Motivation to pursue anti-TNFα treatment in patients with Crohn's disease – the SPACE motivation study. Issue 9 (September 2020)

• Record Type: Journal Article
• Authors: D'Amico, Ferdinando; Peyrin-Biroulet, Laurent; Vandromme, Luc; Bouhnik, Yoram; Faure, Patrick; Nahon, Stéphane; Hagege, Hervé; Hebuterne, Xavier; Benkhalifa, Salim; Nachury, Maria
• Is Part Of: Digestive and liver disease. Volume 52:Issue 9(2020)
• Page Start: 995
• Page End: 1001
• Publication Date: 2020-09
• Subjects: Anti-tumor necrosis factor α -- Crohn's disease -- Motivation -- Treatment adherence -- Satisfaction of patients with Crohn's disease questionnaire (SPACE-Q); Digestive organs -- Diseases -- Periodicals; Liver -- Diseases -- Periodicals; 616.33005
• DOI: 10.1016/j.dld.2020.05.032
• Languages: English
• ISSNs: 1590-8658

Abstract

Abstract: Background: Crohn's disease (CD) is a chronic disorder requiring long-term treatment. However, up to 20% of patients interrupt temporarily or permanently anti-TNFα. Primary aim was to identify internal and external factors influencing patient's motivation to pursue anti-TNFα in active CD. Methods: This was a French, multicentre, prospective study enrolling CD patients on anti-TNFα therapy since more than 3 months. Patients completed the Satisfaction of Patients with Crohn's Disease questionnaire (SPACE-Q) and other patient-reported-outcome tools at inclusion visit, and after 6 and 12 months. Results: A total of 274 patients were included: 146 (53.3%) received adalimumab, while 128 (46.7%) infliximab. Most patients (78%) were still treated with anti-TNFα 12 months after enrolment. Patients' perception of necessity (p = 0.01) and concerns (p<0.0001) regarding medication, evaluated through the Belief about Medicines Questionnaire (BMQ), and expectation confirmation towards treatment convenience (p = 0.02), towards efficacy (p = 0.04), and treatment satisfaction (p = 0.03) according to SPACE-Q, correlated with motivation to pursue treatment. Patients with higher treatment satisfaction (p = 0.0004), stronger belief in treatment necessity (p<0.0001) and fewer concerns (p = 0.0002) were more likely to be very motivated. Conclusion: Treatment satisfaction, treatment necessity, and concerns are correlated to motivation to pursue anti-TNFα. Specific questions focused on these patients' perceptions could help physicians to identify patients at risk of non-adherence and prevent therapy interruption.