Most Read Articles
6 days ago
Older women with longer endogenous oestrogen exposure and hormone therapy use are at much higher odds of having favourable cognitive status in late life, a recent study suggests.
4 days ago
In patients with atrial fibrillation (AF) and stable coronary artery disease (CAD), rivaroxaban monotherapy is noninferior to combination treatment with an antiplatelet therapy in terms of cutting the risk of cardiovascular events and mortality, according to data from the AFIRE trial.
Elvira Manzano, 5 days ago
Supplementation with omega-3 fatty acids or vitamin D3 for up to 5 years has no effect on kidney function in adults with type 2 diabetes (T2D), the VITAL-DKD* ancillary study has shown.
Jairia Dela Cruz, 2 days ago
Many patients with nonvalvular atrial fibrillation (NVAF) in Thailand use anticoagulants, but the uptake of nonvitamin-K oral anticoagulants remains suboptimal despite showing an upward trend, according to data from the COOL-AF registry presented at the European Society of Cardioloy (ESC) Asia Congress 2019 with APSC and AFC.

Remote CBT works better than treatment as usual in refractory IBS

11 Jul 2019

Cognitive behavioural therapy (CBT), delivered over the web or phone, yields superior improvements in irritable bowel syndrome (IBS) symptoms and more favourable effects on life and mood in comparison with treatment as usual (TAU), according to data from the ACTIB* trial.

Researchers conducted a three-arm randomized controlled trial, including 558 IBS patients (mean age, 43.1 years; 75.8 percent female) who were assigned to receive telephone-delivered CBT (TCBT; n=186), web-based CBT (WCBT) with minimal therapist support (n=185) or TAU (n=187). All patients had refractory IBS (clinically significant symptoms for ≥12 months despite first-line therapies).

Of the patients, 70.1 percent completed 12 months of follow-up. The primary outcomes of interest were IBS Symptom Severity Score (IBS-SSS) and Work and Social Adjustment Scale (WSAS) at 12 months.

Compared with TAU, both TCBT and WCBT significantly reduced IBS-SSS (mean differences, 61.6 and 35.2 points; p<0.001 and p=0.002, respectively). More patients in both CBT arms achieved a clinically significant change in IBS-SSS (50 points) from baseline to 12 months (72.8 percent in TCBT; 66.1 percent in WCBT; 44.3 percent in TAU).

Similar results were observed with respect to the effect of IBS symptoms on the ability to work and manage at home, participate in social and private leisure activities, and maintain relationships. Specifically, WSAS score was lower by 3.5 points (p<0.001) in the TCBT arm and by 3.0 points in the WCBT arm than in the TAU arm at 12 months (p<0.001 and p=0.001, respectively).

Furthermore, both CBT interventions produced significantly greater improvements on all secondary outcomes (IBS-SSS and WSAS at 3 and 6 months after randomization; mood, symptom relief and ability to cope with symptoms at 3, 6 and 12 months) compared with TAU.

No serious adverse reactions to treatment were seen.

The findings of the current trial reinforce NICE guidance, which currently relies on a limited evidence base of mostly face-to-face CBT, the researchers pointed out. Patients with refractory IBS can benefit from CBT for IBS and that telephone-delivered or web-delivered CBT can provide sustained improvements.

*Assessing Cognitive–behavioural Therapy in Irritable Bowel syndrome

Digital Edition
Asia's trusted medical magazine for healthcare professionals. Get your MIMS Doctor - Malaysia digital copy today!
Sign In To Download
Editor's Recommendations
Most Read Articles
6 days ago
Older women with longer endogenous oestrogen exposure and hormone therapy use are at much higher odds of having favourable cognitive status in late life, a recent study suggests.
4 days ago
In patients with atrial fibrillation (AF) and stable coronary artery disease (CAD), rivaroxaban monotherapy is noninferior to combination treatment with an antiplatelet therapy in terms of cutting the risk of cardiovascular events and mortality, according to data from the AFIRE trial.
Elvira Manzano, 5 days ago
Supplementation with omega-3 fatty acids or vitamin D3 for up to 5 years has no effect on kidney function in adults with type 2 diabetes (T2D), the VITAL-DKD* ancillary study has shown.
Jairia Dela Cruz, 2 days ago
Many patients with nonvalvular atrial fibrillation (NVAF) in Thailand use anticoagulants, but the uptake of nonvitamin-K oral anticoagulants remains suboptimal despite showing an upward trend, according to data from the COOL-AF registry presented at the European Society of Cardioloy (ESC) Asia Congress 2019 with APSC and AFC.