Irritable Bowel Syndrome Clinical Trial
Official title:
Structured Patient Education Versus Written Information for Patients With Irritable Bowel Syndrome
In this randomized controlled study in patients with irritable bowel syndrome (IBS) we plan to compare the effects of a structured patient group education (IBS school) with receiving only written information in the form of a IBS-guidebook. The effects of the interventions on GI and psychological symptom severity, knowledge and quality of life will be assessed with validated questionnaires at baseline and 3 and 6 months after the intervention.
In this randomized controlled study in patients with irritable bowel syndrome (IBS) we plan
to compare the effects of a structured patient group education (IBS school) with receiving
only written information in the form of a IBS-guidebook. We plan to include men and women 18
to 70 years old, with IBS according to the Rome II criteria, who are referred from
physicians in primary care and secondary/tertiary care to participate in the study. The
education will be held at the GI out patient clinic at Sahlgrenska University hospital in
Gothenburg. A nurse, specialized in GI functional disorders will conduct an interview with
each patient for about 30 minutes to collect additional information from the patients before
inclusion. The patients will be informed about the positive results obtained in previous
studies with both interventions, i.e. a structured patient education (IBS school) and a
self-help guidebook. Patients with an organic GI disease and/or with another disease
potentially affecting the GI symptoms were excluded. Likewise, patients with a severe
psychiatric disease were excluded due to potential problems to participate in a group
intervention. In order to allocate an equal number of patients to both of the interventions
during the study, a number of up to 20 patients will be interviewed in a block during one
week. After all these interviews the patients will be randomly divided into two groups with
an equal number of patients in each group. The groups will then be randomized 1:1 to either
start the IBS school within two to three weeks, or to receive the IBS Guidebook. The
patients in the guidebook group will be offered to participate in the IBS school six months
later, as part of the clinical routine at our unit (as requested by the ethics committee).
The effects of the interventions on GI and psychological symptom severity, knowledge and
quality of life will be assessed with validated questionnaires at baseline and 3 and 6
months after the intervention:
1. Perceived knowledge about IBS
2. IBS Severity Scoring System (IBS-SSS)
3. IBS Quality of Life (IBSQOL)
4. Visceral Sensitivity Index (VSI)
5. The Hospital Anxiety and Depression Scale (HAD)
The interventions:
IBS school The IBS school is designed based on the self-efficacy theory , and the general
theory of nursing. Moreover, the education is performed based on a biopsychosocial model
considered to be important in functional GI disorders. The IBS-school consists of six
sessions held once per week in a group setting with eight to ten patients in each group.
Five different health care professionals (nurse, gastroenterologist, dietician,
physiotherapist and psychologist) are involved in the education, in order to cover a wide
spectra of issues related to IBS. Each of the professionals will hold one session for two
hours where a lot of space is given for discussion in the group. This intervention has been
described in detail previously (Ringström et. al. Submitted).
IBS Guidebook The IBS Guidebook consists of two booklets, written for IBS patients by one of
the gastroenterologists in this study (MS). The booklets are detailed and cover the same
areas of issues related to IBS as are covered in the structured education, namely
pathophysiological mechanisms, GI and extra intestinal symptoms, the diagnostic workup,
treatment options, food related issues, psychological and lifestyle factors.
;
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Single Blind (Outcomes Assessor), Primary Purpose: Treatment
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