Dartmouth-Hitchcock Inflammatory Bowel Disease Center, Section of Gastroenterology and Hepatology, Dartmouth-Hitchcock Medical Center, Lebanon, NH.
College of Public Health, Temple University, Philadelphia, PA.
Inflamm Bowel Dis. 2020 Jan 1;26(1):141-146. doi: 10.1093/ibd/izz121.
Biologic medications have advanced the management of inflammatory bowel diseases (IBD) but are underutilized in the treatment algorithm. One reason may be related to patients' concerns about adverse events and their perceptions of risk. The aim of this study was to compare patients' perceptions of risk of IBD treatment with their perceived risk of everyday occurrences and other medications and how these perceptions may be influenced by personality traits.
A cross-sectional study of consecutive IBD patients was conducted at a single tertiary care center. Participants were asked to report about their perception of risk of IBD medications, non-IBD medications, invasive procedures, and everyday life occurrences. Participants responded also to the Multidimensional Health Locus of Control (MHLC) scale to characterize beliefs about control over health outcomes.
A total of 130 patients with IBD completed the questionnaires. There was a broad range of disease severity and prior medication use. Biologics elicited the highest dread of all IBD medications, but this was still lower than their fear of surgery. Patients believed that biologics were of higher benefit than immunomodulators and mesalamines, but riskier. Having the personality trait of an internally developed locus of control was associated with the perception that biologics are less dreadful.
Patients with IBD perceive biologics to be of higher benefit but riskier and more dreadful as compared with immunomodulators. Risk perception may be about more than their knowledge base but also about how much control patients typically believe they have over their daily lives.
生物制剂在炎症性肠病（IBD）的治疗中取得了进展，但在治疗方案中未得到充分利用。原因之一可能与患者对不良反应的担忧以及对风险的看法有关。本研究旨在比较患者对 IBD 治疗风险的看法与对日常事件和其他药物的风险感知，以及这些看法如何受到个性特征的影响。
在一家三级保健中心进行了一项连续 IBD 患者的横断面研究。要求参与者报告他们对 IBD 药物、非 IBD 药物、侵入性程序和日常生活事件的风险感知。参与者还回答了多维健康控制源量表（MHLC），以描述对健康结果控制的信念。
共有 130 名 IBD 患者完成了问卷调查。患者的疾病严重程度和既往用药情况差异较大。生物制剂引起了所有 IBD 药物中最高的恐惧，但仍低于手术的恐惧。患者认为生物制剂比免疫调节剂和 mesalamines 更有效，但风险更高。具有内在控制源个性特征的患者认为生物制剂的可怕程度较低。
与免疫调节剂相比，IBD 患者认为生物制剂的益处更高，但风险更大，更可怕。风险感知不仅仅与他们的知识库有关，还与患者通常对日常生活的控制程度有关。
