Medikamentöse Versorgung von Patienten mit Colitisulcerosa

Background: Patients with ulcerative colitis experience various impairments. The pharmacological treatment of the disease comprises 5-aminosalicylic acid, corticosteroids as well as immunomodulatory and biological agents. Little self-reported data exist on the prescription of these drugs. Methods: This cross-sectional study was conducted in 2005 as a postal survey in different regions of Germany [Kiel/Lübeck, Halle (Saale), Minden, Regensburg]. Patients with ulcerative colitis (UC) were recruited from specialised gastroenterological practices, university outpatient clinics, and the member registry of a prominent patient organisation (DCCV). Participants returned a questionnaire including established items and scales on physical and psychosocial well-being as well as the self-reported current medication. Results: A total of 444 patients with ulcerative colitis returned the questionnaires. Most of the participants were female, had a high level of school education and were currently employed. Twenty-eight percent of the participants reported to receive corticosteroids and 71% reported a current treatment with 5-aminosalicylic acid. Approximately one quarter of our study population reported a treatment with immunomodulatory agents. Analgesics were reported to be prescribed only in 15% of the patients, primarily in patients with depressive symptoms. Patients recruited from specialised gastroenterological practices and university outpatient clinics were more likely to report the prescription of 5-aminosalicylic acid and immunomodulatory drugs than members of the patient organisation. Only 7% of our patients received loperamide, however, probiotics (12%) and complementary agents (36%) seem to have an important role with regard to prevalence of intake. About 40% of women but only 28% of the men reported to use complementary agents. Persons with a duration of illness of less than 11 years (median split) were almost twice as likely to take corticosteroids than persons with a longer duration of ulcerative colitis. Discussion: Our results suggest an estimation of prescription rates in ulcerative colitis. However, they raise new questions, for example, concerning a potential underuse of immunomodulatory agents in this patient population. With regard to the identified differences in prescription rates according to psychosocial characteristics further studies are needed to examine these relationships.