Observational Study of Perspectives of Inflammatory Bowel Disease Patients Concerning the Use of Corticosteroids

Abstract

Aim: We aimed to investigate the factors that make inflammatory bowel disease (IBD) patients more or less likely to be willing to take corticosteroids. Methods: Respondents completed a questionnaire. The primary outcome was whether the respondents would or would not use corticosteroids again to treat their IBD. Three separate univariate and multivariate analyses were performed to examine which variables predicted willingness to take steroids, including specific side effects. Results: Four hundred fifty three respondents (321 with Crohn's disease, 115 with ulcerative colitis; mean age 40 years, 297 [66%] female) completed the questionnaire. Corticosteroid efficacy (OR 6.83, 95% CI 3.67-12.7), lack of previous negative side effects (OR 0.11, 95% CI 0.04-0.32), and positive side effects (OR 2.96, 95% CI 1.63-5.40) were associated with a willingness to use corticosteroids in the future. In multivariate analysis, weight gain (OR 0.53, 95% CI 0.29-0.98) and hallucinations (OR 0.28, CI 0.09-0.89) were associated with an unwillingness to use corticosteroids again, whereas increased energy (OR 2.30, 95% CI 1.20-4.42) was the only significant positive side effect in a multivariate model. Conclusions: Past experiences with corticosteroids influence whether patients will take corticosteroids again. Clinicians should enquire about side effects and positive psychological symptoms associated with corticosteroid use.