Pattern and predictors of medication use among adults in southwestern Nigeria: A community-based cross-sectional study.

Population-based drug utilization studies are scanty in Nigeria. The aim was to determine the pattern and predictors of medication use among adults in the communities of Southwestern Nigeria. A cross-sectional study was conducted among adults selected by multi-stage sampling from Oyo State communities. The questionnaires, adapted from the WHO Students' Drug Use Questionnaire and previous studies, were pretested and interviewer administered. The respondents' socio-demographic characteristics, the pattern of medication use, prescribers, and sources of drug acquisition were obtained. Binary logistic regression was used to determine the predictor of medications used. Of the 999 respondents, 501 resided in rural communities while 498 dwelled in urban areas. The mean (±SD) age of the respondents was 38 ± 15 years. The median (range)% prevalence of medication use were as follows: lifetime use, 58.2 (17.7-81.0); current use, 31.2 (8.9-65.9); and past use, 20.3 (9.2-28.9). Medications were mainly obtained from patent medicine stores, median (range%), 71 (65-80). The commonly used drugs were paracetamol, 626 (67.6); nonsteroidal anti-inflammatory drugs, 174 (18.8); artemether/lumefantrine, 422 (68.2); ampicillin/cloxacillin, 220 (48.6); and chlorpheniramine, 59 (39.9). Factors predictive of current medication use, adjusted odd ratio (95% confidence interval) were as follows: antimalarial [male, 0.7 (0.5, 0.9)]; antibacterial [male, 0.6 (0.4-0.9)]; analgesics [married, 1.5 (1.1-2.2); presence of health facilities, 0.5 (0.3-0.7); and shorter distance to health facility, 1.5 (1.1-2.1)]. Antimalarials, antibacterial, and analgesics were commonly used and inappropriately obtained by adults in Southwestern Nigeria. Factors predictive of current medication use were gender, marital status, the presence of health facilities, and distance to health facilities. There is a need for more extensive countrywide medication use studies and enlightenment programs to ensure the appropriate use of medications.

Compounded medications for cardiovascular use in neonatology: an integrative review / Medicamentos manipulados de uso cardiovascular em neonatologia: uma revisão integrativa

ABSTRACT Objective: To analyze the profile of the compounded cardiovascular medicines prescribed in neonatology in Brazil. Data source: An integrative bibliographic review was carried out, including studies published in the last 20 years. The used descriptors were: Intensive Care Neonatal, Off-Label Use, Pharmaceutical Preparations, in the databases Virtual Health Library (VHL), PubMed, and Scientific Electronic Library Online (SciELO). Review articles and guidelines were excluded. The quality of the evidence was analyzed, and 10 articles were selected to integrate the study. Data synthesis: The profile of routine prescrption in the neonatal unit was evaluated. The main cardiovascular medications prescribed as compounding formulation were: Spironolactone, Captopril, Furosemide, Hydrochlorothiazide, Propranolol, Amiodarone, Nifedipine, Carvedilol, Digoxin, Enalapril, Epinephrine, and Hydralazine. The drugs were obtained from adaptations of dosage forms, through the transformation of capsules or tablets into liquid formulations, as a solution, suspension, or syrup, as well as in the form of solutions prepared from active pharmaceutical ingredients. The compounding of medications made drug therapy possible in neonatology, considering that such medications do not have registration of the oral liquid dosage form in the country, despite being part of the List of Essential Medicines for Children of the Word Health Organization. Conclusions: It was possible to analyze the profile of compounded cardiovascular medicines prescribed in neonatology in Brazil. The results showed the need for the development of medications suitable for the neonatal population, and the standardization of operational procedures for preparing extemporaneous formulations in neonatology to increase drug safety.

