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

Abstract

IntroductionRecent 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.MethodsA 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.ResultsIn 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.ConclusionThe 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.FundingJanssen Pharmaceuticals.

Biologic treatment of Japanese patients with inflammatory bowel disease

“…Younger IBD patients, a long time since diagnosis, surgical history, and visiting university hospitals were the key determinant factors for receiving biologic agents for Japanese IBD patients. Previous research in Japan also demonstrated that IBD patients who are treated with a biologics are also very fond of being involved in the treatment decision [ 21 ] Involvement in the treatment decision in turn corresponds to higher levels of patient’s treatment satisfaction [ 22 ].…”

“…This study was a secondary data analysis of Morishige et al [ 21 ] that was based on a nationwide online survey of 1035 patients. The survey was undertaken by IPSOS Healthcare, Inc., Tokyo, Japan, that runs a database containing 2,263,991 Japanese individuals.…”

Shared Decision-Making and Patient Satisfaction in Japanese Rheumatoid Arthritis Patients: A New “Preference Fit” Framework for Treatment Assessment

“…Traditionally, Japanese doctors have been described as being on the ''paternalistic,'' or prescriptive, end of the doctor-patient relationship spectrum, and older patients in particular are said to revere physicians as authority figures [26]. However, this has begun to change in recent years, and SDM has been introduced into Japanese Medical School curricula as well as into treatment practice [27][28][29][30][31]. We were therefore interested to determine the extent to which Japanese patients express an interest in being involved in treatment decisions.…”

Efficacy and safety of a new vedolizumab subcutaneous formulation in Japanese patients with moderately to severely active ulcerative colitis

“…Results showed that patients receiving biologics significantly favored SDM compared with those not receiving biologics, that patients with history of surgery significantly favored SDM compared with those without, and that most patients treated at university hospitals favored SDM. 29 In addition, a clear correlation was observed between the level of agreement that patients and their doctors had regarding SDM and patients' overall satisfaction with their treatment. 30 Having both SC and IV routes of administration as available treatment options may help physicians to tailor treatment decisions and thus maximize patient compliance and improve clinical outcomes.…”