Patients’ Experiences of Telephone-Based & Web-Based [CBT] for Irritable Bowel Syndrome: Longitudinal Qualitative Study, 2020, Bishop, Chalder et al

Andy

Andy

Retired committee member
Background: Cognitive behavioral therapy (CBT) is recommended in guidelines for people with refractory irritable bowel syndrome (IBS). However, the availability of CBT is limited, and poor adherence has been reported in face-to-face CBT.

Objective: Nested within a randomized controlled trial of telephone- and web-delivered CBT for refractory IBS, this qualitative study aims to identify barriers to and facilitators of engagement over time with the interventions, identify social and psychological processes of change, and provide insight into trial results.

Methods: A longitudinal qualitative study was nested in a randomized controlled trial. Repeated semistructured interviews were conducted at 3 (n=34) and 12 months (n=25) post baseline. Participants received telephone-based CBT (TCBT; n=17 at 3 months and n=13 at 12 months) or web-based CBT (WCBT; n=17 at 3 months and n=12 at 12 months). Inductive thematic analysis was used to analyze the data.

Results: Participants viewed CBT as credible for IBS, perceived their therapists as knowledgeable and supportive, and liked the flexibility of web-based and telephone-based delivery; these factors facilitated engagement. Potential barriers to engagement in both groups (mostly overcome by our participants) included initial skepticism and concerns about the biopsychosocial nature of CBT, initial concerns about telephone-delivered talking therapy, challenges of maintaining motivation and self-discipline given already busy lives, and finding nothing new in the WCBT (WCBT group only). Participants described helpful changes in their understanding of IBS, attitudes toward IBS, ability to recognize IBS patterns, and IBS-related behaviors. Consistent with the trial results, participants described lasting positive effects on their symptoms, work, and social lives. Reasons and remedies for some attenuation of effects were identified.

Conclusions: Both TCBT and WCBT for IBS were positively received and had lasting positive impacts on participants’ understanding of IBS, IBS-related behaviors, symptoms, and quality of life. These forms of CBT may broaden access to CBT for IBS.
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Open access, https://www.jmir.org/2020/11/e18691
 
So the point of CBT for IBS is to provide patients with an understanding of IBS, it's related behaviours, symptoms and quality of life?

This is certainly a far cry from the initial trials of all things CBT that were meant as a cure. This only provides the vaguest idea of improvement -- 'lasting positive impact on . . . quality of life' whatever is that supposed to mean?

And how can they know it's a lasting impact unless they do a decade long follow-up? For PwIBS that would be closer to 'lasting impact' in real terms rather than a few months.

I really don't know why I'm bothering to comment tbh. We all know that this type of 'research' is of no value and all the reasons why have been well documented on many threads here.
 
Snowdrop said:
So the point of CBT for IBS is to provide patients with an understanding of IBS, it's related behaviours, symptoms and quality of life?

This is certainly a far cry from the initial trials of all things CBT that were meant as a cure. This only provides the vaguest idea of improvement -- 'lasting positive impact on . . . quality of life' whatever is that supposed to mean?

And how can they know it's a lasting impact unless they do a decade long follow-up? For PwIBS that would be closer to 'lasting impact' in real terms rather than a few months.
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Many or most big trials have a qualitative element alongside the quantitative one. That's really standard. The qualitative studies provide in-depth understanding of various aspects of the study. They're not really designed to stand alone as presenting recommendations for actionable results in population-level programs. The point is, they've published their main trial results, and they stink--even though the authors claim their approach is effective anyway.
 
dave30th said:
Many or most big trials have a qualitative element alongside the quantitative one. That's really standard. The qualitative studies provide in-depth understanding of various aspects of the study. They're not really designed to stand alone as presenting recommendations for actionable results in population-level programs. The point is, they've published their main trial results, and they stink--even though the authors claim their approach is effective anyway.
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same as in CODES project
"TC talks briefly about the CODES trial .. and said that the therapy improved Quality of Life for the patients."

https://www.s4me.info/threads/cochr...n-adults-2020-ganslv-et-al.15975/#post-275002
 
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