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N005. Examination of the efficacy of Chronic Disease Self-management Programme (CDSMP) for patients with inflammatory bowel disease (IBD): a pilot study

M. Forry1, E. McDonnell2, J. Wilson-O'Raghallaigh2, O. Kelly1, A. O'Toole1, F. Murray1, G. Harewood1, S. Patchett3, 1Beaumont Hospital, Gastroenterology, Dublin, Ireland, 2Beaumont Hospital, Psychology, Dublin, Ireland, 3Beaumont Hospital, Dublin, Ireland

Background

The need for a psychosocial intervention for patients with IBD was recognised by multidisciplinary healthcare professionals working at a major Irish hospital. CDSMP was identified as a leading model of psychosocial intervention in development since 1992 at Stanford University. This pilot study is the first reported use of CDSMP for patients with IBD.

Methods

A repeated measures design with waitlist control (n = 44) was utilised with treatment group participating in CDSMP, which consisted of 6 weekly sessions of 2.5 hours duration co-facilitated by a trained patient and healthcare professional. Mood was measured using the hospital anxiety and depression scale (HADS). The Rand 36-Item Health Survey (SF-36) was used to measure general health related quality of life (HRQoL) using eight scales (General Health, Physical Functioning, Bodily Pain, Role-Physical, Role-Emotional, Energy/Fatigue, Social Functioning & Emotional Well Being). Total scores range from 0–100 with higher scores indicating better (HRQoL). The Short Inflammatory Bowel Disease Questionnaire (SIBDQ) was used to measure physical, social, and emotional status (score 10–70, poor to good HRQoL) in patients with IBD.

Results

Of the 44 patients participated in the pilot study, 11 were male (25%) and 33 female (75%). Data relating to mood, impact of illness and social role functioning was obtained with significant improvement in mood achieved in the treatment group in comparison to the waitlist control. Paired sample t-tests indicated a significant reduction in levels of depression noted on the HADS (p = 0.05). Pre-intervention 14% of the treatment group displayed mild depression. Post-intervention no clinical levels of depression were evident in the treatment group compared to 17% of waitlist control who displayed mild to severe levels of depression. Paired sample t-tests indicated significant improvement in the SF-36 on the factor of emotional well-being (p = 0.04). Of note, 14% of the treatment group were experiencing relapses in their condition at the end of the CDSMP. The SIBDQ showed positive trends towards an improvement of symptoms though at a non-significant level.

Conclusion

The results of this study indicate that CDSMP appears to be an effective psychosocial intervention for patients with IBD. Considerations are made to the implementation of the CDSMP in hospital and community settings in Ireland for this patient group.