title: Physicians Should Provide Shared Decision-Making for Anti-TNF Therapy to Inflammatory Bowel Disease Patients.
abstract: Shared decision-making may increase the effectiveness of inflammatory bowel disease (IBD) treatment, as different anti-tumor necrosis factor (anti-TNF) administrations may have different effects on the quality of life (QOL). Patient preference is integral to the selection of anti-TNFs and their routes of administration, however, previous studies on the patient preference to anti-TNFs are inconsistent and limited. We evaluated the predictive factors for preferences to anti-TNF administrations in IBD patients between March and August in 2015. Consecutive adult IBD patients who received care at one of four university hospitals in Korea were invited to participate in this study. Patients were administered questionnaires about their preferences regarding anti-TNF therapy and QOL. During the study period, 322 IBD patients completed the questionnaires. IBD patients preferred intravenous anti-TNFs to subcutaneous anti-TNFs (2.4:1), and 58.4% of patients preferred shared decision-making. When comparing subcutaneous anti-TNF therapy with intravenous anti-TNF therapy, patients with higher income levels, patients who experienced adverse events with prior medication and patients with a longer disease duration preferred subcutaneous anti-TNF therapy over intravenous anti-TNF therapy (P = 0.043, P = 0.000, and P = 0.029, respectively). In a logistic regression analysis, high income level (odds ratio [OR] 2.0; 95% confidence interval [CI] 1.1-3.5; P = 0.026) and an adverse event with prior medication (OR 4.0; 95% CI 2.2-7.2; P = 0.000) and were found to be independent predictors for preference to subcutaneous anti-TNF therapy. Therefore, physicians should share decision-making with their IBD patients regarding the mode of anti-TNF administration.
authors.affiliation: Department of Internal Medicine, Kyung Hee University School of Medicine, Seoul, Korea.
authors.forename: Jae Myung
authors.identifier: http://orcid.org/0000-0001-9403-230X
authors.initials: JM
authors.lastname: Cha
authors.affiliation: Department of Internal Medicine, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: Dong Il
authors.identifier: http://orcid.org/0000-0003-2307-8575
authors.initials: DI
authors.lastname: Park
authors.affiliation: Department of Gastroenterology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.
authors.forename: Sang Hyoung
authors.identifier: http://orcid.org/0000-0002-5366-5749
authors.initials: SH
authors.lastname: Park
authors.affiliation: Department of Internal Medicine, Dankook University School of Medicine, Cheonan, Korea.
authors.forename: Jeong Eun
authors.identifier: http://orcid.org/0000-0001-5706-3967
authors.initials: JE
authors.lastname: Shin
authors.affiliation: Department of Gastroenterology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.
authors.forename: Wan Soo
authors.identifier: http://orcid.org/0000-0001-9545-0140
authors.initials: WS
authors.lastname: Kim
authors.affiliation: Department of Gastroenterology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea. sky@amc.seoul.kr.
authors.forename: Suk Kyun
authors.identifier: http://orcid.org/0000-0003-2772-2575
authors.initials: SK
authors.lastname: Yang
mesh_terms: D061605:Administration, Intravenous; D000328:Adult; D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D003424:Crohn Disease / Q000188:drug therapy; D003657:Decision Making; D003710:Demography; D005260:Female; D006801:Humans; D007167:Immunotherapy; D015212:Inflammatory Bowel Diseases / Q000188:drug therapy* / Q000523:psychology; D007279:Injections, Subcutaneous; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D057240:Patient Preference; D010820:Physicians / Q000523:psychology; D011788:Quality of Life; D011795:Surveys and Questionnaires; D014409:Tumor Necrosis Factor-alpha / Q000276:immunology*
chemical_list: D000911:Antibodies, Monoclonal; D014409:Tumor Necrosis Factor-alpha
keywords: Anti-TNF; Crohn's Disease; Inflammatory Bowel Disease; Shared Decision-Making; Ulcerative Colitis