Editorial: shared decision‐making intervention in patients with Crohnʼs disease—a personalised, patient‐centred approach

The shared decision- making (SDM) process highlights the impor-tance of clinicians and patients working together to make healthcare decisions that are consistent with patient preferences and values, with the aim of achieving the best outcomes from treatment options. 1 Previous studies have reported that most patients with inflammatory bowel disease (IBD) would like to be actively involved in the decision process, and wish for a close collaboration with their cli-nician. 2,3 The potential benefits of SDM for treatment selection may also include improved adherence to therapy and reduced healthcare resource utilisation and costs. 1,4 Zisman- Ilani and colleagues conducted the first multi- centre cluster randomised controlled trial comparing patients with Crohn's disease (CD) who used SDM (intervention group) to those receiving standard of care (control group). 5 A total of 158 patients, with no prior CD complications who were eligible to receive immunomodulators and/or biologics were enrolled. SDM included two web- based tools. These were PROSPECT (Personalised Risk and Outcome Prediction Tool) - a validated, interactive and predictive aid to stratify patients with a high versus low risk of developing CD complications, and a tool informing patients on benefits and risks of available therapies for CD. 6 The proportion of patients choosing a combination therapy (bi-ologic combined with an immunomodulator) was significantly higher in the intervention group than the control group (25% vs. 5%, respectively; p < 0.001). In addition, the intervention group had significantly less decisional conflict and greater trust in the provider's decisions about treatment than the control population ( p = 0.02 and p = 0.04, respectively). Although the study was not powered