Treatment Adherence Among Patients With Inflammatory Bowel Disease Receiving Anti-TNF Therapy

Inflammatory bowel disease (IBD) is a chronic condition characterized by periods of remission and relapse, requiring long-term treatment adherence to maintain disease control and prevent complications. Anti-tumor necrosis factor (anti-TNF) agents are widely used in the management of moderate to severe IBD; however, suboptimal adherence remains a significant clinical problem due to concerns related to adverse effects, treatment burden, and insufficient patient knowledge. This randomized controlled trial evaluated the effectiveness of a nurse-led, Health Belief Model (HBM)-based structured patient education program on treatment adherence among patients with inflammatory bowel disease (IBD) receiving anti-TNF-α therapy. The study was conducted as a two-center trial between February and July 2024 in the gastroenterology inpatient units and outpatient clinics in Izmir, Turkey. A total of 408 patients were screened, and 140 eligible patients were enrolled and allocated 1:1 to intervention (n=70) and control (n=70) groups. Participants were randomized using stratified randomization to balance potential confounders, with strata defined by sex, age group (18-35, 36-54, ≥55), IBD type (ulcerative colitis/Crohn's disease), IBD diagnosis duration (\

Inclusion Criteria: * Aged 18 years or older * Diagnosed with inflammatory bowel disease (Crohn's disease or ulcerative colitis) * Diagnosed with inflammatory bowel disease for at least 6 months * Receiving anti-TNF-α therapy for at least 3 months * Able to read and write in Turkish * Able to communicate effectively * Cognitively competent * Provided written informed consent and agreed to participate in the study Exclusion Criteria: * Presence of cognitive disorders that may impair understanding or decision-making (e.g., dementia, Alzheimer's disease) * History of malignant or premalignant disease * Use of more than four concurrent medications (e.g., medications for hypertension, diabetes, cancer, or hematologic diseases)