Obstacles to Medication Adherence for Patients with Inflammatory Bowel Disease: A Qualitative Study in East China

Fen Xu,1,2,* Jingjing Xing,3,* Mingna Fan,4 Zhiping Zhu,5 Yan Chen,6 Wen Hu,7 Yunxian Zhou1 1School of Nursing, Zhejiang Chinese Medical University, Hangzhou, People’s Republic of China; 2Department of Gastroenterology, Hangzhou Third Hospital, Hangzhou, People’s Republic of China; 3Department of Nursing, Zhejiang Orthopedic Hospital, Hangzhou, People’s Republic of China; 4Department of Nursing, Hangzhou Hospital of Traditional Chinese Medicine, Hangzhou, People’s Republic of China; 5Department of Vascular Surgery, Hangzhou Third Hospital, Hangzhou, People’s Republic of China; 6Department of Gastroenterology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, People’s Republic of China; 7State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, Collaborative National Clinical Research Center for Infectious Diseases, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, People’s Republic of China*These authors contributed equally to this workCorrespondence: Yunxian Zhou, School of Nursing, Zhejiang Chinese Medical University, 548 Binwen Road, Binjiang District, Hangzhou, Zhejiang, 310053, People’s Republic of China, Tel +860571-86633121, Email [email protected]: To identify the factors impacting medication non-adherence in patients with inflammatory bowel disease (IBD) in China, and to provide a reference for effective interventions.Patients and Methods: Individual semi-structured interviews were conducted between December 2020 and July 2021 in four tertiary hospitals in East China. A conventional content analysis method was used in data analysis to extract themes and sub-themes in IBD Patients with poor medication adherence.Results: The 10 participants included were those who were diagnosed with IBD at least 1 year and could provide rich information and express strong desire. Seven themes emerged after data analysis: (a) non-acceptance of disease; (b) Lack of cognition of disease; (c) medication beliefs; (d) perceived efficacy; (e) Forgetting and delays; (f) costs of medication; (g) personality and psychological factors.Conclusion: Our data confirmed that in addition to comprehensive disease education and effective communication, medical staff should also pay attention to individualized factors, and develop effective response strategies for medication management support to reduce recurrence and control the disease.Keywords: Crohn’s disease, inflammatory bowel disease, medication adherence, ulcerative colitis, qualitative study