Perceptions of fecal microbiota transplantation for Clostridium difficile infection

Factors that predict acceptance

Leslie Park, Anjali Mone, Jennifer C. Price, Demetrios Tzimas, Jacqueline Hirsh, Michael A. Poles, Lisa Malter, Lea Chen

Research output: Contribution to journalArticle

Abstract

Background Despite the effectiveness of fecal microbiota transplantation (FMT) for treating recurrent Clostridium difficile (C. difficile) infection, some patients are reluctant to accept this therapy. Our study examined attitudes towards FMT and factors that contribute to patients’ acceptance of this treatment. Methods We distributed patient surveys at a Veterans Affairs hospital, a public hospital, and an academic faculty practice. Multivariable logistic regression was performed, adjusting for factors associated with FMT acceptance on univariate analysis and prior experience with C. difficile infection. Results Of 267 patients, only 12% knew of FMT prior to the survey, but 77% would undergo the procedure if medically indicated. On multivariable analysis, those with children and with college degrees or higher were more likely to agree to FMT (odds ratio [OR] 2.11, 95% confidence interval [CI] 1.02-4.35; OR 2.27, 95% CI 1.11-4.60 respectively). Sixty-five respondents (71%) chose colonoscopy as the preferred vehicle for FMT, while nasogastric tube was least preferred. Disease transmission was the most common concern (30%, n=242), and FMT success rate was the least selected concern (9.1%). Conclusions Most patients in a diverse sample of gastroenterology clinics had no prior knowledge of FMT, but were receptive to the procedure. Having children and higher education levels were predictors for FMT acceptance. Our findings suggest that barriers to FMT utilization may be overcome with counseling about safety concerns. More data on the risk of transmitting diseases or clinical characteristics, such as obesity, through FMT are needed and will be important for the acceptance of this procedure.

Original languageEnglish (US)
Pages (from-to)83-88
Number of pages6
JournalAnnals of Gastroenterology
Volume30
Issue number1
DOIs
StatePublished - 2017
Externally publishedYes

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Clostridium Infections
Clostridium difficile
Fecal Microbiota Transplantation
Odds Ratio
Confidence Intervals
Veterans Hospitals
Public Hospitals
Gastroenterology
Colonoscopy
Counseling
Obesity
Logistic Models

Keywords

  • Clostridium difficile
  • Fecal microbiota transplantation
  • Fecal transplant
  • FMT
  • Patient perceptions

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Perceptions of fecal microbiota transplantation for Clostridium difficile infection : Factors that predict acceptance. / Park, Leslie; Mone, Anjali; Price, Jennifer C.; Tzimas, Demetrios; Hirsh, Jacqueline; Poles, Michael A.; Malter, Lisa; Chen, Lea.

In: Annals of Gastroenterology, Vol. 30, No. 1, 2017, p. 83-88.

Research output: Contribution to journalArticle

Park, Leslie ; Mone, Anjali ; Price, Jennifer C. ; Tzimas, Demetrios ; Hirsh, Jacqueline ; Poles, Michael A. ; Malter, Lisa ; Chen, Lea. / Perceptions of fecal microbiota transplantation for Clostridium difficile infection : Factors that predict acceptance. In: Annals of Gastroenterology. 2017 ; Vol. 30, No. 1. pp. 83-88.
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abstract = "Background Despite the effectiveness of fecal microbiota transplantation (FMT) for treating recurrent Clostridium difficile (C. difficile) infection, some patients are reluctant to accept this therapy. Our study examined attitudes towards FMT and factors that contribute to patients’ acceptance of this treatment. Methods We distributed patient surveys at a Veterans Affairs hospital, a public hospital, and an academic faculty practice. Multivariable logistic regression was performed, adjusting for factors associated with FMT acceptance on univariate analysis and prior experience with C. difficile infection. Results Of 267 patients, only 12{\%} knew of FMT prior to the survey, but 77{\%} would undergo the procedure if medically indicated. On multivariable analysis, those with children and with college degrees or higher were more likely to agree to FMT (odds ratio [OR] 2.11, 95{\%} confidence interval [CI] 1.02-4.35; OR 2.27, 95{\%} CI 1.11-4.60 respectively). Sixty-five respondents (71{\%}) chose colonoscopy as the preferred vehicle for FMT, while nasogastric tube was least preferred. Disease transmission was the most common concern (30{\%}, n=242), and FMT success rate was the least selected concern (9.1{\%}). Conclusions Most patients in a diverse sample of gastroenterology clinics had no prior knowledge of FMT, but were receptive to the procedure. Having children and higher education levels were predictors for FMT acceptance. Our findings suggest that barriers to FMT utilization may be overcome with counseling about safety concerns. More data on the risk of transmitting diseases or clinical characteristics, such as obesity, through FMT are needed and will be important for the acceptance of this procedure.",
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