Table 1 Questionnaire items 1–20. Results are represented as frequency (n) and percentage (%)
Parameter | N | % |
|---|---|---|
General | ||
Profession Gastroenterologist and/or internist Medical doctor/ Nurse Medical Laboratory technician Pharmacist | 114 71 34 53 28 | 38.0 23.7 11.3 17.7 9.3 |
Familiarity with FMT Yes, I have performed FMT No, I am not familiar but I heard of it No, I am not familiar nor heard of it | 13 287 0 | 4.3 95.7 0 |
Ethical issues | ||
What do you think of FMT?* A promising treatment modality for some diseases The efficacy and safety of FMT is very limited The current data is not sufficient to support the use of FMT I do not know/I am not quite sure | 18 147 88 19 | 6 39 29.3 6.3 |
If it is medically indicated and ethically approved, would you refer FMT to patient? Yes It depends (e.g. conventional treatment failure) No | 15 285 0 | 5 95 0 |
What is/are the reason/s for you to recommend FMT and which you will also inform patients?* Clinical efficacy Safety Failure of conventional treatment More “natural” and “organic” Avoidance of antibiotics Others | 27 57 145 89 19 81 | 9 19 48.3 29.7 6.3 27 |
What’s the reasons for you not to recommend FMT and which you will also inform patients? Unproven treatment and unknown mechanism Infections Long-term risk and safety unknown High expectation from patients puts pressure on physicians Not a standard treatment, easily cause medical litigation Others | 81 114 94 18 121 4 | 27 38 31.3 6 40.3 1.3 |
Is FMT overrated (efficacy exaggerated and risk downplayed)? Agree I do not agree I do not know | 62 126 112 | 20.7 42.0 37.3 |
Would you inform patients about possible risks? I would inform about all risks I would inform about actual physical risk It depends on the comprehensive ability of the patient | 132 55 113 | 44.0 18.3 37.7 |
Do you think FMT has negative effect on patient’s dignity? Agree Disagree I do not know | 129 75 96 | 43.0 25.0 32.0 |
What do you think is the optimal modality to deliver FMT? Lower Upper | 300 0 | 100 0 |
How to protect privacy/confidentiality?* Both donor and recipient are double-blind Donor should be anonymized Establish standardized fecal microbiota bank FMT patients should have private ward or room Ensure confidentiality of patient information during communication with others | 130 41 27 89 83 | 43.3 13.7 9 29.7 27.7 |
Cultural constrains (only for 100 participants) Religion Dietary intake Alcohol consumption | 52 25 23 | 52 25 23 |
Commercialization | ||
What do you think of DIY1 and DTC2 of FMT Worrying It is common in other areas No concerns | 55 244 1 | 18.3 81.3 0.3 |
Future application (e.g. skin care) Likely (with concerns) Unlikely Fictional | 48 252 0 | 16.0 84.0 0 |
Social and regulatory issues of FMT | ||
Do you think it is urgent to apply FMT? Yes urgent It should be suspended | 39 261 | 13.0 87.0 |
Charging standard for FMT? Yes, ASAP No need | 41 259 | 13.7 86.3 |
FMT as first-line for CDI? Yes No | 0 300 | 0 100 |
Barriers to FMT promotion?* Unknown mechanism The yuck factor and anesthetic challenges Stained doctor-patient relationship Lack of pharmaceutical investment No official guidelines and regulations | 101 141 23 25 121 | 33.7 13.7 7.7 8.3 40.3 |
Fecal microbiota bank | ||
Ethical aspect(s) concerns* Informed consent mode Privacy protection of personal information De-identification and anonymity of donors Ownership and property of samples Access regulation to data and sample Future use of specimen and re-contact | 143 113 2 103 57 54 | 47.7 37.7 0.7 34.3 19 18 |
Justice in allocation of benefits and burden Patients should receive benefits Patients should not I do not care | 117 26 157 | 39 47 52.3 |