Compliance To Medicationtherapy And The Formation Of Distance Management For Patients With Inflammatory Bowel Disease

[Bacground] Inflammatory bowel disease (IBD) is a chonic relapsing inflammatory disorders of gastrointestinal tract comprised of ulcerative colitis and Crohn’s disease. Currently, The goal of medicine treatment is to control IBD symptoms, promote healing of the intestinal mucosa, prolonged remission and prevent complications. With the development of medicine, surgery, medication, alternative therapies and traditional chinese medicine are applied to the treatment of IBD and the medicine therapy is the principal treatment.Patients need to take oral long-term drugs to control symptoms and reduce recurrence due to the disease feature of duration, delayed healing, easy to recurrent features. Adherence to these medications is essential to prevent flares in these chronic disorders.Unfortunately, foreign studies have shown that medication compliance of patients with IBD is poor and related domestic research on IBD patient medication compliance is less. Foreign researchers took network as a new means of intervention on IBD patients and achieved good results. This study aimed to describe the medication compliance status of patients with inflammatory bowel disease and analyzes the influencing factors, to establish distance medication management and evaluate the effectiveness of pattern-based remote follow-up care to improve medication compliance and quality of life of patients. So as to provide a reference for making reasonable care intervention model.[Prupose] To investigate the level and influencing factors of medication compliance in patients with inflammatory bowel disease. Distance medicine management program on IBD was constructed and clinical trial were carried out to evaluate the effects of the disease management program and individualized follow-up based on medical cooperation.[Methods]1.With convenience sampling method, Totally 150 IBD patients were recruited and investigated with Morisky Medication Adherence Sale, Mayo score, Crohn’s disease activity index, Medication Possession Ratio, Beliefs about Medicines Questionnaire, and Crohn’s and Colitis Knowledge Sale.We used SPSS16.0 software to analyzes the factors that influence patient medication compliance.2.With purposive sampling method and data saturation principle,In-depth interview was conducted to eleven IBD patients and the interview results were analyzed by phenomenology research method.so as to describe the factors influencing medication compliance of patients.3.120 patients with inflammatory bowel disease were randomly divided into control group and experimental group. The patients in the control group received routine guidance in Post-disease clinic, in addition the patients in the experimental group received 6-mouth distance management program.distance management program include motivational interview, network support (QQ and micro-channel group) and a telephone hotline and individualized follow-up. The patients’ medication adherence, self-efficacy, quality of life and knowledge of the disease were assessed. We used SPSS 16.0 software for statistical analysis and P<0.05 indicates significant difference.[Results]1 The medication adherence score was (6.03±1.12).There were 34.0% patients with low medication adherence,44.7%patients with moderate medication adherence and 21.3% patients with high medication adherence.MPR results show that 36.9% of poor patient compliance, 41.1% of patients with moderate adherence and 22.0% of patients with good compliance. The main influencing factors of patients’medication adherence were the level of knowledge, medication beliefs, extent of disease activity, age and type of disease.2 There are five factors and 10 subheading influence medication compliance of IBD patients, including drug factors (knowledge of the drugs, the method of administration, drug efficacy, side effects of drugs), the financial burden (drug cost, unindependent economy), life events (busy and forget, vacations and out), follow-up appointment (treatment inconvenience, long waiting times) and stigma.3 The effectiveness of distance medication management based on health care cooperation(1) Medication compliance:The MMAS score shows statistically significant differences after 3-month and 6- month intervention (P<0.05), but the MMAS scores of two groups have declined after 6-month intervention.(2) Signs and symptoms:the scores of signs and symptoms have declined after the intervention. The score has showed no statistically significant difference after 3-month intervention (P> 0.05) and statistically significant difference after 6-month intervention (P <0.05).(3) Knowledge level:The CCKOWN score has improved and shown statistically significant difference after 3-month and 6-month intervention (P<0.05).(4) Self-efficacy:There were statistically significant differences in Self-efficacy scores after 3-month and 6- month intervention (P<0.05), but no statistically significant differecnce in health care management (P>0.05)。(5) Quality of Life:The IBDQ scores and its dimensions show statistically significant differences after 3-month and 6- month intervention (P<0.05), the quality of life between two groups were improved (P<0.05).[Conclusions]1. The medication compliance of patients with inflammatory bowel disease is poor and the compliance is closely related to age, type of disease, the level of knowledge, medication beliefs, disease activity, drug factors, economic capacity, life events, treatment difficulties, stigma and so on. Health care should be concerned with the Standardization and continuity of medication, lay emphasis on medication management and evaluation and give guidance and targeted health interventions based on different factors influencing compliance. In addition, health care need to supervise its on-demand medication and maintain the availability of drugs, so as to improve medication compliance and the quality of life.2. The construction of distance medical management was on the result of patient needs and expert advice.Randomized controlled study was conducted to confirm the effects of the program on medication compliance, signs and symptoms, knowledge level, self-efficacy and quality of Life.