Ulcerative Colitis

Improving adherence to treatment in the UK

Background

Ulcerative colitis is a chronic, relapsing–remitting, non-infectious inflammatory disease of the gastrointestinal tract. The aim of treatment is to reduce symptoms and maintain or improve quality of life.

In the UK, ulcerative colitis has an incidence of approximately 10 per 100,000 people annually. Ulcerative Colitis; NICE Clinical Guideline (Jun 2013)

Clinical Issues

The use of mesalazine in ulcerative colitis increases the chances of remission induction and maintenance when compared to placebo, and higher doses are associated with greater chance of success without increasing the risk of adverse events.
Compliance diminishes as the daily dosing schedule increases. As a result, few drugs are prescribed more than four times a day.
However, mesalazine indicated for maintenance therapy in ulcerative colitis initially involved the patient taking six tablets each day in divided doses.
When the license was changed to allow the full daily dose to be taken in one go, it was important to let patients know as this change was likely to significantly improve compliance.

How Patient Connect helped

Patient Connect alerted its network of pharmacies to the adherence challenges and the patient support programme.

Pharmacists delivered the following advice to patients at the point-of-dispensing the target drug.

"Taking your medicine every day reduces the risk of relapse. A daily dose can be taken all in one go if easier to remember"

"You must take their medicine every day, even if you have no symptoms, to help prevent relapses. Taking the daily dose in one go may help you to remember"

Results

Dispensed volumes of the target drug increased in active pharmacies during and after the initial two-month pilot patient support programme.

Three programme extensions, during which clinical message alerts reinforced the message that patients could take their six doses at the same time each day, maintained the positive impact on dispensed volumes, suggesting the patient support programme had a significant impact on medication compliance.