Medication risk-taking behavior in functional dyspepsia patients

Objectives: No medication is approved for the treatment of functional dyspepsia (FD). The risks that patients would be willing to take to cure their FD symptoms are unknown. Methods: FD patients (Rome III criteria) were mailed a questionnaire that assessed demographics, medication use, and prior medication adverse events. Scales to measure FD severity, quality of life, anxiety, depression, impulsiveness, and risk-taking behavior were included. A standard gamble (SG) evaluated willingness to take risks associated with a theoretical FD medication. Data were analyzed using simple descriptive statistics. Results: One hundred and fourteen responses were analyzed (54.5% response rate). The mean age of the patients was 49.2 years; 84% were women and 96% were white. The mean duration of symptoms was 8.2 years (range 1-38 years). The most bothersome symptom was upper abdominal discomfort (25%), followed by upper abdominal pain (22%) and bloating (15%). Forty percent of respondents rated their FD symptoms as moderate and 31% as mild. Forty-six percent reported a side effect from a prescription medication used to treat FD. When asked about a hypothetical medication that could cure their FD symptoms, 49% of respondents reported that they would accept a mean 12.7% risk of sudden death for a 99% chance of cure. Conclusions: This prospective study suggests that FD patients are surprisingly willing to take significant risks with a hypothetical medication to cure their symptoms. To counsel patients effectively and assist in the development of informed, preference-based decisions regarding medication therapy, physicians need to elicit and understand FD patients' risk adversity.