Pharmacist-Led Shared Decision-Making in a Pediatric Patient with Crohn’s Disease and Growth Failure: A Case Report

Inflammatory bowel disease (IBD) is an illness of unknown etiology, leading to chronic intestinal inflammation. It is characterized by repeated periods of remission and relapse. In the current treatment of IBD, multiple therapeutic drugs are listed in the Japanese treatment guidelines. Therefore, selecting a drug that matches the patient's condition and lifestyle is important, and the treatment decisions should be made using shared decision-making (SDM). For children, there is no specific age at which decision-making becomes possible. Therefore, medical professionals must make appropriate assessments regarding their decision-making ability. Although SDM has been shown to be useful in adults, there are no reports of SDM use in children. In this case report, a pharmacist performed multiple SDM for a 15-year-old patient with Crohn's disease. The SDM process reflected the child's changing values, leading to the introduction and continuation of biologic agents, and addressing growth disorders after the disease activity was controlled. To our knowledge, this is the first reported case in which a pharmacist performed SDM based on the condition of a pediatric patient with IBD, effectively implemented treat-to-target strategies, and improved the growth disorder. This case demonstrates the importance of properly controlling disease activity in pediatric patients with IBD and highlights the important role of pharmacists in adjusting drug therapy to suit a child's condition.