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Vol.17 No.3
May, 2023
Frequency : Bimonthly
pISSN 1976-2283
eISSN 2005-1212 
Gut and Liver is an international journal of gastroenterology, focusing on the gastrointestinal tract, liver, biliary tree, pancreas, motility, and neurogastroenterology. Gut atnd Liver delivers up-to-date, authoritative papers on both clinical and research-based topics in gastroenterology. The Journal publishes original articles, case reports, brief communications, letters to the editor and invited review articles in the field of gastroenterology. The Journal is operated by internationally renowned editorial boards and designed to provide a global opportunity to promote academic developments in the field of gastroenterology and hepatology. +MORE
| Yong Chan Lee |
Professor of Medicine Director, Gastrointestinal Research Laboratory Veterans Affairs Medical Center, Univ. California San Francisco San Francisco, USA |
| Jong Pil Im | Seoul National University College of Medicine, Seoul, Korea |
| Robert S. Bresalier | University of Texas M. D. Anderson Cancer Center, Houston, USA |
| Steven H. Itzkowitz | Mount Sinai Medical Center, NY, USA |
All papers submitted to Gut and Liver are reviewed by the editorial team before being sent out for an external peer review to rule out papers that have low priority, insufficient originality, scientific flaws, or the absence of a message of importance to the readers of the Journal. A decision about these papers will usually be made within two or three weeks.
The remaining articles are usually sent to two reviewers. It would be very helpful if you could suggest a selection of reviewers and include their contact details. We may not always use the reviewers you recommend, but suggesting reviewers will make our reviewer database much richer; in the end, everyone will benefit. We reserve the right to return manuscripts in which no reviewers are suggested.
The final responsibility for the decision to accept or reject lies with the editors. In many cases, papers may be rejected despite favorable reviews because of editorial policy or a lack of space. The editor retains the right to determine publication priorities, the style of the paper, and to request, if necessary, that the material submitted be shortened for publication.
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Eun Sil Kim1 
, Ben Kang2
Correspondence to: Ben Kang
ORCID https://orcid.org/0000-0002-8516-9803
E-mail benkang@knu.ac.kr
See “Improvement in Medication Adherence after Pharmacist Intervention Is Associated with Favorable Clinical Outcomes in Patients with Ulcerative Colitis” by Jae Song Kim, et al. on page 736, Vol. 16, No. 5, 2022.
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Gut Liver 2022;16(5):665-666. https://doi.org/10.5009/gnl220358
Published online September 15, 2022, Published date September 15, 2022
Copyright © Gut and Liver.
Considering the requirement of life-long management in patients with inflammatory bowel disease (IBD), adherence to medication is a crucial factor in the management of patients with ulcerative colitis (UC) and Crohn’s disease.1 Previous studies have demonstrated that non-adherence affects 40% to 60% of patients with UC, and has a substantial impact on the course of the disease.2,3 Non-adherence to treatment in patients with IBD may negatively influence patient outcomes, such as increased risk of flares or hospitalization, leading to increased healthcare resource use and costs.3-6 Thus, improving medication adherence in the treatment of IBD is a significant challenge for clinicians.
Three factors create barriers to medication adherence; patients, clinicians and health care system factors.7 Patient factors include inadequate participation in the decision-making process during treatment, previous unpleasant experiences with drugs, poor medical knowledge about their underlying disease, and misbeliefs regarding medication efficacy. Clinician factors include complex prescription and insufficient explanation regarding the effectiveness and side effects of medications. Health care system factors include insurance and accessibility. Taking into account of these factors, it is possible to increase treatment adherence by the intervention of a multidisciplinary team including pharmacists.
Investigating the relationship between medication adherence and clinical outcomes after pharmacist intervention in patients with UC is essential for improving the therapeutic strategy of IBD. Kim
Special interest should also be focused on the assessment of medication adherence. The assessment of medication adherence can be divided into direct and indirect methods.7,9 Direct methods refer to the measurement of drug or metabolite levels, which is capable of revealing whether the patient has been adherent to not to a specific medication. In the treatment of IBD, thiopurine metabolite monitoring is currently used to assess adherence in patients taking thiopurines. However, its use is currently limited in many centers worldwide. Meanwhile, indirect methods include patient questionnaires, patient diaries, pill counts, rates of prescription refills, assessment of patient’s clinical response, electronic medication monitors or measurement of physiologic markers. While self-reported questionnaires or patient diaries are subjective and are inclined to a certain degree of bias, objective measures such as pill counts or electronic medication monitors including medication possession ratio or proportion of days covered are simple and possess the apparent potential to best measure treatment adherence. In this point of view, Kim
As IBD treatment requires patient-centered treatment and multidisciplinary team approach, there is a need for increased awareness of assessing medication adherence, and subsequent pharmacist intervention to improve medication adherence and disease outcomes in patients with IBD. A collaborative approach among gastroenterologists and pharmacists in treating patients with IBD is required to improve medication adherence and furthermore possibly help reach the target and eventually modify the natural course of disease in the era of treat-to-target.10
No potential conflict of interest relevant to this article was reported.