RESUMO Objetivo: Analisar o perfil dos medicamentos cardiovasculares manipulados prescritos em neonatologia no Brasil. Fontes de dados: Foi realizada uma revisão bibliográfica integrativa, incluindo estudos publicados nos últimos 20 anos. As palavras-chave utilizadas foram: intensive care neonatal, off-label use, pharmaceutical preparations, nos bancos de dados da Biblioteca Virtual em Saúde (BVS), PubMed e Biblioteca Eletrônica Científica Online (SciELO). Os artigos de revisão e diretrizes foram excluídos. A qualidade da evidência foi analisada, e foram selecionados 10 artigos para integrar o estudo. Síntese dos dados: Todos os estudos possibilitaram a avaliação do perfil de prescrição na rotina da unidade. Os principais fármacos cardiovasculares, prescritos em formulação extemporânea, foram espironolactona, captopril, furosemida, hidroclorotiazida, propranolol, amiodarona, nifedipina, carvedilol, digoxina, enalapril, epinefrina e hidralazina. Os medicamentos foram obtidos mediante adaptações de formas farmacêuticas, por meio da transformação de cápsulas ou comprimidos em formulações líquidas, como solução, suspensão ou xarope, assim como também na forma de soluções preparadas com base nos insumos farmacêuticos ativos. A manipulação de medicamentos tornou possível o tratamento medicamentoso em neonatologia, uma vez que tais medicamentos não possuem registro da forma farmacêutica líquida oral no país, apesar de integrarem a lista de medicamentos essenciais em pediatria da Organização Mundial da Saúde. Conclusões: Foi possível analisar o perfil dos medicamentos cardiovasculares manipulados prescritos na neonatologia no Brasil. Os resultados evidenciaram a necessidade do desenvolvimento de medicamentos adequados à população neonatal e à padronização dos procedimentos operacionais do preparo de formulações extemporâneas na neonatologia, para aumentar a segurança dos medicamentos.

Drugs utilization profile in England and Wales in the past 15 years: a secular trend analysis.

BACKGROUND: Medication use assessment has a critical role in promoting the effective and rational use of pharmaceutical medications. There are no studies that have explored the utilization of all medications in England and Wales in the past 15 years without restrictions in the age group being studied or class of medications. AIM: To explore the medication utilization pattern of dispensed medications in England and Wales in the past 15 years. METHOD: A secular trend analysis study using publically available dispensing data on the population level in England and Wales for the duration between 2004 and 2019. Medication dispensing data was extracted from the Prescription Cost Analysis database. RESULTS: Medication prescriptions rate increased by 42.6% [from 1,345,095.75 (95% CI 1,345,004.25 - 1,345,187.26) in 2004 to 1,918,138.48 (95% CI 1,918,038.38 - 1,918,238.57) in 2019 per 100,000 persons, trend test, p < 0.001]. During the study period, the most common medication prescriptions were for the cardiovascular system, central nervous system, and endocrine system, which accounted for 30.2%, 18.8%, and 9.4%, respectively. The rate of medication prescriptions for skin, immunological products and vaccines, infections, and musculoskeletal and joint diseases decreased by 18.4%, 15.8%, 9.8%, and 5.7%, respectively. CONCLUSION: The last two decades have witnessed a remarkable rise in the quantity of medications dispensed in community settings. Utilization of chronic disease medications has increased in the past 15 years, specifically, dispensed medications for the cardiovascular system, central nervous system, and endocrine system. It is necessary to conduct additional cohort studies to investigate the clinical outcomes and prescribing safety of these medications.

The temporal association between hospital admissions, biological therapy usage and direct health care costs in rheumatoid arthritis patients.

The Australian Pharmaceutical Benefits Scheme (PBS) has subsidised biological therapy since 2003. We investigated the association between biological therapy for RA hospitalisation rates and health-care costs.Hospital admissions for RA patients between 1995 and 2014 were identified in the Western Australia (WA) Hospital Morbidity Data Collection (ICD codes 714 and M05.00-M06.99). State-specific dispensing data for conventional and biological therapies for RA was obtained from Statistics Australia and expressed as defined daily doses/1000 population/day (DDD) using WA population census. Principal component analysis (PCA) was applied to determine the relationship between DMARDs use and hospital admission rates.A total of 17,125 patients had 50,353 admissions with a diagnostic code for RA. Between 1995 and 2002, the number of RA admissions fell from 7.9 to 2.6/1000 admissions, while conventional therapy use rose from 1.45 to 1.84 DDD. Between 2003 and 2014, RA admissions decreased further to 1.9/1000 hospital admissions, while conventional therapy use increased to 2.19 DDD and biological therapy from 0.01 to 1.0 DDD. In PCA, conventional and biological therapies use had an inverse relationship with hospital admission rates. Annual costs of biological therapy utilisation was 22.5 million in 2003-2014, while the annual cost saving of RA hospital admissions was 9.2 million.The increased use of conventional therapy use for RA has coincided with a significant decline in hospital admissions for RA patients in WA, while a more modest further decline followed biological therapy introduction. Biological therapy was not as cost-effective as conventional in relation to RA hospital admissions costs.

