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Gastroparesis Patients' Willingness to Take Risks With Medications


Navas, Christopher M. MD1; Lacy, Brian E. MD, PhD, FACG1; Crowell, Michael D. PhD, MACG, AGAF2

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American Journal of Gastroenterology: October 2017 - Volume 112 - Issue - p S677
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Introduction: Treating gastroparesis (GP) can be difficult as there is only one FDA approved medication for the treatment of GP and it is associated with side effects in a substantial portion of patients. The willingness of patients to take risks associated with medications to treat GP is unknown. Aims: To evaluate patients with documented GP and assess their willingness to take risks associated with medications used to treat GP.

Methods: A questionnaire was developed, revised after a focus group with GP patients, and mailed to patients previously identified as having documented gastroparesis (those with symptoms consistent with GP, a normal EGD, and a delayed 4 hour gastric emptying scan). The survey included questions on demographics, symptoms, and medication use, in addition to validated questionnaires assessing anxiety and depression (HAD) and impulsivity. It contained a standard gamble to evaluate respondents' willingness to take medication risks.

Results: Questionnaires were sent to 207 GP patients, 91 were returned (44%) and evaluated. 76% were female; the mean age was 49 years. 40% were diabetic. Patients reported an average of 10.5 years of GP symptoms. 51% of patients self-reported their GP symptoms as severe while 33% described symptoms as moderate. GP patients reported that they would accept a median 10% risk of sudden death for a 90% chance to cure their symptoms using a hypothetical medication. Patients with self-reported severe GP symptoms were found to have a significantly increased willingness to take risks associated with medications used to treat GP. Of note, only 2% of patients reported that they routinely take risks in daily life. Patient anxiety as assessed by HADS was found to have a significant negative correlation with willingness to take GP medication associated risks.

Conclusion: GP patients are willing to tolerate relatively high risks associated with a hypothetical medication to cure their symptoms. Patients with severe GP symptoms were more willing to take these medication risks. Patient anxiety was associated with a decreased willingness to accept medication risks. To our knowledge, this is the first study quantifying GP patients' willingness to accept medication associated risk. These results provide information that may help clinicians guide their patients through the complex maze of gastroparesis therapies, and their associated risks.

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