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dc.contributor.authorMoss, Alan C
dc.contributor.authorLillis, Yvonne
dc.contributor.authorEdwards George, Jessica B.
dc.contributor.authorChoudhry, Niteesh Kumar
dc.contributor.authorBerg, Anders Hayden
dc.contributor.authorCheifetz, Adam S.
dc.contributor.authorHorowitz, Gary Leigh
dc.contributor.authorLeffler, Daniel Alexander
dc.date.accessioned2018-06-07T21:24:20Z
dc.date.issued2014
dc.identifier.citationMoss, Alan C, Yvonne Lillis, Jessica B Edwards George, Niteesh K Choudhry, Anders H Berg, Adam S Cheifetz, Gary Horowitz, and Dan A Leffler. 2014. “Attitudes to Mesalamine Questionnaire: A Novel Tool to Predict Mesalamine Nonadherence in Patients with IBD.” The American Journal of Gastroenterology 109 (12) (June 10): 1850–1855. doi:10.1038/ajg.2014.158.en_US
dc.identifier.issn0002-9270en_US
dc.identifier.issn1572-0241en_US
dc.identifier.urihttp://nrs.harvard.edu/urn-3:HUL.InstRepos:37091694
dc.description.abstractOBJECTIVES: Poor adherence to mesalamine is common and driven by a combination of lifestyle and behavioral factors, as well as health beliefs. We sought to develop a valid tool to identify barriers to patient adherence and predict those at risk for future nonadherence. METHODS: A 10-item survey was developed from patient-reported barriers to adherence. The survey was administered to 106 patients with ulcerative colitis who were prescribed mesalamine, and correlated with prospectively collected 12-month pharmacy refills (medication possession ratio (MPR)), urine levels of salicylates, and self-reported adherence (Morisky Medication Adherence Scale (MMAS)-8). RESULTS: From the initial 10-item survey, 8 items correlated highly with the MMAS-8 score at enrollment. Computer-generated randomization produced a derivation cohort of 60 subjects and a validation cohort of 46 subjects to assess the survey items in their ability to predict future adherence. Two items from the patient survey correlated with objective measures of long-term adherence: their belief in the importance of maintenance mesalamine even when in remission and their concerns about side effects. The additive score based on these two items correlated with 12-month MPR in both the derivation and validation cohorts (P<0.05). Scores on these two items were associated with a higher risk of being nonadherent over the subsequent 12 months (relative risk (RR) =2.2, 95% confidence interval=1.5–3.5, P=0.04). The area under the curve for the performance of this 2-item tool was greater than that of the 10-item MMAS-8 score for predicting MPR scores over 12 months (area under the curve 0.7 vs. 0.5). CONCLUSIONS: Patients’ beliefs about the need for maintenance mesalamine and their concerns about side effects influence their adherence to mesalamine over time. These concerns could easily be raised in practice to identify patients at risk of nonadherence (Clinical Trial number NCT01349504).en_US
dc.description.sponsorshipAfrican and African American Studiesen_US
dc.language.isoen_USen_US
dc.publisherSpringer Natureen_US
dc.relation.isversionofdoi:10.1038/ajg.2014.158en_US
dc.relation.hasversionhttp://scholar.harvard.edu/nkc/publications/attitudes-mesalamine-questionnaire-novel-tool-predict-mesalamine-nonadherenceen_US
dash.licenseMETA_ONLY
dc.titleAttitudes to Mesalamine Questionnaire: A Novel Tool to Predict Mesalamine Nonadherence in Patients with IBDen_US
dc.typeJournal Articleen_US
dc.date.updated2014-09-22T13:52:25Z
dc.description.versionVersion of Recorden_US
dc.relation.journalThe American Journal of Gastroenterologyen_US
dash.depositing.authorChoudhry, Niteesh Kumar
dash.embargo.until10000-01-01
dash.affiliation.otherHarvard Medical Schoolen_US
dc.identifier.doi10.1038/ajg.2014.158*
dash.contributor.affiliatedHorowitz, Gary Leigh
dash.contributor.affiliatedBerg, Anders
dash.contributor.affiliatedLeffler, Daniel
dash.contributor.affiliatedCheifetz, Adam
dash.contributor.affiliatedMoss, Alan
dash.contributor.affiliatedChoudhry, Niteesh


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