Korean J Intern Med.  2024 Sep;39(5):783-792. 10.3904/kjim.2024.053.

Perception of fecal microbiota transplantation in patients with ulcerative colitis in Korea: a KASID multicenter study

• Park J
• Hong SN
• Lee HS
• Shin J
• Oh EH
• Nam K
• Seong G
• Kim HG
• Kim JO
• Jeon SR
• The Small Intestine Research Group and the Microbiome Research Group of the Korean Association for the Study of Intestinal Diseases (KASID)

• KMID: 2558769
• DOI: http://doi.org/10.3904/kjim.2024.053

Abstract

Background/Aims
Fecal microbiota transplantation (FMT) is a promising therapy for inducing and maintaining remission in patients with ulcerative colitis (UC). However, FMT has not been approved for UC treatment in Korea. Our study aimed to investigate patient perceptions of FMT under the national medical policy.
Methods
This was a prospective, multicenter study. Patients with UC ≥ 19 years of age were included. Patients were surveyed using 22 questions on FMT. Changes in perceptions of FMT before and after education were also compared.
Results
A total of 210 patients with UC were enrolled. We found that 51.4% of the patients were unaware that FMT was an alternative treatment option for UC. After reading the educational materials on FMT, more patients were willing to undergo this procedure (27.1% vs. 46.7%; p < 0.001). The preferred fecal donor was the one recommended by a physician (41.0%), and the preferred transplantation method was the oral capsule (30.4%). A large proportion of patients (50.0%) reported that the national medical policy influenced their choice of FMT treatment. When patients felt severe disease activity, their willingness to undergo FMT increased (92.3% vs. 43.1%; p = 0.001).
Conclusions
Education can increase preference for FMT in patients with UC. When patients have severe disease symptoms or their quality of life decreases their willingness to undergo FMT increases. Moreover, national medical policies may influence patient choices regarding FMT.

Keyword

Ulcerative colitis; Fecal microbiota transplantation; Education; National medical policy; Severity