A Systematic Review of Self-Management Interventions for Children and Adolescents With Inflammatory Bowel Disease.
adolescents
children
inflammatory bowel disease
self-management
Journal
Inflammatory bowel diseases
ISSN: 1536-4844
Titre abrégé: Inflamm Bowel Dis
Pays: England
ID NLM: 9508162
Informations de publication
Date de publication:
14 03 2019
14 03 2019
Historique:
received:
27
06
2018
pubmed:
9
10
2018
medline:
15
2
2020
entrez:
9
10
2018
Statut:
ppublish
Résumé
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. 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. 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. 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.
Sections du résumé
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.
Identifiants
pubmed: 30295786
pii: 5117847
doi: 10.1093/ibd/izy299
doi:
Types de publication
Journal Article
Systematic Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
685-698Informations de copyright
© 2018 Crohn’s & Colitis Foundation. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.