Oral ulcer activity in Behcet's disease: Poor medication adherence is an underestimated risk factor

Abstract

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Objective: The aim of this study was to evaluate the relationship between oral ulcer activity and medication adherence according to gender in Behçet's disease (BD) patients. Material and Methods: The study group included 330 BD patients (F/M: 167/163, mean age: 38.5±10.5 years). Oral ulcer activity and medication adherence were evaluated in the previous month. Medication adherence was evaluated using the 8-item Morisky Medication Adherence Scale (MMAS-8) having a score range of "0" to "8" with high scores indicating better adherence. Low adherence was defined as <6 points on MMAS-8.Results: Over half of the group had active oral ulcers (n=219, 66.4%) within the month preceding the visit. The number of oral ulcers was significantly higher in female patients with low medication adherence (2.39±3.24) than in the rest of the female group (1.28±2.05; p=0.023). Although a similar trend was also observed in male patients (2.14±3.3 vs. 1.81±2.31), a significant relationship was not observed (p=0.89). The frequency of medication intake per day was lower in patients with high medication adherence than in the rest of the study group (p=0.04).Conclusion: Low medication adherence is a hidden risk factor in the management of BD. Poor adherence was associated with oral ulcer activity in female BD patients.