دورية أكاديمية
Therapist telephone-delivered CBT and web-based CBT compared with treatment as usual in refractory irritable bowel syndrome: the ACTIB three-arm RCT
| العنوان: | Therapist telephone-delivered CBT and web-based CBT compared with treatment as usual in refractory irritable bowel syndrome: the ACTIB three-arm RCT |
|---|---|
| المؤلفون: | Hazel Everitt, Sabine Landau, Paul Little, Felicity L Bishop, Gillian O’Reilly, Alice Sibelli, Rachel Holland, Stephanie Hughes, Sula Windgassen, Paul McCrone, Kim Goldsmith, Nicholas Coleman, Robert Logan, Trudie Chalder, Rona Moss-Morris |
| المصدر: | Health Technology Assessment, Vol 23, Iss 17 (2019) |
| بيانات النشر: | NIHR Journals Library, 2019. |
| سنة النشر: | 2019 |
| المجموعة: | LCC:Medical technology |
| مصطلحات موضوعية: | IRRITABLE BOWEL SYNDROME, COGNITIVE–BEHAVIOURAL THERAPY, DIGITAL INTERVENTION, SELF-MANAGEMENT, RANDOMISED CONTROLLED TRIAL, Medical technology, R855-855.5 |
| الوصف: | Background: Irritable bowel syndrome (IBS) affects 10–22% of people in the UK. Abdominal pain, bloating and altered bowel habits affect quality of life and can lead to time off work. Current treatment relies on a positive diagnosis, reassurance, lifestyle advice and drug therapies, but many people suffer ongoing symptoms. Cognitive–behavioural therapy (CBT) is recommended in guidelines for patients with ongoing symptoms but its availability is limited. Objectives: To determine the clinical effectiveness and cost-effectiveness of therapist telephone-delivered CBT (TCBT) and web-based CBT (WCBT) with minimal therapist support compared with treatment as usual (TAU) in refractory IBS. Design: This was a three-arm randomised controlled trial. Setting: This trial took place in UK primary and secondary care. Participants: Adults with refractory IBS (clinically significant symptoms for 12 months despite first-line therapies) were recruited from 74 general practices and three gastroenterology centres from May 2014 to March 2016. Interventions: TCBT – patient CBT self-management manual, six 60-minute telephone sessions over 9 weeks and two 60-minute booster sessions at 4 and 8 months (8 hours’ therapist time). WCBT – interactive, tailored web-based CBT, three 30-minute telephone sessions over 9 weeks and two 30-minute boosters at 4 and 8 months (2.5 hours’ therapist time). Main outcome measures: Primary outcomes – IBS symptom severity score (IBS SSS) and Work and Social Adjustment Scale (WSAS) at 12 months. Cost-effectiveness [quality-adjusted life-years (QALYs) and health-care costs]. Results: In total, 558 out of 1452 patients (38.4%) screened for eligibility were recruited – 186 were randomised to TCBT, 185 were randomised to WCBT and 187 were randomised to TAU. The mean baseline Irritable Bowel Syndrome Symptom Severity Score (IBS SSS) was 265.0. An intention-to-treat analysis with multiple imputation was carried out at 12 months; IBS SSS were 61.6 points lower in the TCBT arm [95% confidence interval (CI) 89.5 to 33.8; p |
| نوع الوثيقة: | article |
| وصف الملف: | electronic resource |
| اللغة: | English |
| تدمد: | 1366-5278 2046-4924 |
| Relation: | https://doaj.org/toc/1366-5278; https://doaj.org/toc/2046-4924 |
| DOI: | 10.3310/hta23170 |
| URL الوصول: | https://doaj.org/article/8c2c29ab41344896b8264658bdab0c74 |
| رقم الأكسشن: | edsdoj.8c2c29ab41344896b8264658bdab0c74 |
| قاعدة البيانات: | Directory of Open Access Journals |
Full Text Finder | تدمد: | 13665278 20464924 |
|---|---|
| DOI: | 10.3310/hta23170 |