title: How patients view probiotics: findings from a multicenter study of patients with inflammatory bowel disease and irritable bowel syndrome.
abstract: BACKGROUND
  Patients with inflammatory bowel disease (IBD) and irritable bowel syndrome (IBS) have access to a growing number of probiotic products marketed to improve digestive health. It is unclear how patients make decisions about probiotics and what role they expect their gastroenterologists to play as they consider using probiotics. Understanding patients' knowledge, attitudes and expectations of probiotics may help gastroenterologists engage patients in collaborative discussions about probiotics.
  
  
  METHODS
  Focus groups were conducted with patients with IBD and IBS at the Cleveland Clinic, Mayo Clinic, and Johns Hopkins University. Inductive analytic methods were used to identify common themes and draw interpretations from focus group narratives.
  
  
  RESULTS
  One hundred thirty-six patients participated in 22 focus groups between March and August 2009. Patients viewed probiotics as an appealing alternative to pharmaceutical drugs and understood probiotics as a more "natural," low-risk therapeutic option. Many patients were hesitant to use them without consulting their gastroenterologists. Patients would weigh the risks and benefits of probiotics, their disease severity and satisfaction with current treatments when considering probiotic use.
  
  
  CONCLUSIONS
  Patients are interested in probiotics but have many unanswered questions about their use. Our findings suggest that patients with IBD and IBS will look to gastroenterologists and other clinicians as trustworthy advisors regarding the utility of probiotics as an alternative or supplement to pharmaceutical drugs. Gastroenterologists and other clinicians who care for patients with these diseases should be prepared to discuss the potential benefits and risks of probiotics and assist patients in making informed decisions about their use.
authors.affiliation: Department of Bioethics, Cleveland Clinic, Cleveland, OH 44195, USA.
authors.forename: MaryBeth
authors.initials: M
authors.lastname: Mercer
authors.forename: Margaret A
authors.initials: MA
authors.lastname: Brinich
authors.forename: Gail
authors.initials: G
authors.lastname: Geller
authors.forename: Krista
authors.initials: K
authors.lastname: Harrison
authors.forename: Janelle
authors.initials: J
authors.lastname: Highland
authors.forename: Katherine
authors.initials: K
authors.lastname: James
authors.forename: Patricia
authors.initials: P
authors.lastname: Marshall
authors.forename: Jennifer B
authors.initials: JB
authors.lastname: McCormick
authors.forename: Jon
authors.initials: J
authors.lastname: Tilburt
authors.forename: Jean-Paul
authors.initials: JP
authors.lastname: Achkar
authors.forename: Ruth M
authors.initials: RM
authors.lastname: Farrell
authors.forename: Richard R
authors.initials: RR
authors.lastname: Sharp
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015142:Baltimore; D003093:Colitis, Ulcerative / Q000628:therapy; D003424:Crohn Disease / Q000628:therapy; D005260:Female; D017144:Focus Groups; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000628:therapy*; D043183:Irritable Bowel Syndrome / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D008910:Minnesota; D009820:Ohio; D010342:Patient Acceptance of Health Care; D010819:Physician's Role; D019936:Probiotics / Q000009:adverse effects / Q000627:therapeutic use*; D016896:Treatment Outcome; D055815:Young Adult