Behavioral interventions may prolong remission in patients with inflammatory bowel disease.
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.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 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.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.
Keefer, L; Kiebles, JL; Martinovich, Z; Cohen, E; Van Denburg, A; Barrett, TA
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