LAUSR

We read with great interest the article by Palatka et al. [1] showing that hybrid imaging such as PET/CT holds promise for grading inflammation in Crohn’s disease (CD). Inflammatory bowel diseases (IBD) are chronic, disabling and incurable conditions [2]. Nowadays, only 1 in 3 IBD patients respond positively to existing treatment. Before implementing personalised medicine in clinical practice it is essential to have a clear understanding of patients’ preferences and level of adherence to such an approach [3,4]. However, there is currently no data available on IBD patients’ views on personalised medicine. We conducted a patient survey in October and November 2018 at the Nancy University Hospital using 4 focus groups and 12 IBD patients in total (10 with CD and 2 with ulcerative colitis; average age 1⁄4 39.3 years) from the outpatient clinic in order to identify areas of concern and interest as regards personalised medicine in IBD. Based on a literature review and expert interviews [4,5], a questionnaire was designed and carried out amongst all 12 patients. It was composed of open-ended questions (Table 1). Saturation was reached by the fourth focus group. A qualitative analysis of transcripts was performed. Verbatim analyses revealed that none of the patients had heard about personalised medicine although all participants were attracted by the concept. The most commonly identified advantages of personalised medicine were a psychological benefit due to the potential of receiving the most effective treatment and of decreasing chronic pain thus improving quality of life. The only disadvantage quoted was the potential burden of additional medical tests. However, all said they would undergo as many tests as needed (even in nuclear medicine) to find the most appropriate treatment. In general, participants wanted to receive both pre and post-investigation information from their gastroenterologist which included: the purpose, usefulness and safety of each test, the interpretation of results and the implication of the results both for themselves and their treatment. Patients said they would like to be more involved in decision-making regarding their treatment. These results show that patients are attracted by the concept of personalised medicine as they believe it would improve disease monitoring and decrease both psychological distress and chronic pain. These findings will support the design of patient-centred models of personalised medicine and improvements to IBD patient management. Patient education and patient gastroenterologist communication should be central to future models of IBD care.