Available to download - Managing your life with...Irritable Bowel Syndrome. This guide will give you detailed and up-to-date information about irritable bowel syndrome. It will help you find the best way to manage your condition and show you how other people cope with irritable bowel syndrome.
This randomised controlled trial was designed to establish whether a self-help guidebook produced following a number of focus group meetings with patients with irritable bowel syndrome improved symptoms, social functioning, use of primary and secondary health-care, drug usage and is acceptable to users and health professionals. The guidebook incorporated self-care strategies used successfully by patients to manage their symptoms and provided evidence-based information in response to the needs identified by those with IBS. The guidebook was evaluated in a randomised controlled trial with three arms: Provision of self-help guidebook; Provision of self-help guidebook plus invitation to attend one self-help group meeting which we facilitate; Treatment as usual (these patients are sent the guidebook at the end of the project ).
Patients with established IBS who consulted their GP for problems with IBS were recruited in three Health Authorities in Greater Manchester. Patients were then randomised to one of the three study arms. In addition to the quantitative data being collected qualitative interviews were undertaken with patients at the end of the one year follow up period. A total of 420 patients have been recruited from 200 GPs. Postal questionnaires were completed at three points: baseline, 1-month and 12 months. There was a 96% response rate at 1-month and an 87% response rate at 12 months and GP records were reviewed for 96% of the patients. A total of 10 in-depth qualitative interviews have been undertaken.
The number of medical consultations during the trial was significantly lower in the intervention group. At one year, patients in the guidebook group had a 60% reduction in primary care consultations (p<0.001) and a reduction in perceived symptom severity (p<0.001) compared with controls. Allocation to the self-help group conferred no additional benefit. Whilst symptom scores for pain, diarrhoea, constipation and bloating remained similar for both groups, patient perceptions of symptoms were significantly improved in favour of the intervention. Costs per patient were reduced by £73 (C.I. £43, £103) or 40% per year.
Introduction of a self-help guidebook results in a reduction in primary care consultations, a perceived reduction in symptoms and significant health service savings. This suggests that patients attending their primary care physician with functional abdominal symptoms should be offered self-help information as part of their management.