Tendencias en el uso de fármacos para la COVID-19 durante la primera ola de la pandemia en un hospital de Lima, Perú / Trends in drugs usage for COVID-19 during the first wave of the pandemic in a hospital in Lima, Peru

Resumen Con el objetivo de evaluar las tendencias en el uso de fármacos en pacientes con la COVID-19 de un hospital del Perú durante la primera ola de la pandemia se realizó un estudio retrospectivo entre abril y septiembre del 2020. Se revisaron las historias clínicas de pacientes hospitalizados por neumonía por COVID-19 en el Hospital Nacional Dos de Mayo (Lima, Perú). De un total de 3103 pacientes, se incluyeron 381 historias clínica (77,4% varones y mediana de edad de 44 años). Se observó un incremento del uso de cuatro fármacos prehospitalarios (azitromicina, ivermectina, corticoides y ceftriaxona), y una disminución del uso de seis fármacos intrahospitalarios (ceftriaxona, azitromicina, hidroxicloroquina, ivermectina, pulso de corticoides y anticoagulación profiláctica); además, el uso de anticoagulación intrahospitalaria aumentó. Estos hallazgos sugieren que el manejo de la COVID-19 varió durante la primera ola de la pandemia, aumentando el uso de fármacos prehospitalarios y disminuyendo el uso de fármacos intrahospitalarios.

Abstract This study aimed to evaluate the pharmacological trends in patients with COVID-19 from a hospital in Peru during the first wave of the pandemic. Retrospective study conducted between April and September 2020. The medical records of patients hospitalized for COVID-19 pneumonia at the Dos de Mayo National Hospital (Lima, Peru) were reviewed. Of a total of 3103 patients, 381 medical records were included (77.4% male, median age: 44 years). The use of four prehospital drugs increased (azithromycin, ivermectin, corticosteroids, and ceftriaxone), while the in-hospital use of six drugs (ceftriaxone, azithromycin, hydroxychloroquine, ivermectin, corticosteroid pulse, and prophylactic anticoagulation) decreased and in-hospital anticoagulation use decreased. These findings suggest that the management of COVID-19 has varied during the first wave of the pandemic, typically increasing prehospital drug use and decreasing inpatient use.

Increase of binucleated cells in the oral mucosa: a study on the use of psychotropics by students of a Brazilian institution

SUMMARY This study aimed to assess the prevalence of medical and nonmedical use of psychiatric medication among undergraduate students of health sciences from a public university in Brasil. Another objective was to determine the frequency of nuclear morphological abnormalities in the buccal mucosa of students using psychiatric drugs. A cross-sectional study based on a Web survey was carried out with 375 health sciences undergraduate students from schools of Pharmacy, Physical Education, Nutrition, and Medicine. Additionally, spontaneous genetic damages in exfoliated cells of the buccal mucosa of 41 individuals by counting micronucleus (MN) and binucleated (BN) cells frequencies were evaluated. The results showed 76 (20.3%) of students reported the use of psychotropic drugs after enrolling in university. The majority of these students were from Pharmacy and Medicine programs, females, aged between 18-25 years old, nonsmokers, alcohol addicts, and with a family history of mental illness. In addition, Medical students, individuals with high-income, who live alone and are in the last period of the program are more likely to use psychotropic drugs. Moreover, exposure to psychiatric medication was able to increase the number of binucleated cells. These results provide evidence that the use of psychoactive drugs is increased in the academic context and may be related to the failure of the cell cycle.

RESUMO O objetivo deste estudo foi avaliar a prevalência de uso médico e não médico de medicação psiquiátrica entre estudantes de graduação em Ciências da Saúde de uma universidade pública do Brasil. Outro objetivo foi determinar a frequência de anormalidades nucleares morfológicas na mucosa bucal desses estudantes. Realizou-se um estudo transversal baseado na Web com 375 estudantes de graduação em Ciências da Saúde das escolas de Farmácia, Educação Física, Nutrição e Medicina. Adicionalmente, danos genéticos espontâneos em células esfoliadas da mucosa bucal de 41 indivíduos foram analisados para estudo da frequência de micronúcleos e células binucleadas. Os resultados mostraram que 76 (20,8%) dos estudantes relataram que usaram drogas psicotrópicas após se matricularem na universidade. O uso desses medicamentos foi maior entre estudantes de cursos de Farmácia e Medicina, sexo feminino, idade entre 18 e 25 anos, não tabagistas, alcoolistas e histórico familiar de doença mental. Além disso, estudantes de Medicina, indivíduos com alta renda, que moram sozinhos e estão no último período do curso são mais propensos a usar drogas psicotrópicas. Ademais, a exposição à medicação psiquiátrica foi capaz de aumentar o número de células binucleadas. Esses resultados fornecem evidências de que o uso de drogas psicotrópicas aumenta no contexto acadêmico e pode estar relacionado à falha do ciclo celular.

