A randomised controlled trial to assess the effectiveness and cost of a patient orientated self management approach to chronic inflammatory bowel disease

167Citations
Citations of this article
150Readers
Mendeley users who have this article in their library.

Abstract

Objectives: We developed a patient centred approach to chronic disease self management by providing information designed to promote patient choice. We then conducted a randomised controlled trial of the approach in inflammatory bowel disease (IBD) to assess whether it could alter clinical outcome and affect health service use. Design: A multicentre cluster randomised controlled trial. Setting: The trial was conducted in the outpatient departments of 19 hospitals with randomisation by treatment centre, 10 control sites, and nine intervention sites. For patients at intervention sites, an individual self management plan was negotiated and written information provided. Participants: A total of 700 patients with established inflammatory bowel disease were recruited. Main outcome measures: Main outcome measures recorded at one year were: quality of life, health service resource use, and patient satisfaction. Secondary outcomes included measures of enablement-confidence to cope with the condition. Results: One year following the intervention, self managing patients had made fewer hospital visits (difference -1.04 (95% confidence interval (CI) -1.43 to -0.65); p<0.001) without increase in the number of primary care visits, and quality of life was maintained without evidence of anxiety about the programme. The two groups were similar with respect to satisfaction with consultations. Immediately after the initial consultation, those who had undergone self management training reported greater confidence in being able to cope with their condition (difference 0.90 (95% CI 0.12-1.68); p<0.03). Conclusions: 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.

References Powered by Scopus

The Hospital Anxiety and Depression Scale

36645Citations
N/AReaders
Get full text

Evidence suggesting that a chronic disease self-management program can improve health status while reducing hospitalization a randomized trial

1792Citations
N/AReaders
Get full text

A New Measure of Health Status for Clinical Trials in Inflammatory Bowel Disease

1111Citations
N/AReaders
Get full text

Cited by Powered by Scopus

The second European evidence-based Consensus on the diagnosis and management of Crohn's disease: Special situations

708Citations
N/AReaders
Get full text

Self-management education programmes by lay leaders for people with chronic conditions

505Citations
N/AReaders
Get full text

Interventions for providers to promote a patient-centred approach in clinical consultations

425Citations
N/AReaders
Get full text

Register to see more suggestions

Mendeley helps you to discover research relevant for your work.

Already have an account?

Cite

CITATION STYLE

APA

Kennedy, A. P., Nelson, E., Reeves, D., Richardson, G., Roberts, C., Robinson, A., … Thompson, D. G. (2004). A randomised controlled trial to assess the effectiveness and cost of a patient orientated self management approach to chronic inflammatory bowel disease. Gut, 53(11), 1639–1645. https://doi.org/10.1136/gut.2003.034256

Readers' Seniority

Tooltip

PhD / Post grad / Masters / Doc 57

60%

Researcher 22

23%

Lecturer / Post doc 9

9%

Professor / Associate Prof. 7

7%

Readers' Discipline

Tooltip

Medicine and Dentistry 49

56%

Nursing and Health Professions 16

18%

Psychology 16

18%

Social Sciences 7

8%

Save time finding and organizing research with Mendeley

Sign up for free