Patients’ Educational Program Could Improve Azathioprine Adherence in Crohn’s Disease Maintenance Therapy
Aim. To determine the risk factors of nonadherence to azathioprine (AZA) maintenance therapy for Crohn’s disease (CD) and to evaluate the influence of patients’ educational program on adherence to AZA maintenance therapy. Methods. Patients receiving AZA as maintenance therapy for CD were enrolled. D...
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| Format: | Article |
| Language: | English |
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Wiley
2020-01-01
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| Series: | Gastroenterology Research and Practice |
| Online Access: | http://dx.doi.org/10.1155/2020/6848293 |
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| author | Lei Wang Rong Fan Chen Zhang Liwen Hong Tianyu Zhang Zhengting Wang Jie Zhong |
| author_facet | Lei Wang Rong Fan Chen Zhang Liwen Hong Tianyu Zhang Zhengting Wang Jie Zhong |
| author_sort | Lei Wang |
| collection | DOAJ |
| description | Aim. To determine the risk factors of nonadherence to azathioprine (AZA) maintenance therapy for Crohn’s disease (CD) and to evaluate the influence of patients’ educational program on adherence to AZA maintenance therapy. Methods. Patients receiving AZA as maintenance therapy for CD were enrolled. Demographic data, clinical data, and usage information were collected. Univariate and multivariate analyses were performed to identify the risk factors of nonadherence. Then, patients’ educational program was conducted. One year after the program, the improvements in adherence and relapse rates were compared between educational and noneducational groups. Results. A total of 378 CD patients receiving AZA as maintenance therapy were enrolled from September 2008 to September 2018. Nonadherence occurred in 43.9% (166/378) of patients. Univariate analysis revealed that young age, education, alcoholism, anxiety, depression, concern belief, and lack of necessity belief and AZA knowledge were risk factors of nonadherence (P<0.05). Multivariate logistic regression showed that anxiety (OR 6.244, 95% CI 2.563–15.213), depression (OR 3.801, 95% CI 1.281–11.278), and concern belief (OR 19.531, 95% CI 3.393–120.732) were independent risk factors of nonadherence. Necessity belief (OR 0.961, 95% CI 0.925–0.999) and AZA knowledge (OR 0.823, 95% CI 0.758–0.903) were protective factors of adherence. One year after the AZA educational program, the necessity belief, AZA knowledge, and adherence of the educational group significantly improved (P<0.05). Concern belief was significantly lower in the educational group than that in the noneducational group (P<0.05). Moreover, the noneducational group suffered significantly higher endoscopic relapse rates than that the educational group (15.9% vs. 30.1%, P=0.035). Conclusions. Nonadherence occurred frequently in CD patients receiving AZA maintenance therapy. Educational programs could improve patients’ adherence mainly by promoting their beliefs and knowledge of AZA and could reduce relapse rates during treatment. |
| format | Article |
| id | doaj-art-7e1811dd9c2f4c459a7820fca5c33149 |
| institution | Kabale University |
| issn | 1687-6121 1687-630X |
| language | English |
| publishDate | 2020-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Gastroenterology Research and Practice |
| spelling | doaj-art-7e1811dd9c2f4c459a7820fca5c331492025-02-03T01:24:39ZengWileyGastroenterology Research and Practice1687-61211687-630X2020-01-01202010.1155/2020/68482936848293Patients’ Educational Program Could Improve Azathioprine Adherence in Crohn’s Disease Maintenance TherapyLei Wang0Rong Fan1Chen Zhang2Liwen Hong3Tianyu Zhang4Zhengting Wang5Jie Zhong6Department of Gastroenterology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, ChinaDepartment of Gastroenterology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, ChinaDepartment of Gastroenterology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, ChinaDepartment of Gastroenterology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, ChinaDepartment of Gastroenterology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, ChinaDepartment of Gastroenterology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, ChinaDepartment of Gastroenterology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, ChinaAim. To determine the risk factors of nonadherence to azathioprine (AZA) maintenance therapy for Crohn’s disease (CD) and to evaluate the influence of patients’ educational program on adherence to AZA maintenance therapy. Methods. Patients receiving AZA as maintenance therapy for CD were enrolled. Demographic data, clinical data, and usage information were collected. Univariate and multivariate analyses were performed to identify the risk factors of nonadherence. Then, patients’ educational program was conducted. One year after the program, the improvements in adherence and relapse rates were compared between educational and noneducational groups. Results. A total of 378 CD patients receiving AZA as maintenance therapy were enrolled from September 2008 to September 2018. Nonadherence occurred in 43.9% (166/378) of patients. Univariate analysis revealed that young age, education, alcoholism, anxiety, depression, concern belief, and lack of necessity belief and AZA knowledge were risk factors of nonadherence (P<0.05). Multivariate logistic regression showed that anxiety (OR 6.244, 95% CI 2.563–15.213), depression (OR 3.801, 95% CI 1.281–11.278), and concern belief (OR 19.531, 95% CI 3.393–120.732) were independent risk factors of nonadherence. Necessity belief (OR 0.961, 95% CI 0.925–0.999) and AZA knowledge (OR 0.823, 95% CI 0.758–0.903) were protective factors of adherence. One year after the AZA educational program, the necessity belief, AZA knowledge, and adherence of the educational group significantly improved (P<0.05). Concern belief was significantly lower in the educational group than that in the noneducational group (P<0.05). Moreover, the noneducational group suffered significantly higher endoscopic relapse rates than that the educational group (15.9% vs. 30.1%, P=0.035). Conclusions. Nonadherence occurred frequently in CD patients receiving AZA maintenance therapy. Educational programs could improve patients’ adherence mainly by promoting their beliefs and knowledge of AZA and could reduce relapse rates during treatment.http://dx.doi.org/10.1155/2020/6848293 |
| spellingShingle | Lei Wang Rong Fan Chen Zhang Liwen Hong Tianyu Zhang Zhengting Wang Jie Zhong Patients’ Educational Program Could Improve Azathioprine Adherence in Crohn’s Disease Maintenance Therapy Gastroenterology Research and Practice |
| title | Patients’ Educational Program Could Improve Azathioprine Adherence in Crohn’s Disease Maintenance Therapy |
| title_full | Patients’ Educational Program Could Improve Azathioprine Adherence in Crohn’s Disease Maintenance Therapy |
| title_fullStr | Patients’ Educational Program Could Improve Azathioprine Adherence in Crohn’s Disease Maintenance Therapy |
| title_full_unstemmed | Patients’ Educational Program Could Improve Azathioprine Adherence in Crohn’s Disease Maintenance Therapy |
| title_short | Patients’ Educational Program Could Improve Azathioprine Adherence in Crohn’s Disease Maintenance Therapy |
| title_sort | patients educational program could improve azathioprine adherence in crohn s disease maintenance therapy |
| url | http://dx.doi.org/10.1155/2020/6848293 |
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