Armazenamento e descarte de medicamentos por acadêmicos da área da saúde de uma universidade pública paranaense / Storage and disposal of medicines by academics from health area from a public university of Paraná

Os medicamentos são ferramentas imprescindíveis para o estabelecimento da saúde e requerem cuidados quanto ao seu armazenamento e descarte. Este estudo teve como objetivo verificar a forma de armazenamento e descarte de medicamentos por estudantes da área da saúde de uma universidade pública paranaense. Realizou-se um estudo transversal com os estudantes dos cursos de Enfermagem,Farmácia e Medicina da Universidade Estadual de Londrina, por meio da aplicação de um questionário auto respondível. A coleta de dados foi executada nas salas de aula da própria universidade entre os meses de maio a junho de 2014, resultando em 564 estudantes entrevistados. Considerou-se descarte correto quando o estudante referisse destinar os medicamentos vencidos ou inapropriados ao uso em locais que fazem o recolhimento destes produtos. Os estudantes apresentaram idade média de 21,0 anos (desvio padrão: 3,3); sendo 74,1% do sexo feminino. O quarto foi o principal local citado para o armazenamento dos medicamentos (47,8%), sendo que a maioria os mantém fora do alcance das crianças (82,6%). Quanto à verificação do prazo de validade, 60,1% dos estudantes realizam esta prática. A maioria (64,5%) guarda as sobras de tratamentos para futura utilização, sendo o lixo doméstico (63,0%) o principal local citado para o descarte dos que estão vencidos. Apenas 20,7% descartavam os medicamentos corretamente. A população em estudo realiza um correto armazenamento dos medicamentos, no entanto, grande parte desconhece a existência de locais de recolhimento e promove o descarte inadequado dos mesmos, assim,faz-se necessário a criação de medidas para conscientização e orientação dos futuros profissionais.

Medicines are indispensable tools for the health establishment and care is required in their storage and disposal. This study aimed to verify the form of storage and disposal of medicines by students from the Health Sciences Department of a public university in Paraná. A cross-sectional study was conducted with students of Nursing, Pharmacy and Medicine courses from Universidade Estadual de Londrina, Paraná, Brazil, through the application of a self-report study. The data collection was performed in the University’s classrooms during the months of May to June of 2014, resulting in 564 students surveyed. It was considered proper disposal when the student referred to disposing the expired or inappropriate for use products inlocations that make the collection of these products. The students interviewed had a mean age of 21.0 years (Standart Deviation: 3.3); 74.1% of the total were female. The bedroom was the main location quoted forstorage of medicines (47.8%) most of them keep the medicines out of reach of children (82.6%). Regarding the verification of the expiration date 60.1% of the students do this practice. Most of (64.5%) keeps there mains of treatments for future use, and household waste (63.0%) was the main mentioned location for the disposal of those who are expired. Only 20.7% discarded the medicines correctly. The study population stores the products correctly, however, most are largely unaware of the disposal locations. There fore, it isnecessary to promote awareness and guidance for the future professionals.

A study on the drug utilization trends in the cardiovascular emergencies in a tertiary care hospital.

OBJECTIVES: To observe the cardiovascular emergencies which were most frequently treated and to quantify the drug utilization trends in the cardiovascular emergencies, in terms of the Defined Daily Doses [DDD] and the prescribing prevalence in the cardiovascular emergencies. METHODS: This prescription based study was undertaken in the Medicine ICU of the government medical hospital. The age, sex, diagnosis (only cardiovascular) and the drugs which were prescribed, were recorded for each patient. Also, the brand names and the generic names of the prescribed drugs were noted. The collected data was analyzed to study the drug utilization trends. RESULTS: It was observed that the most commonly treated cardiovascular disease was IHD. The IHD was more in males than in females who were below 50 years of age and it was nearly equal in the age groups which were above 50 years. The use of Angiotensin Converting Enzyme (ACE) inhibitors was higher than that of the beta blockers and the calcium channel blockers. The patients with cardiovascular emergencies also had preceding associated diseases like diabetes mellitus and hypertension. CONCLUSIONS: The protocol of the management which was followed by the college in the treatment of cardiovascular emergencies was competent enough, as the clinical outcomes of the patients were favourable. But there was a guideline incongruent prescribing behaviour which was statistically significant, for which there is a need to undertake large scale studies.