Gut and Liver 2022; 16(5): 665-666
Published online September 15, 2022 https://doi.org/10.5009/gnl220358
Copyright © Gut and Liver.
Eun Sil Kim1 , Ben Kang2
1Department of Pediatrics, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, and 2Department of Pediatrics, School of Medicine, Kyungpook National University, Daegu, Korea
Correspondence to:Ben Kang
ORCID https://orcid.org/0000-0002-8516-9803
E-mail benkang@knu.ac.kr
See “Improvement in Medication Adherence after Pharmacist Intervention Is Associated with Favorable Clinical Outcomes in Patients with Ulcerative Colitis” by Jae Song Kim, et al. on page 736, Vol. 16, No. 5, 2022.
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Considering the requirement of life-long management in patients with inflammatory bowel disease (IBD), adherence to medication is a crucial factor in the management of patients with ulcerative colitis (UC) and Crohn’s disease.1 Previous studies have demonstrated that non-adherence affects 40% to 60% of patients with UC, and has a substantial impact on the course of the disease.2,3 Non-adherence to treatment in patients with IBD may negatively influence patient outcomes, such as increased risk of flares or hospitalization, leading to increased healthcare resource use and costs.3-6 Thus, improving medication adherence in the treatment of IBD is a significant challenge for clinicians.
Three factors create barriers to medication adherence; patients, clinicians and health care system factors.7 Patient factors include inadequate participation in the decision-making process during treatment, previous unpleasant experiences with drugs, poor medical knowledge about their underlying disease, and misbeliefs regarding medication efficacy. Clinician factors include complex prescription and insufficient explanation regarding the effectiveness and side effects of medications. Health care system factors include insurance and accessibility. Taking into account of these factors, it is possible to increase treatment adherence by the intervention of a multidisciplinary team including pharmacists.
Investigating the relationship between medication adherence and clinical outcomes after pharmacist intervention in patients with UC is essential for improving the therapeutic strategy of IBD. Kim
Special interest should also be focused on the assessment of medication adherence. The assessment of medication adherence can be divided into direct and indirect methods.7,9 Direct methods refer to the measurement of drug or metabolite levels, which is capable of revealing whether the patient has been adherent to not to a specific medication. In the treatment of IBD, thiopurine metabolite monitoring is currently used to assess adherence in patients taking thiopurines. However, its use is currently limited in many centers worldwide. Meanwhile, indirect methods include patient questionnaires, patient diaries, pill counts, rates of prescription refills, assessment of patient’s clinical response, electronic medication monitors or measurement of physiologic markers. While self-reported questionnaires or patient diaries are subjective and are inclined to a certain degree of bias, objective measures such as pill counts or electronic medication monitors including medication possession ratio or proportion of days covered are simple and possess the apparent potential to best measure treatment adherence. In this point of view, Kim
As IBD treatment requires patient-centered treatment and multidisciplinary team approach, there is a need for increased awareness of assessing medication adherence, and subsequent pharmacist intervention to improve medication adherence and disease outcomes in patients with IBD. A collaborative approach among gastroenterologists and pharmacists in treating patients with IBD is required to improve medication adherence and furthermore possibly help reach the target and eventually modify the natural course of disease in the era of treat-to-target.10
No potential conflict of interest relevant to this article was reported.
pISSN 1976-2283
eISSN 2005-1212
Gut and Liver is an international journal of gastroenterology, focusing on the gastrointestinal tract, liver, biliary tree, pancreas, motility, and neurogastroenterology. Gut atnd Liver delivers up-to-date, authoritative papers on both clinical and research-based topics in gastroenterology. The Journal publishes original articles, case reports, brief communications, letters to the editor and invited review articles in the field of gastroenterology. The Journal is operated by internationally renowned editorial boards and designed to provide a global opportunity to promote academic developments in the field of gastroenterology and hepatology. +MORE
| Yong Chan Lee |
Professor of Medicine Director, Gastrointestinal Research Laboratory Veterans Affairs Medical Center, Univ. California San Francisco San Francisco, USA |
| Jong Pil Im | Seoul National University College of Medicine, Seoul, Korea |
| Robert S. Bresalier | University of Texas M. D. Anderson Cancer Center, Houston, USA |
| Steven H. Itzkowitz | Mount Sinai Medical Center, NY, USA |
All papers submitted to Gut and Liver are reviewed by the editorial team before being sent out for an external peer review to rule out papers that have low priority, insufficient originality, scientific flaws, or the absence of a message of importance to the readers of the Journal. A decision about these papers will usually be made within two or three weeks.
The remaining articles are usually sent to two reviewers. It would be very helpful if you could suggest a selection of reviewers and include their contact details. We may not always use the reviewers you recommend, but suggesting reviewers will make our reviewer database much richer; in the end, everyone will benefit. We reserve the right to return manuscripts in which no reviewers are suggested.
The final responsibility for the decision to accept or reject lies with the editors. In many cases, papers may be rejected despite favorable reviews because of editorial policy or a lack of space. The editor retains the right to determine publication priorities, the style of the paper, and to request, if necessary, that the material submitted be shortened for publication.
