Covert dose reduction is a distinct type of medication non-adherence observed across all care settings in Inflammatory Bowel Disease

Abstract

Background: Non-adherence by dose omission is common and deleterious to outcomes in Inflammatory Bowel Disease (IBD), but covert dose reduction (CDR) remains unexplored. Aims: To determine frequency and attitudinal predictors of overall medication non-adherence and of covert dose reduction as separate entities. Methods: A cross sectional questionnaire was undertaken involving IBD patients in three different geographical regions and care settings. Demographics, medication adherence by dose omission, and rate of patient initiated dose reduction of conventional meds without practitioner knowledge (CDR) were assessed, along with attitudes toward IBD medication. Results: Of 473 respondents (mean age 50.3. years, 60.2% female) frequency of non-adherence was 21.9%, and CDR 26.9% (p.