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Shared decision making in inflammatory bowel disease: helping patients understand the tradeoffs between treatment options
  1. Corey A Siegel
  1. Correspondence to Dr Corey A Siegel, Inflammatory Bowel Disease Center, Section of Gastroenterology and Hepatology, Dartmouth-Hitchcock Medical Center, Lebanon, NH 03756, USA; corey.a.siegel{at}


The treatment of inflammatory bowel disease is becoming more complicated with new medications and new treatment paradigms. Although data are accumulating that the earlier use of immunomodulators and anti-tumor necrosis factor agents are more effective than the standard “step-up” pyramidal treatment algorithm, patients may not be comfortable with this more intensive therapeutic approach. The process of shared decision making engages patients in treatment decisions to optimize the chance that a chosen therapy matches their personal preferences for care. Decision aids are standard shared decision making tools, which are used to present evidence-based data in a patient-friendly manner to help patients with preference- sensitive decisions. Not all care decisions are preference-sensitive, and not all patients are interested in being part of a shared medical decision. The responsibility of the provider is to identify how much of a role patients want, and then determine which decisions need their input to provide the best patient-centered care. The overall goal is to involve patients in decisions so that they are educated about their options, confident in the plan, adherent to chosen therapy and ultimately have a better quality of life.

  • Crohn's
  • ulcerative colitis
  • shared decision making
  • patient preferences

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  • Dartmouth-Hitchcock Medical Center and Cedars-Sinai Medical Center have a US patent pending on intellectual property related to the Crohn's disease Risk Prediction Outcome Tool, filed on March 24, 2010, as Docket No. 076/0008. Inventors are CA Siegel, LS Siegel and MC Dubinsky.

  • Funding CAS is supported by a Crohn's and Colitis Foundation of America career development award and by grant number K23DK078678 from the National Institute of Diabetes, Digestive and Kidney Diseases. CAS serves as a consultant to Abbott Laboratories, Centocor, Elan, Prometheus Labs and UCB.

  • Competing interests None.

  • Provenance and peer review Commissioned; externally peer reviewed.