Treatment Decision-making in Chinese Inflammatory Bowel Disease Patients

2021 ◽  
Author(s):  
Li Yang ◽  
Xiaomei Song ◽  
Yan Chen ◽  
Yue Li ◽  
Yubei Gu ◽  
...  
Keyword(s):  
Decision Making ◽  
Inflammatory Bowel Disease ◽  
Treatment Decision ◽  
Illness Severity ◽  
Factors Affecting ◽  
Treatment Decision Making ◽  
Significant Difference ◽  
Employment Situation ◽  
Inflammatory Bowel ◽  
Actual Decision

Abstract BACKGROUND Inflammatory bowel disease (IBD) is rising in China, and the tendency for lifelong recurrence decreases patients’ quality of life. However, no studies on treatment decision-making in Chinese patients with IBD exist. Thus, this study aimed to determine the actual and ideal decision-making as well as factors affecting decision-making in Chinese IBD patients. METHODS A multi-center online questionnaire was distributed among patients diagnosed with IBD. To assess factors that influence treatment decision-making, univariate and multivariate logistic regression analyses were performed. RESULTS From March 20, 2018, to May 20, 2018, 866 patients completed the questionnaires, including 222 patients with ulcerative colitis, 588 patients with Crohn’s disease and 56 patients with unclassified IBD. There was a significant difference between ideal and actual decision-making in Chinese IBD patients (P ˂ .005). The factors affecting ideal decision-making included income, education, illness severity, religiosity, the importance of the treatment decision, the employment situation, and occupation area. The factors affecting actual decision-making included age, illness severity, religiosity, the employment situation, economic anxiety, concern about the side effects, and the importance of the treatment decision. CONCLUSION There is a significant difference between ideal and actual decision-making in IBD patients in China. That is, the economy, religiosity, illness severity, and concern about the side effects of treatment are the most important factors affecting treatment decisions in Chinese IBD patients.

Physicians' views on the influence of patient participation on treatment decisions - an explorative study

2007 ◽  
Vol 20 (3) ◽  
pp. 174-182 ◽  
Author(s):  
Elina Jaakkola
Keyword(s):  
Decision Making ◽  
Patient Participation ◽  
Treatment Decision ◽  
Treatment Decisions ◽  
Role Expectations ◽  
Customer Participation ◽  
Health Care Managers ◽  
Treatment Decision Making ◽  
Explorative Study ◽  
Significant Difference

While patient participation in treatment decisions is increasingly advocated in medical literature, patient demand has been considered to cause unnecessary prescribing. Using the concept of customer participation as discussed in services marketing and management literature as a theoretical base, the paper analyses the influence of patient participation on the medical service process and treatment decision-making. A qualitative, explorative study was conducted to investigate American and British physicians' views on patient participation in the treatment of osteoporosis and schizophrenia. It became evident that in the cases of both osteoporosis and schizophrenia, patients influence prescribing decisions despite the significant difference in their willingness and ability to participate. The manifestations of patient participation were divided into three groups: (1) resources, such as the patient's condition and information about it, and his/her preconceived notions and preferences, (2) actions, such as preparing for the service, negotiating decisions and implementing the treatment, and (3) the patient's role expectations and inclination to participate. The influence of such manifestations on prescribing decision-making is discussed in detail, and differences between the studied illnesses are explained. Implications to health-care managers and practitioners are discussed.

P021 READABILITY AND QUALITY OF ONLINE RESOURCES ON NUTRITION AS IT RELATES TO IBD

2020 ◽  
Vol 26 (Supplement_1) ◽  
pp. S55-S55
Author(s):  
Ali Khan ◽  
Scott Baumgartner ◽  
Vinay Rao ◽  
Marie Borum
Keyword(s):  
Decision Making ◽  
Inflammatory Bowel Disease ◽  
Shared Decision Making ◽  
Grade Level ◽  
Online Resources ◽  
Shared Decision ◽  
Significant Difference ◽  
Inflammatory Bowel ◽  
Academic Websites

Abstract Background Nutrition plays an essential role in inflammatory bowel disease (IBD). Optimizing nutritional status can help prevent malnutrition, osteoporosis, and may be an effective primary therapy for many patients. Patients with IBD are increasingly turning to the Internet for information. This study evaluated the readability and quality of online resources discussing nutrition for IBD. Methods Google search engine was used to query “nutrition and inflammatory bowel disease” to access the first 100 websites. Websites that were non-accessible, duplicates, videos without transcripts or evaluated animal models were excluded. Websites were categorized as informational or academic/professional. Readability was determined using the validated Flesch-Kincaid Grade Level Calculation. The quality of the information was determined using the validated DISCERN score. Websites were reviewed for inclusion of a discussion of shared decision making between patients and physicians. Statistical analysis was performed using a two-tailed Fisher’s Exact Test and a two-sample T-test with a significance value set at p <0.05. Results 89 of 100 websites met the inclusion criteria. 50 (56.2%) websites were informational and 39 (43.8%) were academic. The average Flesch-Kincaid Grade level was 13.2, with no significant difference between informational and academic websites (13.1 and 13.4 grade levels, respectively; p=0.760). The average DISCERN score was “good” without significant difference between informational and academic websites (45.75 and 45.74, respectively; p=0.994). Academic websites had significantly more “excellent” DISCERN scores than informational websites (76% and 24%, respectively; p = 0.0054). There were no significant difference in “good” or “poor” DISCERN scores between academic and informational websites (p=0.527 and p=0.095, respectively) (Figure 1). Shared decision making between patient and physician was discussed among 33.7% of all sources, significantly more often among informational than academic sources (60% and 0%, respectively; p=0.0001). Discussion Patients often self-manage their symptoms using easily accessible online resources. While our study demonstrated near identical DISCERN scores between academic and informational websites, the average Flesch-Kincaid Grade Level exceeded the NIH recommended 6th grade reading level. Informational websites, however, were more likely to encourage shared decision making between physician and patient. It may be important for academic online resources to specifically emphasize communication that encourages shared decision making between IBD patients and physicians. As the use of online resources continues to increase, further efforts should focus on developing informational resources written at a grade level which is applicable to the general public.