Avaliação da utilização de medicamentos na prática clínica em um hospital público / Assessment of drugs prescribed to medical in-patients in a public hospital

Através desta pesquisa, objetivou-se estudar o consumo dos medicamentos em pacientes hospitalizados na clínica médica de um hospital público na cidade de Campina Grande (PB). O estudo caracterizou-se como descritivo e exploratório, de caráter transversal, com abordagens quali-quantitativas, e foi constituído por uma amostra de 107 pacientes que iniciaram internação na clínica médica no período de agosto de 2007 a julho de 2008. Os 107 pacientes apresentavam 270 diagnósticos ativos, sendo as doenças do aparelho circulatório as de maior ocorrência. Dos pacientes, 65,4% eram idosos e 3,33% dos medicamentos prescritos foram considerados impróprios para eles. Os pacientes que apresentaram possíveis 107 RAMs totalizaram 43%, com média de 2,32 por paciente; as que afetaram o sistema gastrintestinal dos pacientes foram as identificadas com maior frequência. Houve 42 interações distintas, envolvendo 26 tipos de fármacos. Dessa forma, os resultados podem ser úteis no estímulo ao desenvolvimento de mecanismos de avaliação de processos que visem reduzir esses riscos, aumentando a chance de resultados terapêuticos positivos e benefícios para os pacientes.

We studied the consumption of drugs by in-patients in the medical ward of a public hospital in the city of Campina Grande, PB, Brazil. This paper describes a descriptive / exploratory cross-sectional quali-quantitative study of a sample of 107 patients who were admitted to the general medical ward, from August 2007 to July 2008. The 107 patients were diagnosed with 270 active complaints, mainly diseases of the circulatory system. Most of the patients (65.4%) were elderly and 3.33% of drugs prescribed for them are considered unfit for use in the elderly. Many patients (43%) presented 107 possible Adverse Drug Reactions, with an average of 2.32 per patient, those affecting the gastrointestinal system of the patients being identified most frequently. There were 42 different drug interactions, involving 26 types of drug. We hope these results may be useful in stimulating the development of means to assess drug treatment in hospital, so as to reduce these risks and increase the chance of positive outcomes and therapeutic benefits for the patients.

Intervención educativa sobre prescripción de AINES en un hospital de baja complejidad / Educational program on prescription of nsaids in a low-complexity hospital

Se analizó el efecto de dos intervenciones educativas en intervalos de seis meses sobre el uso de aines (grupo M01 según ATC de 2008), medido en términos de costos totales y dosis diarias definidas (ddd)/consultas de urgencias y ambulatorias, entre enero de 2007 y junio de 2008 en el hospital San Antonio del municipio de Marmato (Caldas) en el centro de Colombia. El costo total del grupo M01 disminuyó el 69,3% a diciembre de 2007 y 65,1% en junio de 2008. En ddd/consultas de urgencias y ambulatorias, el descenso fue en el primer semestre del 40,7% y en el segundo semestre del 48,5%. Naproxeno 250 mg e ibuprofeno 400 mg tabletas y diclofenaco 75 mg ampolla disminuyeron en consumos el 74,1%, 38,9% y 78,7%, respectivamente; mientras que diclofenaco 50 mg tableta incrementó el 280,0%. La sustitución en el perfil de uso de diclofenaco oral en lugar de naproxeno oral, y la disminución del uso de diclofenaco inyectable, contribuyó a la disminución del costo total. Los resultados positivos se obtuvieron por la participación y actitud favorable de todos los médicos generales del hospital hacia las reuniones de educación basadas en evidencias.

