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News

Patient-orientated, self-managed IBD reduces number of hospital visits

Patients with chronic inflammatory bowel disease (IBD) report greater confidence in being able to cope with their condition if self-management training is undertaken, reports November's issue of Gut

News image

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Dr Kennedy and colleagues from Manchester, England developed a patient centered approach to chronic disease self management by providing information designed to promote patient choice.

The research group conducted a multicenter cluster, randomized controlled trial of the patient approach to inflammatory bowel disease (IBD).

The researchers assessed whether a patient-directed approach altered clinical outcome or affected health service use.

The researchers conducted the trial in the outpatient departments of 19 hospitals, with randomization by treatment centre, 10 control sites, and 9 intervention sites.

Patients at intervention sites negotiated an individual self management plan with their doctors and were given written information.

In total, the researchers included 700 patients with inflammatory bowel disease in the study.

The research team recorded main outcome measures at one year. These included quality of life, health service resource use, and patient satisfaction.

Self managing patients make fewer hospital visits
Gut

Secondary outcomes included measures of enablement—confidence to cope with the condition.

The researchers found that 1 year following the intervention, self managing patients had made fewer hospital visits without increase in the number of primary care visits.

In addition, the team noted that quality of life was maintained without evidence of anxiety about the programme.

The 2 groups were similar with respect to satisfaction with consultations.

The researchers were interested to find that immediately after the initial consultation, those who had undergone self management training reported greater confidence in being able to cope with their condition.

Dr Kennedy, commenting on the group's findings said, "Adoption of this approach for the management of chronic disease such as IBD in the NHS and other managed health care organisations would considerably reduce health provision costs and benefit disease control."

Gut; 2004;53:1639-1645
14 October 2004

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