Systematic review: self-management support interventions for irritable bowel syndrome

Background Irritable bowel syndrome is an extremely common and costly condition. Because there is no cure, patients must be supported to manage their own condition. Aim To assess systematically the interventions used to support irritable bowel syndrome patient self-management. Methods A search of PubMed, EMBASE, CINAHL and PsycINFO was performed to identify all studies that involved self-management support interventions for irritable bowel syndrome. Studies that compared the self-management-related intervention to a control group were included. Results Eleven studies that involved a total of 1657 patients were included. For nearly all studies, the intervention was associated with statistically significant benefits. However, across studies there was significant heterogeneity in terms of sample size, diagnostic criteria, study setting, study design, primary outcome, statistical analyses and study quality. Therefore, individual study results could not be statistically combined. Conclusions Many self-management support interventions appear benefit patients with irritable bowel syndrome. However, studies were limited by methodological flaws. Furthermore, feasibility in 'real world' clinical practice is uncertain. Thus, practical self-management interventions that can be applied across various clinical settings should be developed, and then tested in well-designed clinical trials.