Satisfaction With and Adherence to Off-Label Corticosteroids in Adolescents and Adults With Eosinophilic Esophagitis: Results of a Web-Based Survey in the United States

Benjamin D Gold; Bridgett Goodwin; Kimberly Davis; Carolyn Sweeney; Ryan Ziemiecki; Jeanne Jiang; Tao Fan; Mena Boules; Szu-Ta Chen; David A Katzka

doi:10.1097/MCG.0000000000002006

Satisfaction With and Adherence to Off-Label Corticosteroids in Adolescents and Adults With Eosinophilic Esophagitis: Results of a Web-Based Survey in the United States

J Clin Gastroenterol. 2024 May 15. doi: 10.1097/MCG.0000000000002006. Online ahead of print.

Authors

Affiliations

¹ GI Care for Kids, Children's Center for Digestive Healthcare LLC, Atlanta, GA.
² Takeda Development Center Americas Inc., Cambridge, MA.
³ RTI Health Solutions, Research Triangle Park, NC.
⁴ Takeda Pharmaceuticals USA Inc., Lexington, MA.
⁵ Division of Digestive and Liver Diseases, New York-Presbyterian/Columbia University Irving Medical Center, New York, NY.

PMID: 38747580
DOI: 10.1097/MCG.0000000000002006

Abstract

Goals: We assessed satisfaction with and adherence to off-label corticosteroids in patients with eosinophilic esophagitis (EoE) in the United States.

Background: EoE is a chronic inflammatory disease for which there are currently no US Food and Drug Administration-approved swallowed topical corticosteroids.

Study: This noninterventional, cross-sectional, web-based survey included caregivers of adolescents (aged 11 to 17 y) and adults (aged 18 years or older) with a self-reported [or caregiver-reported (adolescents)] physician diagnosis of EoE who were receiving corticosteroids. Participants were recruited through 2 nonprofit, patient advocacy groups. The 9-item Treatment Satisfaction Questionnaire for Medication (TSQM-9) was used to assess satisfaction across effectiveness, convenience, and global satisfaction domains (scale: 1 to 100 per domain); higher scores indicated greater satisfaction. The 4-item Morisky Green Levine Medication Adherence Scale (MGL-4) was used to assess adherence; an MGL-4 score of <3 indicated adherence. Participants also reported reasons for nonadherence.

Results: Overall, 201 participants (caregivers of adolescents, n=98; adults, n=103) were included in this study. Mean TSQM-9 scores indicated low satisfaction with off-label corticosteroids across all 3 satisfaction domains in adolescents (≤61.1) and adults (≤55.7). Slightly fewer adolescents (37.1%) than adults (40.8%) were considered adherent. Forgetfulness was the most frequently reported reason for nonadherence; some patients chose not to take their medications, owing to poor palatability (adolescents), difficulty taking medications at specific times (adults), or feeling depressed/overwhelmed (adolescents and adults).

Conclusions: Satisfaction with and adherence to off-label corticosteroids were low in this web-based survey of adolescents and adults with EoE in the United States.