Am J Gastroenterol. 2022 Sep 1;117(9):1508-1518.doi: 10.14309/ajg.0000000000001866. Epub 2022 Jun 10.

Christopher V Almario ^1 2, Welmoed K van Deen ³, Michelle Chen ⁴, Rebecca Gale ², Stéphanie Sidorkiewicz ⁵, So Yung Choi ⁶, Nirupama Bonthala ^1 7, Christina Ha ⁸, Gaurav Syal ^1 7, Taylor Dupuy ², Xiaoyu Liu ², Gil Y Melmed ^1 7, Brennan M R Spiegel ^1 2

Author information

¹Karsh Division of Gastroenterology and Hepatology, Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, California, USA.

²Cedars-Sinai Center for Outcomes Research and Education (CS-CORE), Los Angeles, California, USA.

³Erasmus School of Health Policy and Management, Division of Health Technology Assessment, Erasmus University Rotterdam, Rotterdam, the Netherlands.

⁴UC San Diego School of Medicine, La Jolla, California, USA.

⁵Department of General Practice, Université de Paris, Paris, France.

⁶Biostatistics and Bioinformatics Research Center, Cedars-Sinai Cancer, Los Angeles, California, USA.

⁷Inflammatory Bowel and Immunobiology Research Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA.

⁸Division of Gastroenterology and Hepatology, Mayo Clinic, Scottsdale, Arizona, USA.

Abstract

Introduction: To support shared decision-making (SDM) between patients and providers surrounding biologic treatments, we created IBD&me ( ibdandme.org )-a freely available, unbranded, interactive decision aid. We performed a multicenter comparative effectiveness trial comparing the impact of IBD&me on SDM vs a biologics fact sheet developed by the Crohn's & Colitis Foundation.

Methods: We enrolled patients with inflammatory bowel disease (IBD) being seen at a clinic within IBD Qorus-a multicenter adult IBD learning health system-between March 5, 2019, and May 14, 2021. Eligible patients included those with recent IBD-related symptoms who reported that they wanted to discuss biologics with their provider during their upcoming visit. Patients were randomized 1:1 using stratified block randomization and received an e-mail 1 week before their visit inviting them to review either IBD&me or a fact sheet. The primary outcome was patient perception of SDM as measured by the 9-Item SDM Questionnaire (0-100 scale; higher = better); the Student t test was used to compare outcomes between arms.

Results: Overall, 152 patients were randomized (biologics fact sheet 75, IBD&me 77); most patients had Crohn's disease (66.4%) and were biologic-experienced (82.9%). No differences were seen between groups regarding SDM (fact sheet 72.6 ± 25.6, IBD&me 75.0 ± 20.8; P = .57). Most patients stated they would be likely to recommend the fact sheet (79.6%) or IBD&me (84.9%; P = .48) to another patient with IBD.

Discussion: No differences in outcomes were seen between IBD&me and the biologics fact sheet in this comparative effectiveness study; patients reported high satisfaction with both resources. Further study, particularly among biologic naïve patients, is needed to determine the utility of interactive components to IBD decision aids.