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ALIGNed on adherence: subanalysis of adherence in immune-mediated inflammatory diseases in the DACH region of the global ALIGN study.

ABSTRACT: BACKGROUND:Non-adherence to medication is a challenging problem in daily clinical practice. OBJECTIVE:To assess reasons for non-adherence in patients with chronic immune-mediated inflammatory diseases (IMIDs) in a direct comparison including evaluation of treatment necessity and concerns. METHODS:ALIGN was a non-interventional, multicountry, multicentre, self-administered, cross-sectional, epidemiologic survey study. Here, we investigate the German, Austrian and Swiss (DACH) cohort. Six hundred thirty-one patients with different IMIDs (rheumatoid arthritis, ankylosing spondylitis, psoriatic arthritis, plaque psoriasis, Crohn's disease and ulcerative colitis) under systemic therapies were evaluated concerning adherence, beliefs of necessity and concerns towards treatment in patients with IMIDs. RESULTS:The DACH cohort had significantly different levels of adherence depending on the IMID (P < 0.05) and the type of therapy (P < 0.05). Based on the significant influence of concerns on treatment adherence (P < 0.05) and the high belief of treatment necessity, patients could be classified in four attitudinal segments, which were unequally distributed throughout various IMIDs. High concerns had a significant influence on non-adherence, whereas necessity did not. Older age, female sex, TNFi mono-, conventional combination and TNFi combination therapy are positively associated with adherence. CONCLUSIONS:In the DACH region, patients are less concerned about medication and believe in the necessity of treatment. Therefore, we suggest adapting the communication in the various patient groups.

SUBMITTER: Kolios AGA

PROVIDER: S-EPMC6585659 | biostudies-literature | 2019 Jan

REPOSITORIES: biostudies-literature

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ALIGNed on adherence: subanalysis of adherence in immune-mediated inflammatory diseases in the DACH region of the global ALIGN study.

Kolios A G A AGA Hueber A J AJ Michetti P P Mrowietz U U Mustak-Blagusz M M Sator P-G PG Reinshagen M M Wilsmann-Theis D D Gomis-Kleindienst S S Luckey U U Rössler A A Schiefke I I

Journal of the European Academy of Dermatology and Venereology : JEADV 20180822 1

<h4>Background</h4>Non-adherence to medication is a challenging problem in daily clinical practice.<h4>Objective</h4>To assess reasons for non-adherence in patients with chronic immune-mediated inflammatory diseases (IMIDs) in a direct comparison including evaluation of treatment necessity and concerns.<h4>Methods</h4>ALIGN was a non-interventional, multicountry, multicentre, self-administered, cross-sectional, epidemiologic survey study. Here, we investigate the German, Austrian and Swiss (DACH ...[more]

PMID: 29998520

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Project description:IntroductionMedication adherence is critical in chronic immune-mediated inflammatory diseases (IMIDs) and could be affected by patients' treatment-related beliefs. The objective of this study was to determine beliefs about systemic medications in patients with IMIDs and to explore the association of those beliefs and other factors with adherence.MethodsThis was a multi-country, cross-sectional, self-administered survey study. Included were adults diagnosed with one of six IMIDs receiving conventional systemic medications and/or tumor necrosis factor inhibitors (TNFi). Patients' necessity beliefs/concerns towards and adherence to treatments were assessed by the Beliefs about Medicines Questionnaire and four-item Morisky Medication Adherence Scale. Correlation of patients' beliefs about treatment and other factors with adherence were evaluated by multivariable regression analyses.ResultsAmong studied patients (N = 7197), 32.0% received TNFi monotherapy, 27.7% received TNFi-conventional combination therapy, and 40.3% received conventional medications. Across IMIDs, high adherence to systemic treatment was more prevalent in TNFi groups (61.3-80.7%) versus corresponding conventional treatment groups (28.4-64.7%). In at least four IMIDs, greater perception of the illness continuing forever (P < 0.001), of the treatment helping (P < 0.001), and more concerns about the illness (P < 0.01), but not clinical parameters, were associated with higher treatment necessity beliefs. Higher treatment necessity beliefs, older age, Caucasian race, and TNFi therapy were associated with high medication adherence in at least four IMIDs.ConclusionsTreatment necessity beliefs were higher than concerns about current medication in patients with IMID. Illness perceptions had a greater impact on treatment necessity beliefs than clinical parameters. Older age, greater treatment necessity beliefs, and TNFi therapy were associated with high self-reported medication adherence in at least four IMIDs.Trial registrationACTRN12612000977875.FundingAbbVie.

