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日本炎症性肠病患者对共同决策的偏好

Preferences Regarding Shared Decision-Making in Japanese Inflammatory Bowel Disease Patients.

作者信息

Morishige Ryuji, Nakajima Hiroshi, Yoshizawa Kazutake, Mahlich Jörg, Sruamsiri Rosarin

机构信息

Medical Affairs, Janssen Pharmaceutical K.K., Tokyo, Japan.

Health Economics, Janssen Pharmaceutical K.K., Tokyo, Japan.

出版信息

Adv Ther. 2017 Jan;33(12):2242-2256. doi: 10.1007/s12325-016-0436-0. Epub 2016 Nov 2.

Abstract

INTRODUCTION

Recent studies have indicated that patients are showing increased interest in playing a larger role in making decisions regarding their medical treatment. Inflammatory bowel disease (IBD) is a chronic disease that manifests either as Crohn's disease (CD) or ulcerative colitis (UC). IBD treatment is multifaceted and dependent on patient-specific factors. The selection of treatment options is mostly driven by physicians, and it is unclear to what degree patients are involved in shared decision-making (SDM). The objective of the current study is to assess preferences among Japanese patients with IBD in regard to SDM during their treatment for IBD.

METHODS

A nationwide web-based survey was performed in Japan during February 2016. The patients were asked for their basic clinical characteristics, socioeconomic status, medical history, treatment details, and preferences regarding SDM in IBD treatment. Differences were analyzed by chi-square, t tests, a multiple regression analysis, and ordered logistic regression analysis.

RESULTS

In response to the screening survey, a total of 1068 Japanese nationals met the inclusion criteria for this study of being patients diagnosed with IBD who are currently receiving treatment. Of these, 235 had CD and 800 UC; 33 were not specified. Overall, the majority of these patients felt that SDM was very important. Furthermore, interest in SDM was strongly associated with certain disease comorbidities, surgical history, and current treatment, although there were some differences in the results between CD and UC.

CONCLUSION

The present study found that the majority of IBD patients in Japan wanted to have a role in their treatment plan. The results indicate that the patient's preference in regard to SDM was driven by their perception of the severity or progression of their disease.

FUNDING

Janssen Pharmaceuticals.

摘要

引言

最近的研究表明,患者对于在医疗决策中发挥更大作用的兴趣日益浓厚。炎症性肠病(IBD)是一种慢性疾病,表现为克罗恩病(CD)或溃疡性结肠炎(UC)。IBD治疗是多方面的,且取决于患者的特定因素。治疗方案的选择主要由医生主导,目前尚不清楚患者在共同决策(SDM)中参与的程度。本研究的目的是评估日本IBD患者在IBD治疗期间对SDM的偏好。

方法

2016年2月在日本进行了一项全国性的网络调查。询问患者的基本临床特征、社会经济状况、病史、治疗细节以及对IBD治疗中SDM的偏好。通过卡方检验、t检验、多元回归分析和有序逻辑回归分析来分析差异。

结果

在筛查调查中,共有1068名日本国民符合本研究的纳入标准,即被诊断为IBD且正在接受治疗的患者。其中,235人患有CD,800人患有UC;33人未明确说明。总体而言,这些患者中的大多数认为SDM非常重要。此外,对SDM的兴趣与某些疾病合并症、手术史和当前治疗密切相关,尽管CD和UC之间的结果存在一些差异。

结论

本研究发现,日本大多数IBD患者希望在其治疗计划中发挥作用。结果表明,患者对SDM的偏好是由他们对疾病严重程度或进展的认知所驱动的。

资助

杨森制药公司。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e9e7/5126200/09a451af302c/12325_2016_436_Fig1_HTML.jpg

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