Predicting Pre-emptive Discussions of Biologic Treatment: Results from an Openness and Preference Survey of Inflammatory Bowel Disease Patients and Their PrescribersReportar como inadecuado




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Advances in Therapy

, Volume 34, Issue 6, pp 1398–1410

First Online: 08 May 2017Received: 27 October 2016DOI: 10.1007-s12325-017-0545-4

Cite this article as: Kariburyo, M.F., Xie, L., Teeple, A. et al. Adv Ther 2017 34: 1398. doi:10.1007-s12325-017-0545-4

Abstract

IntroductionIt is important to compare patient and provider discrepancies on stated openness to and preference for biologics as well as predictors associated with initial discussions on biologic use.

MethodsPatients N = 263 and physicians N = 100 completed a self-administered Web-based survey assessing demographics, health characteristics, and behaviors related to inflammatory bowel disease IBD treatment. Bootstrap methods were used to check discrepancies between providers’ and patients’ stated openness to and preference for biologics. Classification and regression tree CART analysis identified patient-specific predictors associated with initial biologics discussions.

ResultsA total of 170 patients responded consistently to preference questions, and 169 patients responded consistently to openness questions. Physicians significantly overestimated patients’ openness to biologics in general 85.46% vs. 74.61%, p < 0.0001, but underestimated patients’ openness to the intravenous IV mode of administration MOA; 55.97% vs. 63.96%, p < 0.0001. Overall, physicians significantly underestimated patient preference for IV MOA 22.07% vs. 42.35%, p < 0.0001 and, to a lesser extent, subcutaneous MOA 48.84% vs. 54.69%, p < 0.0001. Among Crohn’s disease CD patients N = 123, CART threshold analysis identified an inpatient visit in the last 6 months, CD diagnosis for more than 3 years, and non-adherence to prior IBD treatment as most positively predictive of having an initial biologics discussion.

ConclusionPhysicians appear to underestimate patient preferences in favor of biologics, especially IV formulations. Since it is unclear if physicians were aware of the patients’ preferences beforehand, this study supports the need for validated, shared decision-making tools when initiating IBD treatment. Additional studies are necessary to measure physicians’ influences on patient preference-treatment-related decisions and the impact on patient outcomes.

KeywordsClassification and regression tree analysis Crohn’s disease Gastroenterology Inflammatory bowel disease Mode of administration Patient preferences Ulcerative colitis Enhanced contentTo view enhanced content for this article go to http:-www.medengine.com-Redeem-4B18F06020323076.





Autor: M. Furaha Kariburyo - Lin Xie - Amanda Teeple - Haoran Tan - Michael Ingham

Fuente: https://link.springer.com/







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