Review article: explaining risks of inflammatory bowel disease therapy to patients

Aliment Pharmacol Ther. 2011 Jan;33(1):23-32. doi: 10.1111/j.1365-2036.2010.04489.x. Epub 2010 Oct 26.

Abstract

Background: Medical treatment for inflammatory bowel disease (IBD) has advanced significantly over the past decade, but it is important to communicate effectively the balance of benefits and risks of therapy to patients to facilitate informed medical decisions.

Aim: To review the available data describing the risk of side effects of IBD medications and to describe effective methods for communicating risk.

Methods: To identify relevant articles for this review, a PubMed search was conducted using relevant key words and phrases. In addition, reference lists from identified manuscripts were searched and recent abstracts from National meetings were reviewed.

Results: The steroid-sparing medications used for the treatment of IBD all carry risks of both common and rare adverse events. Trade-offs need to be made between the risks of these medications vs. the risks of poorly treated disease and corticosteroids. There has been significant research on how best to present risk data to patients, which is summarized in this review.

Conclusions: To ensure that our patients understand their choices and feel comfortable with their treatment, we need to communicate risk data to patients clearly. Patients comprehend absolute numbers better than relative risk, and when available, pictorial representations of data are preferred over solely presenting numerical outcomes.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Adrenal Cortex Hormones / adverse effects*
  • Combined Modality Therapy / adverse effects*
  • Communication*
  • Humans
  • Immunologic Factors / adverse effects*
  • Inflammatory Bowel Diseases / complications*
  • Inflammatory Bowel Diseases / drug therapy
  • Patient Education as Topic
  • Physician-Patient Relations
  • Risk Factors

Substances

  • Adrenal Cortex Hormones
  • Immunologic Factors