The long-term efficacy of psychological interventions in the management of irritable bowel syndrome: a review of randomized controlled trials.
Item
- Title
- The long-term efficacy of psychological interventions in the management of irritable bowel syndrome: a review of randomized controlled trials.
- Author(s)
- Piastri, M
- Abstract
- Background The multifactorial aetiology of irritable bowel syndrome (IBS) and the recent advances in the understanding of the bidirectional network between the gastrointestinal tract and the brain have provided a pathophysiologic basis for the implementation of psychological interventions in the management of IBS. Although reviews have found that psychological interventions help IBS sufferers in coping with their symptoms, limited evidence supports the long-term sustainability of treatment efficacy. Objective This study was conducted to evaluate the efficacy of psychological interventions in the management of IBS symptoms and to determine whether treatment benefits are sustained in the long-term. Furthermore, to inform clinical practice regarding the feasibility of psychological interventions as a long-term management option for patients. Design Structured literature review. Methods Three databases were reviewed for relevant research published between 2008 and 2018 applying Boolean logic. Search returns were filtered according to inclusion/exclusion criteria to address the research question. Data regarding characteristics and outcomes of included studies was extracted. A methodological quality assessment of the included studies was performed using the modified JADAD scale, SORT and EVAT checklists. The standardized mean difference was calculated to measure and compare effect sizes across studies. A regression analysis and calculation of the r-squared value were carried to determine long-term treatment sustainability. Results A total of fifteen studies matched all the inclusion criteria and were included in the final review. Across the scoring systems used, none of the studies obtained ultimate scores, indicating an overall moderate quality. Results from the regression analysis indicated a significant weak relationship between mean effect size and length of follow-up. Discussion Overall patients’ ratings of IBS symptoms improved over the course of the interventions and this effect was sustained during follow-up, however, the consistency of results was questionable due to the large degree of heterogeneity. Interpretation of study results was made difficult by the variety of outcome assessments used. As a whole, the effect of psychological interventions decreased significantly as the length of follow-up increased. Conclusion This review highlighted the limitations in the literature supporting the longevity of psychological interventions in the management of IBS. Although psychological interventions are safe therapeutic modalities, the long-term efficacy remains questionable. Physicians should be aware of these limitations when considering the long-term management care of their patients.
- presented at
- European School of Osteopathy
- Date Accepted
- 2019
- Date Submitted
- 19.11.2019 18:31:09
- Type
- osteo_thesis
- Language
- English
- Submitted by:
- 62
- Pub-Identifier
- 16506
- Inst-Identifier
- 1229
- Keywords
- Irritable Bowel Syndrome (IBS), Literature Review, Long-term Efficacy, Psychological Intervention
- Recommended
- 0
- Item sets
- Thesis
Piastri, M, “The long-term efficacy of psychological interventions in the management of irritable bowel syndrome: a review of randomized controlled trials.”, Osteopathic Research Web, accessed May 5, 2025, https://www.osteopathicresearch.org/s/orw/item/323