- Fecal Incontinence
|Willingness to accept risk with medication in return for cure of symptoms among patients with Rome IV irritable bowel syndrome
Aliment Pharmacol Ther. 2022 Feb 15. doi: 10.1111/apt.16816. Online ahead of print.
Vivek C Goodoory 1 2, Cho Ee Ng 3, Christopher J Black 1 2, Alexander C Ford 1 2
1Leeds Institute of Medical Research at St. James's, University of Leeds, Leeds, UK.
2Leeds Gastroenterology Institute, St. James's University Hospital, Leeds, UK.
3County Durham and Darlington NHS Foundation Trust, Durham, UK.
Background: Some drugs for irritable bowel syndrome (IBS) have serious side effects.
Aims: To examine the willingness of individuals with IBS to accept risks with medication in return for symptom cure.
Methods: We collected demographic, gastrointestinal symptoms, psychological health, quality of life and impact on work and daily activities data from 752 adults with Rome IV-defined IBS. We examined median willingness to accept death in return for cure with a hypothetical medication using a standard gamble, according to these variables.
Results: Participants would accept a median 2.0% (IQR 0.0%-9.0%) risk of death in return for a 98.0% (IQR 91.0%-100.0%) chance of permanent symptom cure. The median accepted risk of death was higher in men (5.0% vs 2.0%, P < 0.001), those with continuous abdominal pain (4.0% vs 1.0%, P < 0.001), more severe symptoms (P = 0.005 for trend), abnormal depression scores (P < 0.001 for trend), higher gastrointestinal symptom-specific anxiety (P < 0.001 for trend), and lower IBS-related quality of life (P < 0.001 for trend). Those willing to accept above median risk of death were more likely to be male (17.1% vs 9.1%, P < 0.001), take higher levels of risks in their daily life (P = 0.008 for trend), and report continuous abdominal pain (53.1% vs 39.4%, P < 0.001), and had higher depression (P = 0.004 for trend) and lower quality of life (P < 0.001 for trend) scores.
Conclusion: Patients are willing to accept significant risks in return for cure of their IBS symptoms.