A novel decision aid improves quality of reproductive decision-making and pregnancy knowledge for women with inflammatory bowel disease

Grace Wang, Neda Karimi, Laura Willmann, Joseph Pipicella, Joseph Descallar, Katie O’Connor, Luiza Peculis, Yvette Leung, Susan Connor, Vivian Huang, Astrid Jane Williams*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

13 Citations (Scopus)

Abstract

Background: Women with inflammatory bowel disease (IBD) with poor IBD-specific reproductive knowledge experience more childlessness and fear of IBD medications in pregnancy. The Pregnancy in IBD Decision Aid (PIDA), developed by an international multidisciplinary team, offers personalized online decision support regarding pregnancy in IBD.
Aims Assess the impact of PIDA on quality of reproductive decision-making and pregnancy-related knowledge among preconception (PC) and pregnant patients with IBD, and evaluate acceptability to patients and clinicians.
Methods: PC and pregnant patients with IBD aged 18–45 completed questionnaires pre- and post-PIDA to assess quality of decision-making (Decisional Conflict Scale (DCS); Decision Self-Efficacy Scale (DSES) and IBD-in-pregnancy knowledge (Crohn's and Colitis Pregnancy Knowledge Score (CCPKnow)). Paired t test assessed for differences pre- and post-PIDA.
Patients and clinicians completed acceptability surveys.
Results: DCS and DSES were completed by 74 patients (42 Crohn’s disease, 32 ulcerative colitis); 41 PC and 33 pregnant.
DCS improved significantly post-PIDA in PC patients regarding pregnancy planning (t(40)=4.83, p<0.0001, Cohen’s dz=0.75) and in pregnant patients regarding medication management (t(32)=2.37, p=0.0242, dz=0.41). DSES for PC patients improved significantly post-PIDA (t(40)=-3.56, p=0.001, dz=-0.56). CCPKnow improved significantly post-PIDA in PC (t(42)=4.93, p<0.0001, dz=-0.75) and pregnant patients (t(32)=5.1, p<0.0001, dz=-0.89). PIDA was deemed
optimal for length, readability, and content amount and considered highly useful by patients (n=73) and clinicians (n=14).
Conclusions: Patients using PIDA developed an improved quality of reproductive decision-making and IBD-in-pregnancy knowledge. PIDA is an accessible tool that can empower women with IBD to make values-congruent, evidence-based decisions regarding pregnancy and may reduce voluntary childlessness
Original languageEnglish
Pages (from-to)4303–4314
Number of pages12
JournalDigestive Diseases and Sciences
Volume67
Issue number9
DOIs
Publication statusPublished - 30 Apr 2022
Externally publishedYes

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