IDDF2021-ABS-0062 A novel decision aid improves knowledge and quality of pregnancy-related decision-making in IBD

Abstract

<h3>Background</h3> Women with inflammatory bowel disease (IBD) with poor IBD-specific reproductive knowledge experience more voluntary childlessness. This is associated with medication fear, which must be addressed given active IBD during preconception correlates with worse intrapartum disease and poor fetal outcomes. The Pregnancy IBD Decision Aid (PIDA) is an online tool offering personalised decision support on fertility, pregnancy, and medications in IBD (IDDF2021-ABS-0062 Figure 1. Screenshot of the Pregnancy IBD Decision Aid tool ). This study aimed to assess PIDA’s impact on knowledge and quality of decision-making among preconception and pregnant IBD patients, and to evaluate its feasibility. <h3>Methods</h3> Preconception and pregnant patients (18-45yrs) from Canada and Australia completed questionnaires before and after viewing PIDA. Quality of decision-making and IBD-specific pregnancy knowledge were assessed using: l Decisional Conflict Scale (DCS) l Self-Efficacy Scale (SES) l Crohn’s and Colitis Pregnancy Knowledge Score (CCPKnow). Patients and clinicians completed feasibility surveys following PIDA review. Paired t-test assessed PIDA’s limited effectiveness. <h3>Results</h3> DCS and SES were completed by 42 Crohn’s disease and 32 ulcerative colitis patients (preconception: <i>n</i>=41; pregnant: <i>n</i>=33). DCS improved for preconception and pregnant patients post-PIDA (effect size 0.44, p&lt;0.0001). SES improved for preconception patients (effect size 0.32, p=0.0001), and in both cohorts CCPKnow also improved (n=76, effect size 0.66, p&lt;0.0001). Seventy-three patients assessed PIDA’s feasibility. PIDA’s length (m=3.05±0.44), readability (m=3.09±0.5) and content amount (m=2.91±0.81) were perceived as appropriate (1=limited, 5=excessive). Perceived usefulness was high among patients (m=4.09±0.93; 1=least useful, 5=most useful). Clinicians (n=14) believed PIDA had appropriate length (m=3.3±0.6), readability (m=3.3±0.8), and content amount (m=3.4±0.8), and deemed PIDA useful for patients (m=4.6±0.8) and themselves (m=4.8±0.8). <h3>Conclusions</h3> PIDA improved patient knowledge and quality of decision-making. Patients developed a strengthened belief in their ability to make informed decisions, and patients/clinicians found PIDA feasible. Therefore, PIDA may reduce voluntary childlessness.