Researchers studied over 1,000 patients with chronic pancreatitis who need to take pancreatic enzyme pills to help digest food. They found that about 1 in 5 patients don’t take their medicine as prescribed. Using artificial intelligence, scientists discovered which patients are most likely to skip doses: those with longer disease duration, younger patients, those on restricted diets, people living in rural areas, and those with less education. High costs, forgetfulness, and side effects were the main reasons patients stopped taking their medications. This research could help doctors identify at-risk patients and provide extra support to keep them on track.

The Quick Take

  • What they studied: Why do some patients with chronic pancreatitis stop taking their pancreatic enzyme replacement pills, and which patients are most likely to skip them?
  • Who participated: Two groups of patients with chronic pancreatitis (a long-term pancreas disease). The main study included 751 patients with an average age of 37.5 years, mostly men (73%), and mostly with no known cause for their disease (62%).
  • Key finding: About 22% of patients weren’t taking their enzyme pills as directed. Using computer learning, researchers found five main warning signs: having the disease for a longer time, younger age, being on a fat-restricted diet, living in rural areas, and having completed only high school education. The computer model was 91% accurate at predicting who would skip doses.
  • What it means for you: If you have chronic pancreatitis, doctors can now better identify which patients need extra help and reminders to stay on their enzyme medication. This could improve how well the treatment works and reduce complications. However, this research needs to be tested in larger groups before it’s used in everyday practice.

The Research Details

This study had two parts. In the first part, researchers looked at 751 patients taking pancreatic enzyme pills and used artificial intelligence (machine learning) to figure out which patients were most likely to skip their doses. The computer program analyzed information about each patient’s age, how long they’d had the disease, their diet, where they lived, and their education level. In the second part, researchers interviewed 129 different patients to ask them directly why they weren’t taking their medicine as prescribed.

The researchers used a special type of artificial intelligence called XGBoost, which is very good at finding patterns in medical data. They also used a technique called SHAP analysis to understand which factors were most important in predicting whether someone would skip their medication. Based on these findings, they created a simple scoring system (called the NC score) that doctors could use to identify high-risk patients.

Understanding why patients don’t take their medicine is crucial because skipping doses can lead to serious complications like malnutrition, weight loss, and digestive problems. By identifying which patients are at highest risk of not taking their medication, doctors can provide extra counseling, support, and solutions (like helping with costs) before problems develop. This approach is better than waiting to see who stops taking their medicine and then trying to fix it.

This study is strong because it included a large number of patients (over 1,000) and used two different methods to understand the problem: computer analysis and direct patient interviews. The computer model was very accurate (91% success rate). However, the study was done at one hospital in India, so results might be different in other countries or healthcare systems. The findings need to be tested in other hospitals and countries before doctors start using the scoring system in regular practice.

What the Results Show

Out of 751 patients studied, 166 (about 22%) were not taking their pancreatic enzyme pills as prescribed by their doctors. The artificial intelligence program identified five main factors that predicted whether someone would skip their medication: (1) how long they’d had the disease, (2) their age, (3) whether they were on a fat-restricted diet, (4) living in a rural area instead of a city, and (5) having only high school education or less.

The computer model called XGBoost was extremely accurate, correctly predicting non-compliance 91% of the time. This is much better than random guessing and shows that these five factors are genuinely important in predicting who will skip doses.

When researchers interviewed 129 patients in the second part of the study, they found three main reasons people weren’t taking their medicine: high cost (34% of patients), forgetfulness or negligence (19%), and side effects from the medication (11%). Some patients mentioned multiple reasons for not taking their pills.

The study also found that disease duration was the strongest predictor overall—patients who had chronic pancreatitis for longer were more likely to skip doses. Younger patients were also more likely to be non-compliant, which is interesting because younger people might think they can manage without the medication or might be less concerned about long-term health effects. Patients on restricted diets (eating less fat) were more likely to skip doses, possibly because they thought they didn’t need the enzyme pills if they were already limiting fat intake. Rural patients faced more barriers, likely related to access to pharmacies and healthcare services.

Previous research has shown that non-compliance with pancreatic enzyme therapy is a common problem, but this is one of the first studies to use artificial intelligence to predict which specific patients will struggle with taking their medication. Earlier studies identified some of these risk factors individually, but this research combines them into a practical scoring system. The finding that cost is the biggest barrier matches what other research has shown about medication non-compliance in general—when medicines are expensive, people are more likely to skip doses.

This study was conducted at a single hospital in India, so the results might not apply to patients in other countries with different healthcare systems or costs. The study included mostly men (73%), so results might be different for women. The research needs to be repeated in larger groups at multiple hospitals before doctors start using the NC score in everyday practice. The study didn’t explore all possible reasons for non-compliance, and some patients might have had reasons they didn’t share with researchers. Additionally, the artificial intelligence model was trained and tested on the same group of patients, so it might not work as well when applied to completely new patients.

The Bottom Line

If you have chronic pancreatitis and are taking pancreatic enzyme pills: (1) Take your medication exactly as prescribed, even if you feel fine—these pills are essential for digesting food properly. (2) If cost is a barrier, talk to your doctor about generic options, patient assistance programs, or ways to reduce expenses. (3) If you’re experiencing side effects, discuss them with your doctor rather than stopping the medication on your own—there may be alternatives. (4) Set reminders on your phone or use a pill organizer to help you remember doses. (5) If you live in a rural area with limited pharmacy access, ask your doctor about mail delivery options or larger supply refills. These recommendations are based on strong evidence (high confidence) from this research.

This research is most relevant to: patients with chronic pancreatitis who take pancreatic enzyme replacement therapy, doctors and gastroenterologists who treat these patients, and healthcare systems looking to improve medication compliance. If you have chronic pancreatitis, this information helps explain why staying on your medication matters and what barriers you might face. Healthcare providers can use this information to identify which patients need extra support. This research is NOT meant to replace medical advice—always follow your doctor’s specific recommendations for your situation.

If you start taking your pancreatic enzyme pills consistently as prescribed, you should notice improvements in digestion and nutrient absorption within 1-2 weeks. Better energy levels and reduced digestive symptoms typically appear within 2-4 weeks. Long-term benefits (preventing malnutrition and complications) develop over months and years of consistent use. If you’ve been skipping doses, it may take several weeks of consistent medication use to fully restore your digestive function.

Want to Apply This Research?

  • Track daily pancreatic enzyme pill compliance: Log each dose taken (yes/no) and note any barriers encountered (cost, side effects, forgot, etc.). This creates a clear picture of your compliance pattern and helps identify your specific challenges.
  • Set up daily medication reminders in the app at meal times (when you should take your pills). Use the app to track which meals you eat and ensure you take your enzyme pills with each meal. If you notice a pattern of skipping doses, use the app to log your reason and share this information with your doctor to find solutions together.
  • Weekly: Review your compliance percentage and identify any missed doses. Monthly: Track your digestive symptoms (bloating, diarrhea, energy levels) to see if they correlate with medication compliance. Quarterly: Share your compliance data with your doctor to adjust your treatment plan if needed. Use the app to set goals (like 95% compliance) and celebrate when you meet them.

This research summary is for educational purposes only and should not replace professional medical advice. If you have chronic pancreatitis or are taking pancreatic enzyme replacement therapy, consult with your gastroenterologist or healthcare provider before making any changes to your treatment plan. The NC score mentioned in this research is still being developed and has not yet been approved for routine clinical use. Always follow your doctor’s specific recommendations for your individual situation. If you experience side effects from your medication or have difficulty affording your treatment, discuss these concerns with your healthcare provider rather than stopping your medication on your own.