factors associated with non-adherence to treatment in IBD patients: Results of the isseo survey. European Psychiatry, 26(S2), 2221–2221.

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