By phone or web, cognitive behavioral therapy is effective for IBS

  • Everitt HA & al.
  • Gut
  • 10 Apr 2019

  • International Clinical Digest
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Takeaway

  • Cognitive behavioral therapy (CBT) for irritable bowel syndrome (IBS) bests treatment as usual (TAU) whether provided online or by phone.
  • This randomized trial with 12-month follow-up used low-intensity CBT for the web and high-intensity for phone, with good adherence with both.

Why this matters

  • Guidelines recommend face-to-face CBT for refractory IBS, but how well delivery would work via the likely more accessible web- or phone-based delivery is not clear.
  • Options for patients with refractory IBS are otherwise limited.

Key results

  • Vs TAU at 12 months, symptom severity scores were:
    • 61.6 points lower with phone delivery (P<.001 and>
    • 35.2 points lower via web delivery (P=.002).
  • Social function scores also improved:
    • By 3.5 points with phone delivery (P<.001 and>
    • By 3.0 points with web delivery (P=.001).

Study design

  • Randomized trial of web-based (n=185) vs phone-based (n=186) vs TAU (n=187) CBT, with 1 year of follow-up.
  • Outcomes included symptom severity score, work and daily function scores.
  • Funding: National Institute for Health Research (UK).

Limitations

  • Necessarily unblinded.

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