A randomised controlled trial of self-help interventions in patients with a primary care diagnosis of IBS

Andrew Robinson ^1*, Victoria Lee ², Anne Kennedy ², Liz Middleton ², Anne Rogers ², David G Thompson ² and David Reeves ²

¹ Hope Hospital, United Kingdom
² University of Manchester, United Kingdom

^* To whom correspondence should be addressed. E-mail: andrew.robinson{at}srht.nhs.uk.

Accepted 15 June 2005

Abstract

Introduction: Functional abdominal symptoms are very common and account for nearly 2 million primary care consultations in Britain every year and produce significant morbidity. The aims of this study were to evaluate the impact of two self-help interventions on consultation rates and symptom severity in patients with a primary care diagnosis of irritable bowel syndrome.

Methods: 420 patients from 54 primary care centres were randomised either to receive self-help information in the form of a guidebook or the guidebook plus a "self- help" group meeting or to be in a control group receiving neither intervention. Data were collected using questionnaires and primary care records.

Results: 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. Actual symptom scores did not change significantly in any group. Costs per patient were reduced by £73 (C.I. £43, £103) or 40% per year.

Conclusion: 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.

Keywords: IBS, functional bowel disorder, primary care, self-help, self-management

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