Biologic therapy continues to be underutilized despite its efficacy and overall favorable side effect profile when compared with corticosteroids. Siegel et al found in a well-done, cross-sectional study that patients perceived that corticosteroids were more beneficial, more familiar, and less dreadful than biologics despite perceiving that corticosteroids are more risky. They also found that perception of risk may be influenced by a patient's personality trait. Patients who believe that their health is influenced by their own choices or behaviors perceived biologic therapy less scary compared with patients who believed their health is influenced by chance. Physicians and patients disagree about how much medication-related risk is tolerable for improvements on efficacy. However, they are both willing to accept risks for therapies that offer significant therapeutic benefit. Physicians are tasked to translate complex evidenced-based data accurately and should take into account a patient's personality trait in order to provide individualized care and help guide shared decision-making. Future research should assess physician's personality traits, treatment experiences, and perception of risks, benefits, and dread of IBD medications and how it influences shared-decision making.
Keywords: biologics; corticosteroids; personality trait; shared decision-making.
Published by Oxford University Press on behalf of Crohn’s & Colitis Foundation 2019.