Making Decisions about Dietary Therapy in Inflammatory Bowel Disease
Abstract
:1. Introduction
2. Dietary Therapy
3. Medical Therapy
4. Motivations to Choose Dietary Therapy
5. Fostering Informed Choice of Dietary Therapy
6. Patient Empowerment, Activation, and Preferences
7. Shared Decision-Making
8. Conclusions
Author Contributions
Funding
Conflicts of Interest
References
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IBD Subtype | Location of Study | Main Findings | Author, Year |
---|---|---|---|
n = 244, 72.5% CD, 27.5% UC | Lorraine, France | The majority of participants avoided a certain food and felt food plays an important role in their disease and chance of relapse | Zallot et al., 2013 [19] |
n = 400, 39% CD, 51% UC | Manchester, UK | The majority of participants associated certain foods as being triggers and would deny themselves a food to avoid a relapse | Limdi et al., 2016 [20] |
n = 446, 100% CD | New Zealand | There is great variation in what patients with CD consider a beneficial or detrimental food | Triggs et al., 2010 [63] |
n = 294, 50.3% CD, 49.7% UC | The Netherlands | The majority of participants considered food to play a larger role in disease management and outcome than medication | de Vries et al., 2019 [64] |
n= 256, 52% CD, 48% UC | Manitoba, Canada | The majority of participants did avoid certain foods and their dietary intake demonstrated deficiencies | Vagianos et al., 2016 [65] |
n = 42, 60% CD, 36% UC, 4% Indeterminate IBD | Germany | Nearly all participants felt restricted in their eating behavior and several felt unsupported by their doctors | Palant et al., 2015 [66] |
n = 4, 67% CD, 33% UC | Australia | The majority of participants consider diet important to their IBD; advice given to the patients about diet was diverse, inadequate, and poorly followed | Holt et al., 2016 [67] |
Type of Approach | Benefits | Available Tools | Unmet Needs |
---|---|---|---|
Patient Empowerment and Patient Activation | Increased control of life, group support, increased confidence, larger contribution to the decision-making process | Proven programs for a variety of chronic diseases | Patient empowerment or activation program specific to dietary therapy in IBD. Existing programs may be applied to IBD generally |
Preference Analysis | Determination of perceived values of risk and reward, enhancement of certainty of preferences based on analysis, detection of similarities or differences in patient and provider preferences | Multiple IBD preference analyses exist in various formats | Preference analysis tool specific to dietary therapy in IBD. Existing IBD preference analyses will guide decisions for dietary therapy |
Shared Decision-Making | Patient feels valued, improved transparency and fosters ongoing open communication, improved adherence and confidence in treatment | Well-developed guidance for process in IBD, multiple IBD decision aids in multiple formats | Decision aids for dietary therapy in IBD. SDM process in IBD should be applied, in part, to dietary therapy presently |
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Solomon, S.; Park, E.; Picoraro, J.A. Making Decisions about Dietary Therapy in Inflammatory Bowel Disease. Gastrointest. Disord. 2020, 2, 353-365. https://doi.org/10.3390/gidisord2040032
Solomon S, Park E, Picoraro JA. Making Decisions about Dietary Therapy in Inflammatory Bowel Disease. Gastrointestinal Disorders. 2020; 2(4):353-365. https://doi.org/10.3390/gidisord2040032
Chicago/Turabian StyleSolomon, Sydney, Eunie Park, and Joseph A. Picoraro. 2020. "Making Decisions about Dietary Therapy in Inflammatory Bowel Disease" Gastrointestinal Disorders 2, no. 4: 353-365. https://doi.org/10.3390/gidisord2040032