Does the Effectiveness of Comprehensive Self Management Therapy for IBS Vary With Age

2.50
Hdl Handle:
http://hdl.handle.net/10755/157595
Type:
Presentation
Title:
Does the Effectiveness of Comprehensive Self Management Therapy for IBS Vary With Age
Abstract:
Does the Effectiveness of Comprehensive Self Management Therapy for IBS Vary With Age
Conference Sponsor:Western Institute of Nursing
Conference Year:2009
Author:Poppe, Anne P., MN, RN
P.I. Institution Name:University of Washington, Biobehavioral Nursing and Health Systems
Title:Doctoral Student
Contact Address:1959 NE Pacific Street, Seattle, WA, 98105, USA
Contact Telephone:206-221-6467
Co-Authors:Robert L. Burr, PhD, Research Professor; Kevin C. Cain, PhD, Research Scientist; Margaret Heitkemper, PhD, RN, Professor; Monica Jarrett, PhD, RN, Professor
Purpose: The purpose of this analysis is to determine whether a comprehensive self-management intervention for Irritable Bowel Syndrome (IBS) is as effective in older adults as in younger adults. Background/Rationale: Gastrointestinal disorders are common conditions in the elderly. Recent evidence suggests the prevalence of IBS may be similar in older adults as in younger adults. However, previous cognitive behavioral studies for IBS have primarily focused on treatment effects in the younger population. There is minimal information describing actual treatment effects in older compared to younger adults. Methods: Adults aged 18-70 with IBS were recruited through general advertisement and a targeted mailing through a gastroenterology clinic. Following a baseline assessment, participants were randomized to a comprehensive self-management (CSM) intervention delivered via telephone (T-CSM) or in-person (IP-CSM) as compared to usual care (UC) for adults with IBS. Both CSM interventions were delivered weekly over 9 weeks, and addressed nutritional, cognitive and behavioral strategies for managing IBS symptoms. Outcomes were measured at baseline and 3, 6, and 12 months follow-up times. Two primary outcome variables were analyzed:  a) IBS symptom severity (IBS-SS) from a daily diary, measured as the percent of days with at least one IBS symptom (abdominal pain, bloating, constipation, diarrhea, intestinal gas, urgency) being moderate or worse, and b) IBS-specific quality of life (QOL) measured on a 0-100 scale. Mixed-model analyses were used to analyze data from the three follow-up times, controlling for baseline values of IBS symptom severity and QOL. Results: The 176 adults randomized into treatment groups were divided into three age categories (18-34 years, n = 52; 35-54 years, n = 68; 55 years and older, n = 49).The intervention effects in the two CSM groups (T-CSM and IP-CSM) were similar and were collapsed into one group (CSM-combined, n =111; Usual Care, n = 58). There was no statistically significant interaction between age and treatment group, indicating there is no evidence that treatment is more or less effective at older ages. However, because of the small sample size it is not possible to rule out age difference in treatment effectiveness, in either direction. Implications: Comprehensive self-management therapy leads to improvement in IBS symptoms and quality of life, and this improvement is still maintained at 12 months. The therapy appears to be just as effective in older adults as in younger adults. Therefore, health care providers should consider CSM for older adult patients with gastrointestinal disorders. Further study of CSM with a larger sample size of older adults will be necessary to confirm treatment effectiveness.
Repository Posting Date:
26-Oct-2011
Date of Publication:
17-Oct-2011
Sponsors:
Western Institute of Nursing

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleDoes the Effectiveness of Comprehensive Self Management Therapy for IBS Vary With Ageen_GB
dc.identifier.urihttp://hdl.handle.net/10755/157595-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Does the Effectiveness of Comprehensive Self Management Therapy for IBS Vary With Age</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Western Institute of Nursing</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2009</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Poppe, Anne P., MN, RN</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">University of Washington, Biobehavioral Nursing and Health Systems</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Doctoral Student</td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">1959 NE Pacific Street, Seattle, WA, 98105, USA</td></tr><tr class="item-phone"><td class="label">Contact Telephone:</td><td class="value">206-221-6467</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">apoppe@u.washington.edu</td></tr><tr class="item-co-authors"><td class="label">Co-Authors:</td><td class="value">Robert L. Burr, PhD, Research Professor; Kevin C. Cain, PhD, Research Scientist; Margaret Heitkemper, PhD, RN, Professor; Monica Jarrett, PhD, RN, Professor</td></tr><tr><td colspan="2" class="item-abstract">Purpose: The purpose of this analysis is to determine whether a comprehensive self-management intervention for Irritable Bowel Syndrome (IBS) is as effective in older adults as in younger adults. Background/Rationale: Gastrointestinal disorders are common conditions in the elderly. Recent evidence suggests the prevalence of IBS may be similar in older adults as in younger adults. However, previous cognitive behavioral studies for IBS have primarily focused on treatment effects in the younger population. There is minimal information describing actual treatment effects in older compared to younger adults. Methods: Adults aged 18-70 with IBS were recruited through general advertisement and a targeted mailing through a gastroenterology clinic. Following a baseline assessment, participants were randomized to a comprehensive self-management (CSM) intervention delivered via telephone (T-CSM) or in-person (IP-CSM) as compared to usual care (UC) for adults with IBS. Both CSM interventions were delivered weekly over 9 weeks, and addressed nutritional, cognitive and behavioral strategies for managing IBS symptoms. Outcomes were measured at baseline and 3, 6, and 12 months follow-up times. Two primary outcome variables were analyzed:&nbsp; a) IBS symptom severity (IBS-SS) from a daily diary, measured as the percent of days with at least one IBS symptom (abdominal pain, bloating, constipation, diarrhea, intestinal gas, urgency) being moderate or worse, and b) IBS-specific quality of life (QOL) measured on a 0-100 scale. Mixed-model analyses were used to analyze data from the three follow-up times, controlling for baseline values of IBS symptom severity and QOL. Results: The 176 adults randomized into treatment groups were divided into three age categories (18-34 years, n = 52; 35-54 years, n = 68; 55 years and older, n = 49).The intervention effects in the two CSM groups (T-CSM and IP-CSM) were similar and were collapsed into one group (CSM-combined, n =111; Usual Care, n = 58). There was no statistically significant interaction between age and treatment group, indicating there is no evidence that treatment is more or less effective at older ages. However, because of the small sample size it is not possible to rule out age difference in treatment effectiveness, in either direction. Implications: Comprehensive self-management therapy leads to improvement in IBS symptoms and quality of life, and this improvement is still maintained at 12 months. The therapy appears to be just as effective in older adults as in younger adults. Therefore, health care providers should consider CSM for older adult patients with gastrointestinal disorders. Further study of CSM with a larger sample size of older adults will be necessary to confirm treatment effectiveness.</td></tr></table>en_GB
dc.date.available2011-10-26T20:01:09Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-26T20:01:09Z-
dc.description.sponsorshipWestern Institute of Nursingen_GB
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