Treatment of irritable bowel syndrome in primary care

BMJ ◽  
2008 ◽  
Vol 337 (nov13 3) ◽  
pp. a2213-a2213 ◽  
Author(s):  
R. Jones
Keyword(s):  
Primary Care ◽  
Irritable Bowel Syndrome ◽  
Irritable Bowel

Comparison of irritable bowel syndrome (IBS) patients in gastroenterology and primary care clinics

2003 ◽  
Vol 124 (4) ◽  
pp. A14 ◽  
Author(s):  
Olafur S. Palsson ◽  
Andrew D. Feld ◽  
Rona L. Levy ◽  
Michael Von Korff ◽  
Victoria E. Barghout ◽  
...  
Keyword(s):  
Primary Care ◽  
Irritable Bowel Syndrome ◽  
Primary Care Clinics ◽  
Irritable Bowel

scholarly journals From substance to process: A meta-ethnographic review of how healthcare professionals and patients understand placebos and their effects in primary care

2018 ◽  
Vol 24 (3) ◽  
pp. 315-340 ◽  
Author(s):  
Doug I Hardman ◽  
Adam WA Geraghty ◽  
George Lewith ◽  
Mark Lown ◽  
Clelia Viecelli ◽  
...  
Keyword(s):  
Systematic Review ◽  
Primary Care ◽  
Irritable Bowel Syndrome ◽  
Healthcare Professionals ◽  
Clinical Validity ◽  
Placebo Effects ◽  
Literature Searches ◽  
Irritable Bowel ◽  
Systematic Literature Searches ◽  
Material Substances

Research suggests that a ‘placebo’ can improve conditions common in primary care including pain, depression and irritable bowel syndrome. However, disagreement persists over the definition and clinical relevance of placebo treatments. We conducted a meta-ethnographic, mixed-research systematic review to explore how healthcare professionals and patients understand placebos and their effects in primary care. We conducted systematic literature searches of five databases – augmented by reference chaining, key author searches and expert opinion – related to views on placebos, placebo effects and placebo use in primary care. From a total of 34 eligible quantitative, qualitative and mixed-methods articles reporting findings from 28 studies, 21 were related to healthcare professionals’ views, 11 were related to patients’ views and two were related to both groups. In the studies under review, healthcare professionals reported using placebos at markedly different frequencies. This was highly influenced by how placebos were defined in the studies. Both healthcare professionals and patients predominantly defined placebos as material substances such as ‘inert’ pills, despite this definition being inconsistent with current scientific thinking. However, healthcare professionals also, but less prevalently, defined placebos in a different way: as contextual processes. This better concurs with modern placebo definitions, which focus on context, ritual, meaning and enactivism. However, given the enduring ubiquity of substance definitions, for both healthcare professionals and patients, we question the practical, clinical validity of stretching the term ‘placebo’ towards its modern iteration. To produce ‘placebo effects’, therefore, primary healthcare professionals may be better off abandoning placebo terminology altogether.

A randomized controlled trial of a cognitive behavioural therapy-based self-management intervention for irritable bowel syndrome in primary care

2009 ◽  
Vol 40 (1) ◽  
pp. 85-94 ◽  
Author(s):  
R. Moss-Morris ◽  
L. McAlpine ◽  
L. P. Didsbury ◽  
M. J. Spence
Keyword(s):  
Primary Care ◽  
Irritable Bowel Syndrome ◽  
Controlled Trial ◽  
Behavioural Therapy ◽  
The Self ◽  
Self Management ◽  
Randomized Controlled ◽  
Management Group ◽  
Cognitive Behavioural ◽  
Irritable Bowel

BackgroundRecent 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).MethodSixty-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.ResultsAnalysis 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).ConclusionsThis 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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