Abstract
AIM: Medication adherence is critical in 5-aminosalicylate therapy for patients with ulcerative colitis. Patients with a history of previous medication self-discontinuation may continue to have low adherence due to the influence of inappropriate disease awareness. This study aimed to determine the association between the history of previous medication self-discontinuation and current adherence to 5-aminosalicylates in patients with ulcerative colitis. METHODS AND RESULTS: This cross-sectional study was conducted in Japan from 2021 to 2024. A self-administered questionnaire was used in 228 patients with ulcerative colitis who were taking 5-aminosalicylates. We defined adherence as consumption of ≥ 80% of the prescribed dose. Patients with a history of previous medication self-discontinuation were defined as having discontinued medication at least once in the past by their own judgment. The current adherence rate to 5-aminosalicylates in this study was 92.9% (212/228). The proportion of patients with a history of previous medication self-discontinuation was 7.8% (18/228). History of previous medication self-discontinuation (p < 0.001), younger age (p < 0.001), and once-daily 5-aminosalicylates regimen (p < 0.001) were inversely associated with current adherence to 5-aminosalicylates. CONCLUSION: History of previous medication self-discontinuation was inversely associated with current adherence to 5-aminosalicylates among patients with ulcerative colitis. The results of this study suggest that determining the history of previous medication self-discontinuation may be a valuable tool in assessing current adherence to 5-aminosalicylates, which can be cumbersome.