title: Shared decision making in inflammatory bowel disease: helping patients understand the tradeoffs between treatment options.
abstract: The treatment of inflammatory bowel disease is becoming more complicated with new medications and new treatment paradigms. Although data are accumulating that the earlier use of immunomodulators and anti-tumor necrosis factor agents are more effective than the standard "step-up" pyramidal treatment algorithm, patients may not be comfortable with this more intensive therapeutic approach. The process of shared decision making engages patients in treatment decisions to optimize the chance that a chosen therapy matches their personal preferences for care. Decision aids are standard shared decision making tools, which are used to present evidence-based data in a patient-friendly manner to help patients with preference-sensitive decisions. Not all care decisions are preference-sensitive, and not all patients are interested in being part of a shared medical decision. The responsibility of the provider is to identify how much of a role patients want, and then determine which decisions need their input to provide the best patient-centered care. The overall goal is to involve patients in decisions so that they are educated about their options, confident in the plan, adherent to chosen therapy and ultimately have a better quality of life.
authors.affiliation: Inflammatory Bowel Disease Center, Section of Gastroenterology and Hepatology, Dartmouth-Hitchcock Medical Center, Lebanon, NH 03756, USA. corey.a.siegel@hitchcock.org
authors.forename: Corey A
authors.initials: CA
authors.lastname: Siegel
mesh_terms: D001688:Biological Products / Q000627:therapeutic use; D003657:Decision Making; D003661:Decision Support Techniques; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000188:drug therapy*; D010353:Patient Education as Topic / Q000379:methods; D010358:Patient Participation; D057240:Patient Preference; D010817:Physician-Patient Relations; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors
chemical_list: D001688:Biological Products; D014409:Tumor Necrosis Factor-alpha