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A Critical Review of Self-Management and Educational Interventions in Inflammatory Bowel Disease

Barlow, Cate MSc; Cooke, Debbie PhD; Mulligan, Kathleen PhD; Beck, Eric MD; Newman, Stanton DPhil

doi: 10.1097/SGA.0b013e3181ca03cc

The purpose of this study was to examine self-management and educational interventions developed to support people with inflammatory bowel disease (IBD) and to identify which type of intervention seems to be most effective. The search was deliberately overinclusive to capture studies that evaluated educational and self-management interventions. The following databases were searched: MEDLINE, Embase, CINAHL, PsycINFO, the National Research Register, and Cochrane. Twenty-three studies were included. Thirteen of these were randomized controlled trials. The content of the interventions reviewed varied widely. As expected, it is the three studies that have explicitly labeled themselves as self-management interventions that have incorporated the greatest number of self-management techniques. Two of these studies reported the greatest number of improved outcomes in relation to symptom reporting, psychological well-being, and healthcare resource use. There is clearly a role for information in IBD, but this review supports research in other conditions that shows that education cannot be assumed to lead to improvements in health and well-being. Much of the research in this area focuses on education rather than self-management. Where self-management techniques have been applied, the findings tend to be more promising. Gastroenterology nurses (or in the United Kingdom, IBD specialist nurses) may be best placed to facilitate self-management in this group.

Cate Barlow, MSc, is with the Department of Primary Care & Population Health (formerly Centre for Behavioural & Social Sciences in Medicine), University College London, London, United Kingdom.

Debbie Cooke, PhD, is with the Department of Epidemiology & Public Health (formerly Centre for Behavioural & Social Sciences), University College London, London, United Kingdom.

Kathleen Mulligan, PhD, is with the Academic Centre for Defence Mental Health, Institute of Psychiatry (formerly Centre for Behavioural & Social Sciences), University College London, London, United Kingdom.

Eric Beck, MD, is with the University College London Medical School, London, United Kingdom.

Stanton Newman, DPhil, is with the Division of Research Strategy, University College London, London, United Kingdom.

Correspondence to: Debbie Cooke, PhD, Department of Epidemiology & Public Health, University College London—Gower Street Campus, 1–19 Torrington Place, London WC1E 6BT, United Kingdom (e-mail:

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Received November 24, 2008; accepted July 7, 2009

© The Society of Gastroenterology Nurses & Associates 2010. All Rights Reserved.