Treatment decision making for postoperative Crohn's disease is complex because of the increasing number of maintenance therapies available with competing risk-benefit profiles.
|93% preferred fish oil to 5-aminosalicylic acid|
|Inflammatory Bowel Diseases|
Dr Erin Kennedy and colleagues from Canada determined the distribution of patients' preferences for selected postoperative maintenance therapies.
The research team conducted a cross-sectional survey in which patients with Crohn's disease, who completed a standardized interview.
Each participant completed 5 tasks in the questionnaires.
The first task compared no medication and 5-aminosalicylic acid, the second fish oil and 5-aminosalicylic acid.
The third task compared metronidazole and 5-aminosalicylic acid, and the fourth compared budesonide and 5-aminosalicylic acid.
The fifth task compared azathioprine and 5-aminosalicylic acid.
For each task, the minimum change in treatment effect size between the 2 treatments that the participant considered worthwhile was determined.
The researchers found that the distribution of the participants' preference scores varied widely for each task.
The team assessed that fish oil, metronidazole, budesonide, and azathioprine were considered equally effective to 5-aminosalicylic acid.
The team noted that 93%, 29%, 38%, and 19% of patients preferred fish oil, metronidazole, budesonide, and azathioprine to 5-aminosalicylic acid.
The team of doctors found that these percentages increased to 98%, 55%, 62%, and 51%, respectively, when fish oil, metronidazole, budesonide, and azathioprine were considered to offer a 5% absolute risk reduction relative to 5-aminosalicylic acid.
Regression analysis did not identify any clinical or demographic variables predictive of the participants' treatment preferences.
Dr Kennedys' team concluded, "The participants' preferences for postoperative maintenance therapies were widely distributed, and no clinical or demographic factors predicted these preferences."
"This emphasizes the need for effective communication between physician, and patient in order to select the treatment options most consistent with a patient's informed.