Abstract
BACKGROUND: Adherence to 5-aminosalicylic acid (5-ASA), an anchor drug for ulcerative colitis (UC), affects remission maintenance. This study aimed to investigate the current status of adherence to 5-ASA and identify the factors associated with adherence. METHODS: We enrolled UC patients whose primary maintenance therapy was oral 5-ASA at our hospital between January 2017 and December 2018. The adherence status was examined using a questionnaire survey. Various factors, including patient background and disease activity, were also analyzed to identify those related to adherence. A second questionnaire with the same content was performed 1 year after the initial survey for comparison. RESULTS: In total, 297 patients with UC answered the first questionnaire, of which 278 answered the second questionnaire. Complete adherence rates at the time of the first and second questionnaires were 49.8% (148/297) and 55.8% (155/278), respectively. Full-time employment (p = 0.00893), eating one or two meals per day (p = 0.00641), and multiple daily doses (p = 0.0153) were significantly associated with lower adherence. The 119 patients who fully adhered to both the primary and secondary questionnaires had a significantly higher cumulative non-relapse rate at 1 year than those 159 who were not (85.7% vs. 76.1%, p = 0.0207). CONCLUSIONS: UC patients with high adherence to 5-ASA showed a high rate of remission maintenance, so adherence should be improved by considering factors such as the number of medications taken, work status, and dietary habits.