Two educational interventions were analyzed at intervals of six months on the use of nsaids (group M01 as atc, 2008) measured in terms of total costs and Defined Daily Dose (ddd)/Ambulatory and emergency visits between January 2007 and June 2008 at the San Antonio hospital of Marmato (Caldas) in the center of Colombia. The total cost of the M01 group decreased 69.3% in December 2007 and 65.1% in June 2008. The decline of ddd/emergency and ambulatory consultations was of 40.7% in the first semester, and 48.5% in the second semester. Consumptions of naproxen 250 mg and ibuprofen 400 mg tablets, and diclofenac 75 mg ampoules decreased 74.1%, 38.9%, and 78.7% respectively, while diclofenac 50 mg tablet increased 280.0%. Oral diclofenac substitution instead of oral naproxen, and decreased use of diclofenac injectable, contributed to low total cost. Positive results were obtained by the participation and positive attitude of hospital general physicians to the educational evidence-based meetings.

Adesão ao tratamento medicamentoso de pacientes com doenças inflamatórias intestinais acompanhados no ambulatório de um hospital universitário / Compliance to drug therapy in inflammatory bowel diseases outpatients from an university hospital

RACIONAL: A adesão ao tratamento medicamentoso nas doenças inflamatórias intestinais apresenta grande importância clínica e social. Porém, são escassos os estudos sobre este tema em nosso meio. OBJETIVO: Investigou-se a adesão ao tratamento medicamentoso prescrito, bem como a influência de alguns fatores sobre a adesão, de pacientes com doenças inflamatórias intestinais em acompanhamento em ambulatório de Gastroenterologia de um hospital universitário ligado ao Sistema Único de Saúde (SUS). MÉTODO: Realizou-se estudo transversal, com métodos indiretos, para avaliar a adesão ao tratamento de 26 casos da doença de Crohn, 26 pacientes com retocolite ulcerativa e 4 com colite indeterminada, que faziam uso contínuo de medicamentos, dos quais 89,3 por cento eram fornecidos pelo SUS. Os pacientes foram classificados como tendo alto ou baixo grau de adesão, com base em dois diferentes instrumentos. RESULTADOS: A análise dos medicamentos utilizados revelou baixa adesão em 15,4 por cento de pacientes com doença de Crohn e 13,3 por cento com retocolite ulcerativa. Porém, o teste de Morisky, que avalia hábitos de uso dos medicamentos, mostrou 50 por cento de baixa adesão na doença de Crohn e 63,3 por cento na retocolite ulcerativa. Análise univariada evidenciou na doença de Crohn relação entre baixa adesão e maior duração da doença, estado marital instável, residência próxima ao hospital e envolvimento do cólon. Na retocolite ulcerativa observou-se relação entre baixa adesão e atividade da doença e maior número de medicamentos em uso. Porém, a análise multivariada não evidenciou relação estatisticamente significativa que indicasse influência de qualquer fator sobre a adesão ao tratamento. CONCLUSÕES: Proporções elevadas de pacientes com doenças inflamatórias intestinais apresentam hábitos de uso de medicamentos indicativos de baixa adesão, difíceis de prever a partir de dados demográficos e clínicos, o que aponta para a necessidade de maior atenção...

BACKGROUND: Compliance to drug therapy is important for a successful treatment. Although many studies have assessed compliance to treatment in patients with chronic diseases, few investigations have been carried out in inflammatory bowel diseases. AIM: To assess compliance to drug therapy in patients with inflammatory bowel diseases - Crohn's disease and ulcerative colitis -, followed at a university hospital, who had prescribed medication supplied by the Brazilian National Health System. METHODS: In a cross sectional study, a structured interview was applied to assess the compliance of 26 Crohn's disease patients, 26 ulcerative colitis patients and 4 cases with undetermined colitis. Patients were characterized as presenting higher or lower degree of compliance, based on the comparison of the information provided by the patient in the interview and data in the medical records. The Morisky test was also used to assess the behavioral pattern of the patient regarding the daily use of the medication. RESULTS: The interview showed that 15.4 percent of patients with Crohn's disease and 13.3 percent of those with ulcerative colitis could be regarded as less compliant. However, the Morisky test revealed lower compliance in 50 percent of patients with Crohn's disease and 63.3 percent of those with ulcerative colitis. Univariate analysis showed an association between low compliance and long disease duration, married status and colon involvement in Crohn's disease, and between low compliance and increased disease activity and greater number of medications in ulcerative colitis. However, multivariate analysis did not confirm any association between low compliance and any demographic or clinical factor. CONCLUSIONS: A high degree of noncompliance to treatment, linked to habitual behavior and hard to predict from demographic or clinical factor, was detected in inflammatory bowel disease patients, which suggests the need for investment in patient education...