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Review
. 2023 Mar 27;8(1):1-12.
doi: 10.1159/000530021. eCollection 2023 Jan-Dec.

A Systematic Review of Self-Management Interventions for Patients with Inflammatory Bowel Disease

Masami Iizawa  1 , Lisa Hirose  1 , Maya Nunotani  2 , Mikiko Nakashoji  1 , Ai Tairaka  1 , Jovelle L Fernandez  1
Affiliations
Review

A Systematic Review of Self-Management Interventions for Patients with Inflammatory Bowel Disease

Masami Iizawa et al. Inflamm Intest Dis. .

Abstract

Introduction: Previous studies have reported the effectiveness of inflammatory bowel disease (IBD) self-management. However, it is unclear which types of self-management interventions are effective. We conducted a systematic literature review to clarify the status and efficacy of self-management interventions for IBD.

Methods: Searches were performed in databases including Embase, Medline, and Cochrane Library. Randomized, controlled studies of interventions in adult human participants with IBD involving a self-management component published in English from 2000 to 2020 were included. Studies were stratified based on study design, baseline demographic characteristics, methodological quality, and how outcomes were measured and analyzed for statistically significant improvements in outcomes, such as psychological health, quality of life, and healthcare resource usage.

Results: Among 50 studies included, 31 considered patients with IBD and 14 and 5 focused on patients with ulcerative colitis and Crohn's disease, respectively. Improvements in an outcome were reported in 33 (66%) studies. Most of the interventions that significantly improved an outcome index were based on symptom management and many of these were also delivered in combination with provision of information. We also note that among effective interventions, many were conducted with individualized and patient-participatory activities, and multidisciplinary healthcare practitioners were responsible for delivery of the interventions.

Conclusion: Ongoing interventions that focus on symptom management with provision of information may support self-management behavior in patients with IBD. A participatory intervention targeting individuals was suggested to be an effective intervention method.

Keywords: Inflammatory bowel disease; Quality of life; Remote monitoring; Self-management; Symptom management.

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Conflict of interest statement

M.I., L.H., M. Nakashoji, and A.T. are employees of Takeda Pharmaceutical Company and J.L.F. was an employee of Takeda Pharmaceutical Company; M.N. has served as a consultant for Takeda Pharmaceutical Company; J.L.F. owns restricted stocks in Takeda Pharmaceuticals and GlaxoSmithKline.

Figures

Fig. 1.
Fig. 1.
Summary of study flow.
Fig. 2.
Fig. 2.
Risk of bias analysis.
Fig. 3.
Fig. 3.
Network diagram showing common statistically significant intervention combinations (across ≥2 studies). Area of each node represents the number of articles and the thickness of lines between nodes represents the number of studies sharing the combination, where “Other” includes: accessing support services, action plans, career planning, contracting, coping, decision making, goal setting, group psychotherapy, managing uncertainty, problem-solving, rational-emotive therapy, and spirituality (online suppl. Table 4).
Fig. 4.
Fig. 4.
Total number of studies (unfilled bars) classified by intervention style and type, with proportion of studies having statistically significant outcomes indicated by solid shading. a Lecture and participation. b Group and individual. c Number of occasions. d Delivery team. HCP, health care provider.
See this image and copyright information in PMC

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