Objective: Shared decision making (SDM) is a strategy to facilitate patient-centered care and is increasingly important in inflammatory bowel disease (IBD). This study aimed to explore the experiences, needs, and barriers of patients and health care professionals (HCPs) with respect to SDM in IBD in Belgium.
Methods: In this qualitative study, semi-structured interviews were held with IBD patients (n=15), IBD nurses (n=12), and gastroenterologists (n=11) in Belgium. The interviews were transcribed and analyzed using the thematic framework analysis.
Results: While the importance of SDM in IBD treatment was recognized by most participants, some were either unaware of the concept of SDM or had misconceptions about it. Although gastroenterologists and IBD nurses were familiar with this concept, they had difficulties in providing a definition that was consistent with the respective literature. Patients expressed their desire to be actively involved in the decision-making process, but to varying degrees and in different ways. Most patients mentioned that SDM could be advantageous in substantiating a better patient-doctor relationship. Patients highlighted the importance of having clinicians that listen to them and involve them in each decision-making process. These were important elements to consider which help the development of a strong and trustworthy relationship between patients and their treating physician. Almost all gastroenterologists agreed that implementing SDM in clinical practice could help to inform patients concerning their therapy options and therefore increase their therapy compliance. Furthermore, the study found several barriers for implementing SDM at different levels in clinical practice. Participants acknowledged that some patients may face challenges participating in SDM. These challenges can include cognitive impairment, language barriers, and fear of disagreeing with their gastroenterologist. At the implementation level, barriers include time constraints. The need for quick decisions was seen as a barrier at the decision-making level for gastroenterologists. Furthermore, insufficient patient-centered information, lack of knowledge and skills, and low conviction about SDM effectiveness were identified as barriers at the innovation level. However, participants reported the importance of IBD nurses. They could play a pivotal role in resolving some of the existing barriers, as they are an accessible point of contact for patients who can provide emotional, informational, and decision support.
Conclusion: Even though participants recognize the importance of SDM in managing IBD, it is not yet systematically applied in routine clinical practice. The majority of patients expressed a desire to actively participate in the decision-making process but emphasized the need for clear communication and collaborative involvement. The study underlines that SDM can play a critical role in enhancing patient outcomes and aims to encourage clinicians to engage patients in decision-making. Considering this, gastroenterologists should adopt a patient-centric approach, incorporating SDM that considers the distinct needs and obstacles faced by each patient. Enhancing overall communication between patients and gastroenterologists, creating tools like Patient Decision Aids (PtDAs), and establishing conducive environments for SDM conversations can facilitate the implementation of SDM. Moreover, it's crucial to recognize and support IBD nurses as accessible points of contact for patients. Currently, there are various barriers hindering the integration of SDM in IBD care. This qualitative study underlines the necessity for more education and training on SDM specifically for gastroenterologists in Belgium. Additionally, patient organizations can significantly contribute to raising awareness about SDM among patients and promoting patient empowerment. Finally, the findings of this study may also inform multistakeholder interventions to implement SDM in IBD.

**Objective:** Shared decision making (SDM) is a strategy to facilitate patient-centered care and is increasingly important in inflammatory bowel disease (IBD). This study aimed to explore the experiences, needs, and barriers of patients and health care professionals (HCPs) with respect to SDM in IBD in Belgium.
**Methods:** In this qualitative study**,** semi-structured interviews were held with IBD patients (n=15), IBD nurses (n=12), and gastroenterologists (n=11) in Belgium. The interviews were transcribed and analyzed using the thematic framework analysis.
**Results:** While the importance of SDM in IBD treatment was recognized by most participants, some were either unaware of the concept of SDM or had misconceptions about it. Although gastroenterologists and IBD nurses were familiar with this concept, they had difficulties in providing a definition that was consistent with the respective literature. Patients expressed their desire to be actively involved in the decision-making process, but to varying degrees and in different ways. Most patients mentioned that SDM could be advantageous in substantiating a better patient-doctor relationship. Patients highlighted the importance of having clinicians that listen to them and involve them in each decision-making process. These were important elements to consider which help the development of a strong and trustworthy relationship between patients and their treating physician. Almost all gastroenterologists agreed that implementing SDM in clinical practice could help to inform patients concerning their therapy options and therefore increase their therapy compliance. Furthermore, the study found several barriers for implementing SDM at different levels in clinical practice. Participants acknowledged that some patients may face challenges participating in SDM. These challenges can include cognitive impairment, language barriers, and fear of disagreeing with their gastroenterologist. At the implementation level, barriers include time constraints. The need for quick decisions was seen as a barrier at the decision-making level for gastroenterologists. Furthermore, insufficient patient-centered information, lack of knowledge and skills, and low conviction about SDM effectiveness were identified as barriers at the innovation level. However, participants reported the importance of IBD nurses. They could play a pivotal role in resolving some of the existing barriers, as they are an accessible point of contact for patients who can provide emotional, informational, and decision support.
**Conclusion:** Even though participants recognize the importance of SDM in managing IBD, it is not yet systematically applied in routine clinical practice. The majority of patients expressed a desire to actively participate in the decision-making process but emphasized the need for clear communication and collaborative involvement. The study underlines that SDM can play a critical role in enhancing patient outcomes and aims to encourage clinicians to engage patients in decision-making. Considering this, gastroenterologists should adopt a patient-centric approach, incorporating SDM that considers the distinct needs and obstacles faced by each patient. Enhancing overall communication between patients and gastroenterologists, creating tools like Patient Decision Aids (PtDAs), and establishing conducive environments for SDM conversations can facilitate the implementation of SDM. Moreover, it's crucial to recognize and support IBD nurses as accessible points of contact for patients. Currently, there are various barriers hindering the integration of SDM in IBD care. This qualitative study underlines the necessity for more education and training on SDM specifically for gastroenterologists in Belgium. Additionally, patient organizations can significantly contribute to raising awareness about SDM among patients and promoting patient empowerment. Finally, the findings of this study may also inform multistakeholder interventions to implement SDM in IBD.

Shared Decision Making in Inflammatory Bowel Disease: Experiences and Opportunities of Patients and Health Care Professionals

DIA Europe 2024 will focus on sustainability, innovation and collaboration – three key pillars for shaping the future of healthcare. From the environmental impact of pharmaceuticals and of the drug development lifecycle to sustainable partnerships and sustainable healthcare systems, DIA Europe 2024 will be the prime opportunity to discuss how collaboration and innovation can support sustainability in healthcare and each stakeholder’s role in making it happen.

Join us in the vibrant city of Brussels for an unforgettable experience, where the power of collaboration will be on full display to inspire actionable outcomes and mobilise for solutions the life sciences’ community. Witness first-hand the profound impact of united efforts, gain valuable insights from across the drug development lifecycle, and play an active role in shaping the future of the pharmaceutical arena.

DIA Europe 2024

A global, member-driven non-profit organization mobilizing life sciences and healthcare. DIA fosters innovation to improve health and well-being worldwide. Professionals from 80 countries continue to engage with DIA through our unparalleled membership network, educational offerings, and professional development opportunities.