Transition clinic attendance is associated with improved beliefs and attitudes toward medicine in patients with inflammatory bowel disease

摘要

AIM To evaluated the differences in knowledge, adherence, attitudes, and beliefs about medicine in adolescents with inflammatory bowel disease(IBD) attending transition clinics.METHODS We prospectively enrolled patients from July 2012 to June 2013. All adolescents who attended a tertiarycentre-based dedicated IBD transition clinic were invited to participate. Adolescent controls were recruited from university-affiliated gastroenterology offices. Participants completed questionnaires about their disease and reported adherence to prescribed therapy. Beliefs in Medicine Questionnaire was used to evaluate patients' attitudes and beliefs. Beliefs of medication overuse, harm, necessity and concerns were rated on a Likert scale. Based on necessity and concern ratings, attitudes were then characterized as accepting, ambivalent, skeptical and indifferent. RESULTS One hundred and twelve adolescents were included and 59 attended transition clinics. Self-reported adherence rates were poor, with only 67.4% and 56.8% of patients on any IBD medication were adherent in the transition and control groups, respectively. Adolescents in the transition cohort held significantly stronger beliefs that medications were necessary(P = 0.0035). Approximately 20% of adolescents in both cohorts had accepting attitudes toward their prescribed medicine. However, compared to the control group, adolescents in the transition cohort were less skeptical of(6.8% vs 20.8%) and more ambivalent(61% vs 34%)(OR = 0.15; 95%CI: 0.03-0.75; P = 0.02) to treatment.CONCLUSION Attendance at dedicated transition clinics was associated with differences in attitudes in adolescents with IBD.