Many IBD Patients Skipped or Reduced Medication Doses Because of the COVID-19 Pandemic

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Sumary of Many IBD Patients Skipped or Reduced Medication Doses Because of the COVID-19 Pandemic:

  • One in 20 patients with inflammatory bowel disease (IBD) skipped or reduced doses of their medications or stopped taking prescribed drugs altogether during the COVID-19 pandemic, according to a study published in March 2021 in the Journal of Gastroenterology and Hepatology Open..
  • The study, based on a survey of 262 IBD patients in Australia, didn’t examine why some people cut back on prescribed medications..
  • But it possible that stay-at-home orders and rising unemployment during the pandemic played a role, along with mistaken concerns that IBD medications could increase the risk of getting COVID-19 or having severe illness, says the lead study author, Alex Barnes, MD, MPH, a gastroenterologist at the College of Medicine and Public Health at Flinders University in Adelaide, South Australia..
  • “I would hope that efforts to spread information regarding the safety of IBD medications in the setting of the COVID-19 pandemic would have been successful in convincing a significant proportion of people to be adherent to IBD medications during the pandemic,”.
  • One troubling finding in the study is that most patients who cut back on their medications didn’t discuss it with the specialist treating them for IBD, particularly because reducing or stopping treatment was associated with several negative health consequences..
  • In particular, patients who reduced or stopped medication usage had increased disease activity, lower rates of remission, and a greater reliance on prednisone and other corticosteroids to keep symptoms in check..
  • “Medication nonadherence could result in a flare and the need for prednisolone — a medication associated with worse COVID-19 outcomes,”.
  • “The take-home message would be to continue on maintenance IBD medication in order to reduce the use of prednisolone and the consequent risk of worse COVID-19 outcomes.”.
  • Healthcare Utilization Decreased Early in the Pandemic The study was small, and it wasn’t representative of all patients in Australia with IBD..
  • Because participants were recruited from IBD treatment centers, it also possible that patients in the study were more engaged with their own care and more apt to take medications as directed than a typical individual with IBD, the study team notes..
  • The survey also wasn’t designed to determine whether any changes in IBD medication regimens during the pandemic directly impacted COVID-19 risk or whether these changes might have a long-term impact on the course of IBD..
  • It was also conducted before vaccines were widely available for COVID-19, which might influence patients’ decisions about IBD medication..
  • “Fortunately, with the availability of the vaccine, known safe practices, and more controlled prevalence of COVID, at least in the United States, patients should now feel relatively okay to pursue their standard medical care and take their prescribed IBD medications,”.
  • The Relationship Between IBD Medications and Risk of COVID Infection Results from the current study mirror medication nonadherence findings from a study of U.S..
  • veterans found that patients who didn’t take IBD medicines as prescribed were significantly more likely to require treatment with corticosteroids like prednisone..
  • Another study in Gastroenterology, published in May 2020, examined data on 525 patients with IBD who were diagnosed with COVID-19..
  • This study found that people who took corticosteroids were almost seven times more likely to develop severe COVID-19..
  • But injected medicines known as tumor necrosis factor (TNF) antagonists, commonly prescribed for IBD, didn’t appear to influence the risk of severe COVID-19…

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