Challenges in adherence to STRIDE-II: Perspectives from gastroenterologists and patients with inflammatory bowel disease

Introduction: The treatment aims to achieve symptomatic remission, normalization of biomarkers such a fecal calprotectin, and endoscopic remission. Therefore, early recognition of inflammatory activity and timely therapeutic intervention are essential to improve the morbidity and mortality. Objective: Evaluate the adherence among gastroenterologists and the patients compliance with medical recommendations in the Inflammatory Bowel Disease Program at Clínica Universidad de los Andes Patients and methods: A retrospective study that included patients presenting with a flare confirmed by colonoscopy. Three follow-up stages were defined: Short-Term Control: symptomatic remission at 3 months, Medium-Term Control: remission of fecal calprotectin as a biomarker (< 250 μg/g) between 4 and 6 months, and Long-Term Control: endoscopic remission between 6 and 9 months. Results: A total of 104 patients were evaluated, 64% of the cohort were females and a median age of 41 years. Among them, 81% had Crohn's disease, with an inflammatory phenotype in 87% and colonic localization in 39%. The remaining 19% had ulcerative colitis with left-sided involvement in 50%. Ninety percent of the patients attended short term control with a symptomatic remission in 72%. Eighty-two percent attended medium term control, resulting in biomarker remission for 83% of them. Seventy seven percent attended long term control, achieving endoscopic remission in 59% of the cases. Conclusion: The results indicate that our program achieves a physician adherence of over 90% to STRIDE-II, with patient's adherence to pharmacological therapy and follow up above 70%. Although these are high percentages, they are subject to improvement.