Patient's Perspectives Important for Early Anti-Tumor Necrosis Factor Treatment in Inflammatory Bowel Disease

被引:25
作者
Baars, Judith E. [1 ]
Siegel, Corey A. [3 ]
Kuipers, Ernst J. [1 ,2 ]
van der Woude, C. Janneke [1 ]
机构
[1] Erasmus MC, Dept Gastroenterol & Hepatol, NL-3000 CA Rotterdam, Netherlands
[2] Erasmus MC, Dept Internal Med, NL-3000 CA Rotterdam, Netherlands
[3] Dartmouth Hitchcock Med Ctr, Dept Gastroenterol & Hepatol, Lebanon, NH 03766 USA
关键词
Inflammatory bowel disease; Patients' perspectives; Infliximab; CROHNS-DISEASE; MAINTENANCE THERAPY; RANDOMIZED-TRIAL; INFLIXIMAB; BENEFITS; RISKS;
D O I
10.1159/000203638
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
Background/Aim: We hypothesized that limited information is given to patients on the risks and benefits of individual therapy, and feedback is lacking to verify if patients correctly interpreted the given information. We assessed the perspectives of patients with inflammatory bowel disease (IBD) concerning the treatment-associated risks/benefits of infliximab. Methods: Patients were asked to complete a survey regarding the benefits and risks of infliximab. Results are reported as descriptive statistics. Comparisons between groups were analyzed using independent t tests and the Kruskal-Wallis test. Results: In total, 152 IBD patients completed the questionnaire. Fifty-seven percent (78/138) estimated the 1-year remission rate from infliximab to be > 50%. Seventy-one percent (104/146) indicated they would not take a drug with risks reflecting those estimated for infliximab if the 1-year remission rate was < 75%. Crohn's disease patients and those recalling a discussion regarding the risks/benefits of infliximab treatment had higher estimates of the 1-year remission rate with infliximab than ulcerative colitis patients (p = 0.03) and patients who did not recall previous information (p = 0.03). Perceptions were independent of age and disease duration. Conclusion: IBD patients misperceive the risks and benefits of infliximab. The majority of patients would not accept treatment-related risks if the 1-year remission rate was < 75%. Counseling on treatment-associated risks and benefits should be ameliorated. Copyright (c) 2009 S. Karger AG, Basel
引用
收藏
页码:30 / 35
页数:6
相关论文
共 13 条
[1]   Shared decision-making in the medical encounter: What does it mean? (Or it takes at least two to tango) [J].
Charles, C ;
Gafni, A ;
Whelan, T .
SOCIAL SCIENCE & MEDICINE, 1997, 44 (05) :681-692
[2]   The safety profile of infliximab in patients with Crohn's disease: The Mayo Clinic experience in 500 patients [J].
Colombel, JF ;
Loftus, EV ;
Tremaine, WJ ;
Egan, LJ ;
Harmsen, WS ;
Schleck, CD ;
Zinsmeister, AR ;
Sandborn, WJ .
GASTROENTEROLOGY, 2004, 126 (01) :19-31
[3]   Impact of the increasing use of immunosuppressants in Crohn's disease on the need for intestinal surgery [J].
Cosnes, J ;
Nion-Larmurier, I ;
Beaugerie, L ;
Afchain, P ;
Tiret, E ;
Gendre, JP .
GUT, 2005, 54 (02) :237-241
[4]   Early combined immunosuppression or conventional management in patients with newly diagnosed Crohn's disease:: an open randomised trial [J].
D'Haens, Geert ;
Baert, Filip ;
van Assche, Gert ;
Caenepeel, Philip ;
Vergauwe, Philippe ;
Tuynman, Hans ;
De Vos, Martine ;
van Deventer, Sander ;
Stitt, Larry ;
Donner, Allan ;
Vermeire, Severine ;
Van De Mierop, Frank J. ;
Coche, Jean-Charles R. ;
van der Woude, Janneke ;
Ochsenkuehn, Thomas ;
van Bodegraven, Ad A. ;
van Hootegem, Philippe P. ;
Lambrecht, Guy L. ;
Mana, Fazia ;
Rutgeerts, Paul ;
Feagan, Brian G. ;
Hommes, Daniel .
LANCET, 2008, 371 (9613) :660-667
[5]   Maintenance infliximab for Crohn's disease: the ACCENT I randomised trial [J].
Hanauer, SB ;
Feagan, BG ;
Lichtenstein, GR ;
Mayer, LF ;
Schreiber, S ;
Colombel, JF ;
Rachmilewitz, D ;
Wolf, DC ;
Olson, A ;
Bao, WH ;
Rutgeerts, P .
LANCET, 2002, 359 (9317) :1541-1549
[6]   Lymphoma risk in inflammatory bowel disease: Is it the disease or its treatment? [J].
Jones, Jennifer L. ;
Loftus, Edward V., Jr. .
INFLAMMATORY BOWEL DISEASES, 2007, 13 (10) :1299-1307
[7]   Infliximab plus azathioprine for steroid-dependent Crohn's disease patients:: A randomized placebo-controlled trial [J].
Lémann, M ;
Mary, JY ;
Duclos, B ;
Veyrac, M ;
Dupas, JL ;
Delchier, JC ;
Laharie, D ;
Moreau, J ;
Cadiot, G ;
Picon, L ;
Bourreille, A ;
Sobahni, I ;
Colombel, JF .
GASTROENTEROLOGY, 2006, 130 (04) :1054-1061
[8]   Infliximab for induction and maintenance therapy for ulcerative colitis [J].
Rutgeerts, P ;
Sandborn, WJ ;
Feagan, BG ;
Reinisch, W ;
Olson, A ;
Johanns, J ;
Travers, S ;
Rachmilewitz, D ;
Hanauer, SB ;
Lichtenstein, GR ;
de Villiers, WJS ;
Present, D ;
Sands, BE ;
Colombel, JF .
NEW ENGLAND JOURNAL OF MEDICINE, 2005, 353 (23) :2462-2476
[9]   Infliximab maintenance therapy for fistulizing Crohn's disease [J].
Sands, BE ;
Anderson, FH ;
Bernstein, CN ;
Chey, WY ;
Feagan, BG ;
Fedorak, RN ;
Kamm, MA ;
Korzenik, JR ;
Lashner, BA ;
Onken, JE ;
Rachmilewitz, D ;
Rutgeerts, P ;
Wild, G ;
Wolf, DC ;
Marsters, PA ;
Travers, SB ;
Blank, MA ;
van Deventer, SJ .
NEW ENGLAND JOURNAL OF MEDICINE, 2004, 350 (09) :876-885
[10]  
SIEGEL CA, 2008, GASTROENTEROLOGY, V134, pA14