Wheat CL, Megan Maass, Beth Devine, Timothy Thornton, David Grembowski and Cynthia W Ko
Objective: Patients with IBD are at risk for serious complications when their disease is poorly managed. Patient non-adherence to medical therapy contributes to suboptimal outcomes, but may be modified through improved education. The primary aim of this study is to identify educational needs, and barriers and factors associated with non-adherence among inflammatory bowel disease (IBD) patients.
Methods: Eighteen IBD patients and ten IBD providers were recruited. Semi-structured interviews were conducted and a qualitative framework approach used to identify patient educational needs, barriers to obtaining information, and factors associated with non-adherence with medical therapy.
Results: Prevention of IBD symptoms and factors contributing to development of IBD were the most frequently identified patient educational needs. Both providers and patients identified diet and nutrition, as well as access to general information about IBD, as important areas of education. Common barriers to obtaining or conveying information for patients and providers included: information oversaturation, ineffective provider communication skills, and lack of provider time. Factors that impact patient comprehension and decision making were also identified. Providers frequently believed that patient non-adherence is associated with lack of current symptoms or denial of their chronic condition.
Conclusion: Our findings highlight several deficits in knowledge in IBD patients. We also identify factors associated with IBD patient comprehension, decision making, and non-adherence to therapy. These results can be used to develop targeted educational resources to improve adherence among IBD patients. We propose that patient self-management programs are potentially effective educational interventions that warrant further study in IBD.
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