Adherence rates with infliximab therapy in Crohn's disease

Background Inflammatory bowel disease is associated with non-adherence to treatment with oral medications. Aim To assess the intravenous infliximab adherence rate and identify risk factors for non-adherence to treatment. Methods Infliximab infusion dates for 1 June 2002-30 October 2003 were obtained. Additional information was obtained from two other administrative and patient-based databases. Non-adherence was defined as a 'No Show' designation for a scheduled appointment. Non-adherence rate, odds ratios for associations to 'No Show' appointments and analysis were performed to identify patient characteristics associated with non-adherent behaviour. Results One thousand hundred and eighty-five infliximab infusions were scheduled for 274 patients. Forty-eight (4%) of appointments were classified as 'No Show'. Six patients accounted for 13/48 (27%) of failed appointments; another 35 patients missed one appointment. 'No Show' appointments were more likely to be for female patients, those on concomitant immunomodulators and those > 18 weeks from initial infusion. Patients who missed > 1 appointment were more likely to be female and have Medicaid vs. those with only one missed appointment (P < 0.05). Indication, patient area code and race were not significantly associated with single or repeated No Show behaviour. Conclusions Overall, the non-adherence rate for infliximab is low. Risk factors that may contribute to non-adherence to treatment include female gender and maintenance dosing.