Background / Aim: Non-adherence to treatment is an important determinant of relapses and complications in Inflammatory bowel disease-ulcerative colitis (IBD-UC). We assessed the adherence to treatment advised in IBD-UC and reasons for non-adherence in tertiary government hospital.

Methods: This cross-sectional study included patients with histologically confirmed IBD-UC admitted indoor as well as those visiting outdoors between December 2020 and August 2023. Non-adherence to treatment was assessed on the basis on questionnaire and defined as medicine intake less than 80% in last two weeks.

Results: A total of 178 participants completed the questionnaire, mean age (34.17±12.3 years), average disease duration was 3.47±2.7 years, and 56 (31.5%) patients were adherent to treatment. The adherence to oral mesalamine, salfasalazine, azathioprine, oral prednisolone, tofacitinib and topical mesalamine were 38.2%, 31.3%, 66.7%, 77.8%, 83.3% and 33.3% respectively. 78 patients were receiving treatment free-of-cost, among them 31 (39.7%) were adherent. The primary reasons for non-adherence among patients were cost and unavailability (33.1%), feeling better without medications (22.9%) and forgetfulness (12.7%). Univariate analysis revealed significant association of adherence with satisfaction (p=0.001), number of hospital visits (p=0.001) and disease awareness (p=0.014). Factors such as demographics, disease characteristics and bearing treatment-cost showed no statistically significant association. Regression analysis identified patient-satisfaction as the sole predictor of medication adherence (p = 0.001).

Conclusion: One-third of patients with UC adhered to medication regimens. Adherence was significantly associated with patient satisfaction, number of hospital visits and disease awareness while education, socioeconomic status, and disease characteristics showed no association. Free-of-cost treatment did not make a difference in adherence.