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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.

UNSTRUCTURED Background/Aims: Inflammatory bowel disease (IBD) patients are at increased risk of infections, bone fractures and skin cancers. We developed preventive health videos using a patient-centered approach, and tested their impact on preventive health uptake. Methods: Five animated videos explaining preventive health recommendations in IBD were iteratively developed with patient-centered focus groups and interviews. A randomized controlled trial was then conducted in an internet-based IBD cohort to test the impact of video vs. text-based educational interventions. The primary outcome was receipt of the influenza vaccine. Secondary outcomes included intent-to-receive other preventive health services. Results: Five animated videos were developed with patient input. A total of 1056 IBD patients were then randomized to receive the video (n=511) or text-only (n=545) interventions; 55% of the video group and 57% of the text-only group had received influenza vaccination in the prior year. Immediately following the intervention, 73% reported intent-to-receive vaccination, with no difference by type of intervention. The proportion of patients who actually received influenza vaccination following the intervention also did not differ by messaging type (p=0.07). The strongest predictor of both intent-to-receive and actual receipt of influenza vaccination was prior influenza vaccination. Older age was also associated with a higher likelihood of intent-to-receive (age 36-75 relative to 18-35 years; p=0.006) as well as actual receipt (age >75 relative to age 18-35 years; p=0.05) of the influenza vaccine. Conclusions: The proportion of patients receiving influenza vaccine was high in both groups, but there was no difference in receipt of, or in intention-to-receive preventive health recommendations by type of messaging. Notably, a portion of patients in both groups had intended to be vaccinated but did not ultimately receive vaccination. Further evaluation of patient-education strategies is warranted to improve preventive health uptake among patients with IBD.

Background Multiple biologics are available to treat inflammatory bowel disease (IBD), which can either be administered subcutaneously (SC) or intravenously (IV). The factors that determine patients’ preferences for SC/IV administration in IBD are largely unknown. This study aims to elucidate how IBD patients trade-off between medications’ route of administration and other medication characteristics, and to understand what drives patients’ preferences. Methods We employed a mixed methods design using data from a prior quantitative conjoint analysis survey and a series of 22 qualitative interviews. We quantitatively assessed individual patients’ preferences for SC or IV medications based on the part-worth utilities derived from the conjoint analysis and identified predictors for these preferences. We used a qualitative analysis to identify key themes surrounding patients’ preferences in the interview data. Results Of 1,077 survey participants, 49% preferred an SC medication every 2 weeks, whereas 51% preferred an IV medication every 8 weeks. More people preferred SC at reduced administration frequencies, whereas less people preferred SC at the expense of lower efficacy or higher side-effects rates. Prior experience with SC/IV was the strongest predictor for patients’ preferences. Qualitatively, we obtained in-depth insights in the perceived advantages and disadvantages of SC and IV medications and in patients’ preconceived ideas. Conclusion While prior SC/IV exposure was a strong predictor for SC/IV preferences, patients’ preferences largely are determined by a variety of other personal factors. The themes we identified could help guide clinicians when discussing therapeutic options with their patients and support shared decision making.

In 2021, the US Preventive Services Task Force lowered the colorectal cancer (CRC) screening age to 45 years. We used conjoint analysis, a method that assesses complex decision making, to update our understanding on people's CRC screening test preferences in the context of new guidelines.We conducted a conjoint analysis survey among unscreened individuals ≥40 years at average risk for CRC to determine the relative importance of screening test attributes in their decision making (eg, modality, effectiveness at reducing CRC risk, bowel prep). We also performed simulations to estimate the proportion of people who would prefer each US Multi-Society Task Force (MSTF) on CRC-recommended test. The analyses were stratified among those aged 40-49 years (newly or soon-to-be eligible for screening) and ≥50 years (have been eligible).Overall, 1000 participants completed the conjoint analysis (40-49 years, n = 456; ≥50 years, n = 544). When considering all 5 US MSTF-recommended tests, there were differences in test preferences between age groups (P = .019), and the most preferred test was a fecal immunochemical test (FIT)-fecal DNA every 3 years: 40-49 years, 34.6%; ≥50 years, 37.3%. When considering only the US MSTF tier 1 tests, most 40- to 49- (68.9%) and ≥50-year-olds (77.4%; P = .004) preferred an annual FIT over a colonoscopy every 10 years.Our findings suggest that more than one-third of people may want to do a FIT-fecal DNA every 3 years for their CRC screening. When only considering US MSTF tier 1 tests, three-fourths of people may prefer an annual FIT over colonoscopy. Further research examining CRC screening test preferences among broader populations is warranted to inform and enhance screening programs.