Psychological Factors Associated With Adherence to Oral Treatment in Ulcerative Colitis

Sonya S. Dasharathy, Millie D. Long, Jeffrey M. Lackner, Dana Ben-Ami Shor, Liu Yang, Nir Bar, Christina Ha, Guy A. Weiss*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


Introduction: Medication nonadherence in patients with ulcerative colitis (UC) can result in frequent relapses, severe disease, and higher risk of colorectal cancer. Behavioral models relying on motivation and perceived competence, like the self-determination theory (SDT), have been implicated in nonadherence; however, the SDT has not been evaluated in the adult UC population. We sought to examine the association between adherence to oral medications in patients with UC and psychological distress, relationship with health care providers, motivation, and competence. Methods: We performed a cross-sectional study within the Inflammatory Bowel Disease (IBD) Partners online registry in which participants completed a baseline survey including demographic information, IBD history, symptoms, medication adherence, and psychosocial factors. Members of the registry with a diagnosis of UC received an online follow-up survey that included baseline questionnaires and assessment of competence, motivation, and patient-physician relationship. Logistic regression models were performed to determine the relationship between psychosocial factors, adherence modifiers, and medication adherence. Results: Of the 410 UC patients included, 29% had low adherence to their medications, 36% had medium adherence, and 34% had high adherence. In the multivariable analysis, younger patients, those with a lower perceived competence, and those with worse relationship with their providers were more likely to have lower adherence to their medications. Conclusions: Poor adherence to oral medications in UC was associated with lower perceived competence and worse relationship with providers. Further interventions based on the SDT can potentially improve adherence and optimize patient care.

Original languageEnglish
Pages (from-to)97-102
Number of pages6
JournalInflammatory Bowel Diseases
Issue number1
StatePublished - 1 Jan 2023
Externally publishedYes


  • adherence
  • competence
  • inflammatory bowel disease
  • motivation
  • self-determination theory
  • ulcerative colitis


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