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A randomised controlled trial of a cognitive behavioural therapy based self-management intervention for irritable bowel syndrome (IBS) in primary care.

A randomised controlled trial of a cognitive behavioural therapy based self-management intervention for irritable bowel syndrome (IBS) in primary care.
A randomised controlled trial of a cognitive behavioural therapy based self-management intervention for irritable bowel syndrome (IBS) in primary care.
Background: recent guidelines for the treatment of irritable bowel syndrome (IBS) emphasize the need for research to facilitate home-based self-management for these patients in primary care. The aim of the current study was to test the efficacy of a manualized cognitive behavioural therapy (CBT)-based self-management programme for IBS in a pilot randomized controlled trial (RCT).
Method: sixty-four primary-care patients meeting Rome criteria for IBS were randomized into either self-management plus treatment as usual (TAU) (n=31) or a TAU control condition (n=33). The self-management condition included a structured 7-week manualized programme that was self-administered in conjunction with a 1-hour face-to-face therapy session and two 1-hour telephone sessions. The primary outcome measures were the Subject's Global Assessment (SGA) of Relief and the Irritable Bowel Syndrome Severity Scoring System (IBS-SSS) assessed at baseline, end of treatment (2 months), and 3 and 6 months post-treatment.
Results: analysis was by intention-to-treat. Twenty-three (76.7%) of the self-management group rated themselves as experiencing symptom relief across all three time periods compared to seven (21.2%) of the TAU controls [odds ratio (OR) 12.2, 95% confidence interval (CI) 3.72–40.1]. At 8 months, 25 (83%) of the self-management group showed a clinically significant change on the IBS-SSS compared to 16 (49%) of the control group (OR 5.3, 95% CI 1.64–17.26).
Conclusions: this study provides preliminary evidence that CBT-based self-management in the form of a structured manual and minimal therapist contact is an effective and acceptable form of treatment for primary-care IBS patients.
0033-2917
85-94
Moss-Morris, R.
a502f58a-d319-49a6-8aea-9dde4efc871e
Bogalo, L.
3e80f971-cf09-47dc-8d4f-1b5310215db4
Didsbury, L.P.
14a73655-dfc4-485a-864b-e39d1a29e20a
Spence, M.J.
de2e6faf-7257-4192-8a7f-6265070ab2e9
Moss-Morris, R.
a502f58a-d319-49a6-8aea-9dde4efc871e
Bogalo, L.
3e80f971-cf09-47dc-8d4f-1b5310215db4
Didsbury, L.P.
14a73655-dfc4-485a-864b-e39d1a29e20a
Spence, M.J.
de2e6faf-7257-4192-8a7f-6265070ab2e9

Moss-Morris, R., Bogalo, L., Didsbury, L.P. and Spence, M.J. (2010) A randomised controlled trial of a cognitive behavioural therapy based self-management intervention for irritable bowel syndrome (IBS) in primary care. Psychological Medicine, 40 (1), 85-94. (doi:10.1017/S0033291709990195).

Record type: Article

Abstract

Background: recent guidelines for the treatment of irritable bowel syndrome (IBS) emphasize the need for research to facilitate home-based self-management for these patients in primary care. The aim of the current study was to test the efficacy of a manualized cognitive behavioural therapy (CBT)-based self-management programme for IBS in a pilot randomized controlled trial (RCT).
Method: sixty-four primary-care patients meeting Rome criteria for IBS were randomized into either self-management plus treatment as usual (TAU) (n=31) or a TAU control condition (n=33). The self-management condition included a structured 7-week manualized programme that was self-administered in conjunction with a 1-hour face-to-face therapy session and two 1-hour telephone sessions. The primary outcome measures were the Subject's Global Assessment (SGA) of Relief and the Irritable Bowel Syndrome Severity Scoring System (IBS-SSS) assessed at baseline, end of treatment (2 months), and 3 and 6 months post-treatment.
Results: analysis was by intention-to-treat. Twenty-three (76.7%) of the self-management group rated themselves as experiencing symptom relief across all three time periods compared to seven (21.2%) of the TAU controls [odds ratio (OR) 12.2, 95% confidence interval (CI) 3.72–40.1]. At 8 months, 25 (83%) of the self-management group showed a clinically significant change on the IBS-SSS compared to 16 (49%) of the control group (OR 5.3, 95% CI 1.64–17.26).
Conclusions: this study provides preliminary evidence that CBT-based self-management in the form of a structured manual and minimal therapist contact is an effective and acceptable form of treatment for primary-care IBS patients.

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Published date: January 2010

Identifiers

Local EPrints ID: 66887
URI: http://eprints.soton.ac.uk/id/eprint/66887
ISSN: 0033-2917
PURE UUID: f2e93fcd-8a2a-449e-bba9-0239aacbd827

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Date deposited: 30 Jul 2009
Last modified: 13 Mar 2024 18:39

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Contributors

Author: R. Moss-Morris
Author: L. Bogalo
Author: L.P. Didsbury
Author: M.J. Spence

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