Patient satisfaction with oncology clinical decision support in South Korea.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e18329-e18329
Author(s):  
Kyounga Lee ◽  
Seon Heui Lee ◽  
Anita Preininger ◽  
JungHo Shim ◽  
Gretchen Jackson
Keyword(s):  
Decision Making ◽  
Medical Center ◽  
Treatment Decision ◽  
Clinical Decision ◽  
Treatment Decisions ◽  
Tumor Board ◽  
Fully Integrated ◽  
Treatment Decision Making ◽  
Level Of Satisfaction ◽  
Significant Difference

e18329 Background: Watson For Oncology (WFO) is an artificial intelligence (AI) tool that presents therapeutic options to oncologists and patients at 9 hospitals in Korea. The earliest user is Gachon University Gil Medical Center (GMC), where the tumor board (MDT) is fully integrated with WfO (MDT-WfO). GMC patients and oncologists may select one of the treatment choices presented by MDT-WfO or choose to follow recommendations of one or more oncologists at GMC augmented by WfO (non-MDT-WfO). This study is aimed at determining the satisfaction of patients who pursue shared decision-making through the MDT-WfO approach. Methods: Cancer patients enrolled in this IRB-approved study and treated at GMC between March and September of 2018 were surveyed. All patients rated satisfaction levels from 1-10 after treatment decision-making was completed, with 1 indicating the lowest level of satisfaction and 10 the highest. For each question, the average satisfaction score for patients in the MDT-WfO group was compared to the mean for patients in the non-MDT-WfO group, with a t-test for significance. Results: There were 9 cancer types treated at GMC from March through September of 2018. Of the of 290 patients enrolled in this study, 130 (44.8%) selected MDT-WfO and 160 (55.2%) did not. Overall, patients that interacted with MDT-WfO viewed GMT more positively (86.9%) after treatment decisions had been made than patients in the non-MDT-WfO group (71.3%).Although patients did not report significantly differing levels of satisfaction for most survey questions, there was a significant difference in terms of satisfaction with the explanation they received from the medical staff. Satisfaction level for this item was 9.52 with MDT-WfO and 9.22 points without ( p = 0.029). Conclusions: Patients reported greater satisfaction in the explanations they received in the MDT-WfO group, consistent with their more positive impression of GMT after treatment decisions were made. More studies are needed to determine if the increase in the level of satisfaction for this item is due to explanations from MDT unrelated or related to WfO. More studies on how WfO is used differently by the tumor board and individual oncologists may provide a unique perspective on how WfO is integrated into the MDT.

Treatment decision making in metastatic prostate cancer (mPC).

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e17552-e17552
Author(s):  
Frank Schumacher ◽  
Jiahui Xu ◽  
Laura Oswald ◽  
Benjamin Lee ◽  
Brian Gonzalez ◽  
...  
Keyword(s):  
Decision Making ◽  
Treatment Decision ◽  
Weighted Kappa ◽  
Similar Efficacy ◽  
Clinic Visit ◽  
Specific Pattern ◽  
Age Group ◽  
Treatment Decision Making ◽  
Physician Perceptions ◽  
Significant Difference

e17552 Background: Multiple treatments with similar efficacy exist for mPC, leaving patients (pts) with complicated treatment choices. Shared decision-making (SDM) can facilitate treatment decisions. The extent to which SDM is used in mPC is unknown. We assessed mPC pt, caregiver, and physician perceptions of decision locus of control (DLOC) (SDM vs. physician- or pt-directed decisions), and the degree of agreement between groups. Methods: Pt/caregiver/physician triads completed surveys of decision-making practices between 12/2016 and 11/2017 after a clinic visit in which a decision occurred. Pts were included only if they had a caregiver present. To evaluate the degree of agreement between pt, caregiver, and physician perceptions of DLOC, we used the quadratic-weighted kappa coefficient (κ). Agreement was evaluated on an overall basis and by pt age group (5-year increments). Results: 50 pt/caregiver/physician triads participated, with median pt age of 72 yo. Most pts were white (96%) and married (90%). A majority of pts, caregivers, and physicians reported SDM (66%, 56%, and 52%, respectively). No group reported completely pt-directed decisions. Pts and physicians demonstrated agreement about DLOC for most encounters (weighted κ = 0.35; P = 0.01). Overall, pts and physicians agreed on the DLOC in 44% of cases, and SDM was the most common agreed-upon DLOC (36%). Relative to physicians, 34% of pts reported more pt influence on DLOC, and 22% of pts reported less pt influence on DLOC. In contrast, caregiver reports of DLOC were independent of physician reports (weighted κ = 0.23; P = 0.55). Overall, caregivers and physicians agreed on DLOC in 38% of cases, and SDM was the most common agreed-upon DLOC (32%). Relative to physicians, 46% of caregivers reported more pt influence on DLOC and 16% of caregivers reported less pt influence on DLOC. There was a statistically significant difference in the degree of agreement by pt age group between pts and physicians (P = 0.045) and caregivers and physicians (P = 0.002), although no specific pattern according to pt age was noted. Conclusions: A majority of pts, caregivers, and physicians reported SDM occurring in routine clinical visits for mPC. Pts reported a higher degree of agreement with their physicians in DLOC than caregivers. Both pts and caregivers perceived greater pt influence on treatment choice than physicians. Efforts to explore the association between SDM, pt satisfaction, and quality of life are ongoing.

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