Project description:AimsThis study aimed to conduct a bibliometric analysis of the relevant literature on the interaction between microbiota and immune in intestinal inflammatory diseases, and show its current status, hotspots, and development trends.MethodsThe related literature was acquired from the Web of Science Core Collection on October 12, 2022. Co-occurrence and cooperation relationship analysis of authors, institutions, countries, references, and keywords in the literature were carried out through CiteSpace 6.1.R3 software and the Online Analysis platform of Literature Metrology. At the same time, the relevant knowledge maps were drawn, and the keywords cluster analysis and emergence analysis were performed.Results3,608 related publications were included, showing that the number of articles in this field is increasing year by year. The results showed that Gasbarrini A and Sokol H were the authors with the highest cumulative number of articles with 25, and the institution with the most articles was Harvard University with 142 articles. The USA was far ahead in the article output, with 1,131 articles, and had a dominant role, followed by China with 707 articles. The journal Frontiers in Immunology contributed the most to this research field with 213 articles. In the cooperation network analysis, the USA, Harvard University, and Xavier RJ were the most widely collaborated country, institution, and author, respectively, which implied a high level of influence. Keywords analysis showed that there were 770 keywords, which were mainly classified as internal related diseases, such as "inflammatory bowel disease", "irritable bowel syndrome", "colorectal cancer", and the mechanism of interaction of microbiota and immune, such as "intestinal microbiota", "commensal microbiota", "regulatory T cell", "dendritic cell", "barrier function", "activation", "anti-inflammatory properties", "intestinal epithelium", and "diversity". Emerging analysis showed that future research hotspots and trends might be the short-chain fatty acid, gut dysbiosis, gut-liver axis, and fusobacterium nucleatum.ConclusionThis research was the first bibliometric analysis of publications in the field of interaction between microbiota and immune in intestinal inflammatory diseases using visualization software and data information mining, and obtained the current status, hotspots, and development of this field, which provides a theoretical basis for its scientific research.

Project description:Many studies have demonstrated the linkage between the IBD3 region (6p21.1-23), an area which encompasses the famous human leukocyte antigen (HLA) complex, and Crohn's disease (CD) or ulcerative colitis (UC). IBD3 is the only region that meets genome-wide significance, and provides stronger evidence of the linkage than 16p13.1-16q12.2 (IBD1), the locus that contains the susceptibility gene CARD15. However, despite these findings, IBD3 susceptibility genes remain elusive and unclear due to the strong linkage disequilibrium, extensive polymorphism, and high gene density that characterize this area and also due to varying allele frequencies in populations around the world. This area presents an extremely high abundance of genes, including the classical and non-classical major histocompatibility complex (MHC) class I and II genes, and other genes, namely MHC class III genes tumor necrosis factor (TNF)-? and -?, and Hsp, whose proteins play key functions in immunological processes. To date, it is not clear which genes within the MHC family contribute to the IBD pathogenesis, although certain HLA alleles have been associated with IBD. Recent insights into the biological function of other genes encoded within the IBD3 region, such as the MHC class I chain-related (MIC) genes, have led investigators to a more comprehensive exploration of this region. MHC class I chain-related molecule A (MICA) is highly polymorphic and interacts with NKG2D, its receptor on the surface of NK, T?? and T CD8(+) cells. Increased expression of MICA in intestinal epithelial cells and increased expression of NKG2D in CD4(+) T cells (lamina propria) in patients with CD have also been reported. MICA alleles have also been associated with IBD, and a variation at amino acid position 129 of the ?2-heavy chain domain seems to categorize MICA alleles into strong and weak binders of NKG2D receptor, thereby influencing the effector cells' function. In this regard, a relevant role of MICA-129-Val/Met single nucleotide polymorphism has recently been implicated in the pathogenesis of IBD. TNF-? and -? also play an important role in inflammatory response. In fact, IBD is commonly treated with TNF-? inhibitors. Additionally, polymorphisms of TNF-? gene are known to affect the gene expression level and particular TNF-? genotypes may influence the response of IBD patients treated with TNF-? inhibitors.

Dataset Information

ALIGNed on adherence: subanalysis of adherence in immune-mediated inflammatory diseases in the DACH region of the global ALIGN study.

Publications

ALIGNed on adherence: subanalysis of adherence in immune-mediated inflammatory diseases in the DACH region of the global ALIGN study.

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