Document Detail

A Random Urine Test Can Identify Patients at Risk of Mesalamine Non-Adherence: A Prospective Study.
MedLine Citation:
PMID:  23295279     Owner:  NLM     Status:  Publisher    
OBJECTIVES:Mesalamine non-adherence is common among patients with ulcerative colitis (UC), and can be difficult to identify in practice. We sought to determine whether a random urine test for salicylates could be used as a marker of 5-aminosalicylic acid (5-ASA) ingestion and identify patients at risk of non-adherence. Our aim is to determine whether measurement of salicylates in a random urine sample correlates with 5-ASA levels, and predicts an individual's risk of mesalamine non-adherence.METHODS:Prospective observational study. Urinary salicylates (by colorimetry) and 5-ASA (by liquid chromatography and tandem-mass spectrometry) were measured in a random urine sample at baseline in patients and controls. Mesalamine adherence was quantified by patient self-reports at enrollment and pharmacy refills of mesalamine over 6 months.RESULTS:A total of 93 patients with UC taking mesalamine maintenance therapy were prospectively enrolled from the clinic. Random urine salicylate levels (by colorimetry) were highly correlated with urine 5-ASA metabolite levels (by mass spectrometry; R2=0.9). A random urine salicylate level above 15 mg/dl distinguished patients who had recently taken mesalamine from controls (area under the curve value 0.9, sensitivity 95%, specificity 77%). A significant proportion of patients (27%) who self-identified as "high adherers" by an adherence questionnaire (Morisky Medication Adherence Scale-8) had random levels of urine salicylate below this threshold. These patients were at higher risk of objectively measured non-adherence to mesalamine over the subsequent 6 months (RR: 2.7, 95% CI: 1.1-7.0).CONCLUSIONS:A random urine salicylate level measured in the clinic can identify patients who have not recently taken mesalamine, and who are at higher risk of longitudinal non-adherence. This test could be used to screen patients who may warrant interventions to improve adherence and prevent disease relapse.Am J Gastroenterol advance online publication, 8 January 2013; doi:10.1038/ajg.2012.419.
Anne E Gifford; Anders H Berg; Conor Lahiff; Adam S Cheifetz; Gary Horowitz; Alan C Moss
Related Documents :
23556019 - Arginase activity - a marker of disease status in patients with visceral leishmaniasis ...
24653859 - The association between blunt cardiac injury and isolated sternal fracture.
24632989 - The rest-activity rhythm and physical activity in early-onset dementia.
24126249 - Correlation between culture-identified bacteria in middle nasal meatus and ct score in ...
23940429 - Comparison of the diagnostic accuracy of ischemia-modified albumin and echocardiography...
24231489 - Refeeding syndrome in a patient with advanced kidney failure due to nephronophthisis.
8762679 - Betel nut and smoking. are they both protective in ulcerative colitis? a pilot study.
19508519 - Selecting patients with faecal incontinence for anal sphincter surgery: the influence o...
7121659 - Antirifampicin antibodies in acute rifampicin-associated renal failure.
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-1-08
Journal Detail:
Title:  The American journal of gastroenterology     Volume:  -     ISSN:  1572-0241     ISO Abbreviation:  Am. J. Gastroenterol.     Publication Date:  2013 Jan 
Date Detail:
Created Date:  2013-1-8     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0421030     Medline TA:  Am J Gastroenterol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Center for Inflammatory Bowel Disease, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

Previous Document:  Does rectal indomethacin eliminate the need for prophylactic pancreatic stent placement in patients ...
Next Document:  Relationship between patterns of alcohol consumption and gastrointestinal symptoms among patients wi...