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Inflammatory Bowel Disease Patients' Willingness to Accept Medication Risk to Avoid Future Disease Relapse.

Publication ,  Journal Article
Bewtra, M; Fairchild, AO; Gilroy, E; Leiman, DA; Kerner, C; Johnson, FR; Lewis, JD
Published in: Am J Gastroenterol
December 2015

OBJECTIVES: Biomarkers, endoscopy and imaging tests can identify patients at increased risk for early recurrence of symptomatic inflammatory bowel disease (IBD). However, patients may be unwilling to accept additional medical therapy risks related to therapy escalation to avoid a future disease relapse. We sought to quantify IBD patients' willingness to accept medication risk to avoid future disease relapse. METHODS: We conducted a discrete-choice experiment among 202 patients with IBD who were offered choices of therapies with varying risks of lymphoma and infection, and varying time to next IBD relapse. Random parameters logit was used to estimate patients' willingness to accept tradeoffs among treatment features in selecting medication therapy to avoid future disease relapse. RESULTS: To avoid a disease relapse over the next 5 years, IBD patients were willing to accept an average of a 28% chance of a serious infection; and an average of 1.8% chance of developing lymphoma. These results did not significantly change when patients were offered 10 years until their next disease relapse, but were lower (11 and 0.7%, respectively) when offered 1.5 years until the next disease relapse. Patients with active disease symptoms were significantly less willing to accept medication risk for time in remission. CONCLUSIONS: IBD patients are willing to accept high levels of lymphoma and serious infection risk to maintain disease remission. These preferences are congruent with the treatment paradigms emphasizing mucosal healing and early aggressive therapy and highlight patients' strong preferences for therapies resulting in durable remission of at least 5 years.

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Published In

Am J Gastroenterol

DOI

EISSN

1572-0241

Publication Date

December 2015

Volume

110

Issue

12

Start / End Page

1675 / 1681

Location

United States

Related Subject Headings

  • Time Factors
  • Risk
  • Recurrence
  • Patient Preference
  • Patient Acceptance of Health Care
  • Middle Aged
  • Male
  • Lymphoma
  • Inflammatory Bowel Diseases
  • Infections
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Bewtra, M., Fairchild, A. O., Gilroy, E., Leiman, D. A., Kerner, C., Johnson, F. R., & Lewis, J. D. (2015). Inflammatory Bowel Disease Patients' Willingness to Accept Medication Risk to Avoid Future Disease Relapse. Am J Gastroenterol, 110(12), 1675–1681. https://doi.org/10.1038/ajg.2015.321
Bewtra, Meenakshi, Angelyn O. Fairchild, Erin Gilroy, David A. Leiman, Caroline Kerner, F Reed Johnson, and James D. Lewis. “Inflammatory Bowel Disease Patients' Willingness to Accept Medication Risk to Avoid Future Disease Relapse.Am J Gastroenterol 110, no. 12 (December 2015): 1675–81. https://doi.org/10.1038/ajg.2015.321.
Bewtra M, Fairchild AO, Gilroy E, Leiman DA, Kerner C, Johnson FR, et al. Inflammatory Bowel Disease Patients' Willingness to Accept Medication Risk to Avoid Future Disease Relapse. Am J Gastroenterol. 2015 Dec;110(12):1675–81.
Bewtra, Meenakshi, et al. “Inflammatory Bowel Disease Patients' Willingness to Accept Medication Risk to Avoid Future Disease Relapse.Am J Gastroenterol, vol. 110, no. 12, Dec. 2015, pp. 1675–81. Pubmed, doi:10.1038/ajg.2015.321.
Bewtra M, Fairchild AO, Gilroy E, Leiman DA, Kerner C, Johnson FR, Lewis JD. Inflammatory Bowel Disease Patients' Willingness to Accept Medication Risk to Avoid Future Disease Relapse. Am J Gastroenterol. 2015 Dec;110(12):1675–1681.

Published In

Am J Gastroenterol

DOI

EISSN

1572-0241

Publication Date

December 2015

Volume

110

Issue

12

Start / End Page

1675 / 1681

Location

United States

Related Subject Headings

  • Time Factors
  • Risk
  • Recurrence
  • Patient Preference
  • Patient Acceptance of Health Care
  • Middle Aged
  • Male
  • Lymphoma
  • Inflammatory Bowel Diseases
  • Infections