Core Outcome Measures in Effectiveness Trials

A Systematic Review of Self-Management Interventions for Children and Adolescents With Inflammatory Bowel Disease

General Information

Abstract:
BACKGROUND: Self-management of inflammatory bowel disease is complex. Children and adolescents (CA) with inflammatory bowel disease (IBD) often have difficulty with managing aspects of their condition, resulting in treatment nonadherence and impaired psychosocial function. Self-management interventions are developed to help support patients and their parents/carers to effectively self-manage. The aim of this systematic review was to evaluate the efficacy of self-management interventions in children and adolescents with IBD. METHODS: The review was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. A systematic literature search of the following databases was conducted to identify controlled trials of interventions aiming to enhance IBD self-management in CA: Medline, Embase, Cochrane, CINAHL, and PsychINFO. Two reviewers screened articles for inclusion. RESULTS: Nine trials (11 articles) met the inclusion criteria. Most were underpowered, with 7 recruiting fewer than 50 participants. The interventions aimed to enhance psychological well-being (n = 5), medication adherence (n = 3), or calcium intake (n = 1). There was considerable heterogeneity in intervention content and outcomes assessment. Some benefits were reported in disease activity, adherence, and psychological well-being, but findings were inconsistent. CONCLUSIONS: Self-management is difficult for CA with IBD; however, this review identified only a small number of interventions to support self-management, most of which were underpowered and only 1 that was conducted outside the United States. Clinical consensus is required on which self-management activities should be recommended to patients and targeted in interventions and which core outcomes should be assessed. Adequately powered trials of interventions are required to identify how best to support self-management in CA with IBD.

Authors:
Tran, L. Mulligan, K.

Publication

Journal:
Inflamm Bowel Dis
Volume:
25
Issue:
4
Pages:
685 - 698
Year:
2019
DOI:
Further Study Information

Date:
Funding source(s):

Health Area

Disease Category
Gastroenterology

Disease Name
Inflammatory bowel disease (IBD)

Target Population

Age Range
0 - 19

Sex
Either


Nature / type of Intervention
Behavioural
Diet and nutrition
Educational/self-management

Method(s)

Systematic review

Stakeholders Involved

Unknown

Study Type

Systematic review of outcomes measured in trials

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