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P590 Inflammatory Bowel Disease Patient's Participation in Therapeutic Decision Making

S. Vavricka1, G. Rogler1, E. Safroneeva2, A. Schoepfer*3

1University of Zurich, Gastroenterology and Hepatology, Zurich, Switzerland, 2University of Bern, Institute of Social and Preventive Medicine, Bern, Switzerland, 3Centre Hospitalier Universitaire Vaudois, Gastroenterology and Hepatology, Lausanne, Switzerland

Background

Non-adherence to medical treatment in patients with inflammatory bowel disease (IBD) is a matter of a grave concern. Active participation in therapeutic decision making, as one of the aspects of patient empowerment, has potential to increase adherence to therapy. However, data from large studies on patients' participation in therapeutic decision making in IBD is scarce. Therefore, we aimed to evaluate the patients' role in therapeutic decision making.

Methods

A paper-based 15-item questionnaire was developed by IBD experts and sent to 2,100 members of the Swiss Association of IBD patients in September, 2014. In addition to patient baseline characteristics, the patients were asked about their experience in regards to developing a therapeutic concept together with their treating gastroenterologist.

Results

A total of 824/2,100 (39.2%) adult IBD patients sent back the completed questionnaires. Of these patients, 66% were female, 57% had CD, 41% had UC, and 2% had unclassified IBD. The age distribution was as follows: 31% were aged up to 40 years, 47% were between 41-60 years, and 22% were > 60 years old. When being asked "How actively were you involved in therapy decisions?" patients chose the following options: 50% told that their gastroenterologist proposed one particular therapy regimen which they followed, 23% told that their gastroenterologists provided them with several therapeutic options of which they chose one, 8% of patients told that they read about various therapeutic options on the internet before discussing their therapy of choice with the gastroenterologist, 7% told that due to their activity in the IBD patients organization they already made their mind about a particular therapy option which they proceeded to discuss with their gastroenterologist, 7% of patients told that they decided for another therapy than the one recommended by their gastroenterologist, and 5% of patients noted that their gastroenterologist provided them with several therapy options, but they thought it is upon the gastroenterologist to select the appropriate treatment. Older patients (55 years of age and older) were more likely to choose the option that it is upon the gastroenterologist to select the appropriate treatment when compared to younger patients (< 55 years) (12.7% vs. 3.6%, p < 0.001). The shorter the disease duration, the more frequently patients followed the therapy recommendation provided by their gastroenterologist.

Conclusion

Younger IBD patients tend to be more actively involved in therapeutic decision making when compared to older IBD patients. The knowledge of patient-specific information seeking behaviors may help gastroenterologists to improve adherence to medical treatments in the long-term run.