Therapeutic adherence in inflammatory bowel disease: User guide from a multidisciplinary modified Delphi consensus

Background: Therapeutic non-adherence can significantly impair the quality of life of patients affected by inflammatory bowel disease (IBD), leading to worse treatment outcomes, more frequent hospitalizations, and increased healthcare expenses. Identifying and enhancing treatment adherence is a key goal in managing IBD. Aim: To establish a consensus on the definition of therapeutic adherence, determination of risk factors, and identify patients with IBD at higher risk of non-adherence. Methods: A modified Delphi method was employed to develop consensus statements. Initially, an extensive literature review was conducted on therapeutic adherence in patients affected by IBD, leading to the formulation of 13 statements. These statements were assessed and approved after two rounds of voting (level of agreement 1 to 9; cut-off ≥7 for approval). Results: In the first voting round, all 13 statements achieved a mean score of ≥7. During a subsequent plenary session, 12 of the 13 statements reached positive consensus, with final cumulative agreement ranging from 80 % to 100 %. Conclusion: The 12 statements are intended to offer practical guidance to enhance therapeutic adherence in patients with IBD. Patients’ profiles at higher risk of non-adherence need prompt recognition and implementation of appropriate strategies by dedicated physicians.