rates and reasons for nonuse of prescription medication for inflammatory bowel disease in a referral clinic background we aimed to determine the rates and reasons for nonuse of inflammatory bowel disease ibdspecific medication in a referral clinicmethods consecutive persons with crohns disease cd n 423 and ulcerative colitis uc n 342 were followed in a single clinic over 2 years at each patient visit it was determined whether and what type of ibdspecific medications were used at that visit if medications were not used the reason for nonuse was recorded disease remission further stratified by clinical remission and deep remission clinical remission plus imaging evidence of remission was considered a reason for nonuse if the attending physician believed the person was in remission and agreed for them to be off medicationsresults nonuse of ibdspecific medication was seen in 121 persons with cd 29 and 65 persons with uc 18 in cd increased age and disease duration were associated with nonuse disease phenotype did not predict nonuse in uc disease duration was associated with nonuse but age was not in cd the most common reason for medication nonuse was deep remission 225 followed by clinical remission 214 not having seen a gastroenterologist for a lengthy period 214 and nonadherence 16 in uc nonuse was attributed to deep remission 277 followed by nonadherence 263 and clinical remission 23conclusions approximately a quarter of persons with ibd attending at a tertiary care practice do not use ibdspecific medications with a higher rate in cd than uc the decision not to use medications was deemed appropriate in approximately onehalf of all nonusers