AG-2020-184_Factors associated with patient ́s preference

Background – Biological therapy and new drugs have revolutionized the treatment of inflammatory bowel disease. Ideally, the choice of medication should be a shared decision with the patient, aiming at greater satisfaction, compliance, and consequently, favorable clinical outcome. Objective – This study aims to evaluate patient’s preferences in the choice of their therapy and the factors that influence this choice. Methods – This cross-sectional study enrolled 101 outpatients with Crohn’s disease or ulcerative colitis. The inclusion criteria were age ≥18 years and no previous exposure to biological therapy. Patients’ preferences were assessed through questions that addressed the preferred mode of administration (oral, subcutaneous, or intravenous) and the factors that determined the choice of medication (efficacy, medical indication, fear of medication, convenience, mode of application, and personal doctors’ indication). Results – The mean age was 43.6±13.5 years, 75.3% were female, and 81.2% were cases of ulcerative colitis. Regarding the mode of administration, the majority of patients preferred oral (87.1%), followed by intravenous (6.93%) and subcutaneous (5.94%) medications. The reasons were “I prefer to take it at home” (42.57%), “I have more freedom” (36.63%), “I don’t like self-application” (29.70%), and “I believe it works better” (19.80%). Younger patients and patients in clinical disease activity preferred intravenous mode compared to the oral route (P<0.05). Doctor’s opinion (98%) was an important factor associated with the medication choice. Conclusion – Oral route was the preferred mode of administration and most patients took their physician’s opinion into account in their choice of medication. HEADINGS – Biological therapy. Drug administration routes. Ulcerative colitis. Crohn disease. Inflammatory bowel diseases. Declared conflict of interest of all authors: none Disclosure of funding: Adhan Amenomori Wu has received scholarship. Grant # ID42174, Brazilian National Council for Scientific and Technological Development (CNPq) PIBIC grant. 1 Universidade Estadual Paulista (Unesp), Faculdade de Medicina, Departamento de Clínica Médica, Botucatu, SP, Brasil. 2 IBD Unit, St Mark’s Hospital, London, United Kingdom. 3 Unesp, Faculdade de Medicina, Departamento de Cirurgia, Botucatu, SP, Brasil. Corresponding author: Ligia Yukie Sassaki. E-mail: ligiasassaki@gmail.com other aspects such as mode of administration (oral, subcutaneous [SC], or intravenous [IV]), and safety profile. The choice of medication from the patient’s perspective is based on drug efficacy, safety concerns, and patient’s preference, besides convenience of administration, drug availability, and speed of action. Consequently, patient involvement in the decision-making process has emerged as one of the pillars of treatment. Patient’s often feel empowered when they are given the opportunity to make treatment decisions alongside their doctor or nurse. Patient’s participation in choosing their medication can result in greater satisfaction(15), compliance, and, therefore, favorable health outcomes. Despite these, patient centered care and shared decision making are concepts that are yet to fully find traction in many developing countries, including Brazil. Herein, this study aimed to evaluate patients’ preferences in choosing their therapy and the variables that influence this choice, in a single center in Brazil.