Patients' Preferences regarding Shared Decision-Making in the Treatment of Inflammatory Bowel Disease: Results from a Patient-Empowerment Study

被引:100
作者
Baars, Judith E. [1 ]
Markus, Tineke [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] Dutch Patients Assoc Crohns Dis & Ulcerat Colitis, Breukelen, Netherlands
关键词
Inflammatory bowel disease; Shared decision-making; Patients' preferences; QUIESCENT ULCERATIVE-COLITIS; QUALITY-OF-LIFE; INFORMATION NEEDS; CROHNS-DISEASE; CANCER; PARTICIPATION; EXPERIENCES; PREVALENCE; PHYSICIANS; EPIDEMIOLOGY;
D O I
10.1159/000253862
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
Background: Shared decision-making is gaining favor in clinical practice, although the extent to which patients want to be involved in choosing their treatment varies substantially. Because data are lacking on the preferences of patients with chronic diseases such as inflammatory bowel disease (IBD), we wanted to assess IBD patients' preferences about being involved in such decisions. Methods: Adult IBD patients were asked to anonymously complete an online survey on their preferences. Non-parametric tests (chi(2)) were used to determine the relationship between responses and respondents. Results: The questionnaire was completed by 1,067 patients, 617 with Crohn's disease and 450 with ulcerative colitis. Patients' mean age was 43 (SD 13.7) years; the majority were female (66%). In total, 866 patients (81%) reported it as 'very important' to be actively involved in the decision-making process, and another 177 (17%) rated it as 'quite important'. When asked how their treatment could be improved, 537 patients (50%) wanted close, equitable collaboration with their physician. This preference was significantly associated with a disease duration of <= 8 years (p = 0.03). Gender and type of IBD were not significantly associated with patients' preferences. Conclusions: This study demonstrates IBD patients' desire to be actively involved in the decision-making process. Further research is needed on physicians' perspectives on shared decision-making, and on finding predictive factors for developing a model for shared decision-making in IBD. Copyright (C) 2010 S. Karger AG, Basel
引用
收藏
页码:113 / 119
页数:7
相关论文
共 32 条
[1]   Patient empowerment in theory and practice: Polysemy or cacophony? [J].
Aujoulat, Isabelle ;
d'Hoore, William ;
Deccache, Alain .
PATIENT EDUCATION AND COUNSELING, 2007, 66 (01) :13-20
[2]   Patient's Perspectives Important for Early Anti-Tumor Necrosis Factor Treatment in Inflammatory Bowel Disease [J].
Baars, Judith E. ;
Siegel, Corey A. ;
Kuipers, Ernst J. ;
van der Woude, C. Janneke .
DIGESTION, 2009, 79 (01) :30-35
[3]   Exploring the decision-making preferences of people with colorectal cancer [J].
Beaver, K ;
Jones, D ;
Susnerwala, S ;
Craven, O ;
Tomlinson, M ;
Witham, G ;
Luker, KA .
HEALTH EXPECTATIONS, 2005, 8 (02) :103-113
[4]   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
[5]   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
[6]   Long-term evolution of disease behavior of Crohn's disease [J].
Cosnes, J ;
Cattan, S ;
Blain, A ;
Beaugerie, L ;
Carbonnel, F ;
Parc, R ;
Gendre, JP .
INFLAMMATORY BOWEL DISEASES, 2002, 8 (04) :244-250
[7]   DECISION-MAKING DURING SERIOUS ILLNESS - WHAT ROLE DO PATIENTS REALLY WANT TO PLAY [J].
DEGNER, LF ;
SLOAN, JA .
JOURNAL OF CLINICAL EPIDEMIOLOGY, 1992, 45 (09) :941-950
[8]   Participation in medical decision making: The patients' perspective [J].
Fraenkel, Liana ;
McGraw, Sarah .
MEDICAL DECISION MAKING, 2007, 27 (05) :533-538
[9]   Patient participation in decision-making [J].
Guadagnoli, E ;
Ward, P .
SOCIAL SCIENCE & MEDICINE, 1998, 47 (03) :329-339
[10]   Increase in incidence and prevalence of inflammatory bowel disease in northern Denmark: a population-based study, 1978-2002 [J].
Jacobsen, Bent A. ;
Fallingborg, Jan ;
Rasmussen, Henrik H. ;
Nielsen, Kari R. ;
Drewes, Asbiorn M. ;
Puho, Erzsebet ;
Nielsen, Gunnar L. ;
Sorensen, Henrik T. .
EUROPEAN JOURNAL OF GASTROENTEROLOGY & HEPATOLOGY, 2006, 18 (06) :601-606