TY - JOUR
T1 - Behavioral interventions may prolong remission in patients with inflammatory bowel disease
AU - Keefer, Laurie
AU - Kiebles, Jennifer L.
AU - Martinovich, Zoran
AU - Cohen, Elyse
AU - Van Denburg, Alyssa
AU - Barrett, Terrence A.
N1 - Funding Information:
This work was supported by a grant from the National Institutes of Health, Institute for Complementary and Alternative Medicine awarded to the first author [grant number R21AT003204 ]. The authors also wish to thank Monika Kwiatek and Bethany Doerfler for their contribution to administration of the treatments featured in this study.
PY - 2011/3
Y1 - 2011/3
N2 - Inflammatory Bowel Diseases (IBDs) are chronic, relapsing and remitting gastrointestinal conditions with no known cure. Previous studies have linked behavioral factors, including stress and medication adherence, to relapse. Purpose: We sought to determine the effect of participation in a behavioral self-management program on incidence of flare within 12 months following behavioral intervention when compared to the natural history of flare incidence prior to program participation. Results: Results from a 2-level regression model indicated that those participants in the treatment group were 57% less likely to flare in the following 12 months (compared to 18% in the control group). The decline in "flare odds" was about 2 times greater in treatment versus controls (OR. = 0.52, t(34). = 2.07, p<0.05). Office visits, ER visits, and disease severity (all p<0.05) were identified as moderators of flare risk. Conclusions: We have demonstrated 1) a statistical model estimating the likelihood of flare rates in the 12 months following a behavioral intervention for IBD (compared to a control condition), and 2) that the introduction of a behavioral intervention can alter the natural course of a chronic, relapsing and remitting gastrointestinal condition such as IBD.
AB - Inflammatory Bowel Diseases (IBDs) are chronic, relapsing and remitting gastrointestinal conditions with no known cure. Previous studies have linked behavioral factors, including stress and medication adherence, to relapse. Purpose: We sought to determine the effect of participation in a behavioral self-management program on incidence of flare within 12 months following behavioral intervention when compared to the natural history of flare incidence prior to program participation. Results: Results from a 2-level regression model indicated that those participants in the treatment group were 57% less likely to flare in the following 12 months (compared to 18% in the control group). The decline in "flare odds" was about 2 times greater in treatment versus controls (OR. = 0.52, t(34). = 2.07, p<0.05). Office visits, ER visits, and disease severity (all p<0.05) were identified as moderators of flare risk. Conclusions: We have demonstrated 1) a statistical model estimating the likelihood of flare rates in the 12 months following a behavioral intervention for IBD (compared to a control condition), and 2) that the introduction of a behavioral intervention can alter the natural course of a chronic, relapsing and remitting gastrointestinal condition such as IBD.
KW - Behavioral self-management
KW - Crohn's disease
KW - Hypnotherapy
KW - IBD
KW - Remission
KW - Ulcerative colitis
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U2 - 10.1016/j.brat.2010.12.005
DO - 10.1016/j.brat.2010.12.005
M3 - Article
C2 - 21256475
AN - SCOPUS:79951676944
VL - 49
SP - 145
EP - 150
JO - Behavioral Assessment
JF - Behavioral Assessment
SN - 0005-7967
IS - 3
ER -