O-016 YI Beliefs in Medications and Treatment Complexity as Predictors of Medication Adherence among Adults With Inflammatory Bowel Disease

Abstract

BACKGROUND: Background and Framework: Inflammatory bowel disease (IBD) is a chronic condition which requires adherence to long-term medication therapy to maintain remission. Patients' beliefs about medications and their perceptions of treatment complexity (discomfort, delivery methods, availability, medication schedule, and storage) may disrupt adherence and management of inflammatory bowel disease. The context of this study was based on a researcher-expanded model incorporating beliefs in medications and treatment complexity within Levanthal's Common-sense Model of Self-regulation in Health and Illness. Significance to Nursing: Poor adherence to medications in patients with IBD results in relapses and subsequently increased healthcare costs, poor quality of life, and increased comorbidities. Nurses have unique opportunities to influence IBD patients' adherence to medication therapy. Purpose: The purpose of this correlational study was to explore beliefs about medications and treatment complexity as predictors of medication adherence. METHODS: Methodology: In this predictive correlational design, treatment complexity and beliefs in medications were tested to determine if they are predictors of medication adherence. Adherence was measured by the Morisky Medication Adherence Scale (MMAS)-8 items. Beliefs in medications were measured by 4 subscales: necessity, concerns, harm, and overuse of the Beliefs in Medication Questionnaire (BMQ). Treatment complexity was measured by a researcher-developed 5-item scale. A researcher developed questionnaire was used to collect data on treatment and illness variables. Through convenience sampling, participants were recruited from face book, IBD organizations, and foundation websites (n = 369 final sample size). RESULTS: In the logistic regression computation, necessity belief was the only predictor of adherence among the 4 beliefs; odds ratio 1.102 (95% CI, = 1.062-1.143), P < 0.05 and treatment complexity was a predictor of adherence; odds ratio 0.824 (95% CI, = 0.768-0.884), P < 0.05. Pearson chi-square test for independence indicated significant association between adherence and reporting of depression, obesity, use of biologics and 5-ASA compounds, and intravenous method of medication administration. CONCLUSIONS: Beliefs in the necessity of IBD medications and treatment complexity were predictors of medication adherence. A large percentage of participants were uncertain about the harmful effects and overuse of all medications in general, and concerned about their specific IBD medications. A significant association between adherence and reporting of depression, obesity, use of biologics and 5-ASA compounds, and intravenous method of medication administration was identified. IMPLICATIONS FOR IBD NURSING PRACTICE: Nurses can assess IBD patients for adherence to medications, beliefs in medications, and perceptions of treatment complexity. Using data, nurses can collaborate with patients to reinforce, clarify, educate, and facilitate therapy to improve adherence and decrease treatment complexity. Ultimately, patients will be empowered to improve medication adherence resulting in better patient outcomes thereby reducing the economic and personal burdens of IBD.