A randomised controlled trial to assess the impact of a package comprising a patient-orientated, evidence-based self-help guidebook and patient-centred consultations on disease management and satisfaction in inflammatory bowel disease

Kennedy A, Nelson E, Reeves D, Richardson G, Roberts C, Robinson A, Rogers A, Sculpher M, Thompson D
Record ID 32003001157
English
Authors' objectives:

The aim of this study was to determine if a whole systems approach to self-management using a guidebook developed with patients combined with physicians trained in patient-centred care improves clinical outcomes and leads to cost-effective use of NHS services.

Authors' results and conclusions: After 1 year, the intervention resulted in fewer hospital visits: 1.9 versus 3.0 per year (p<0.001) without change in the number of primary care visits. Patients felt more able to cope with their condition (p<0.05). The intervention produced no reduction in quality of life and did not raise anxiety. The intervention group reported fewer symptom relapses: 1.8 versus 2.2 (p<0.01); 74% of patients in the intervention group indicated a preference to continue the system. Qualitative results showed the guidebook was effective but organisational limitations constrained patient-centred aspects of the intervention for some. Cost-effectiveness analyses favoured self-management over standard care.
Authors' recommendations: More widespread use of this method in chronic disease management seems likely to improve overall patient satisfaction and reduce health expenditure without evidence of adverse effect on disease control. However, the qualitative data also suggest that further attention needs to be given to self-referral and access arrangements and a re-distribution of control to patients through increased adherence to patient-centred norms on the part of consultants.
Authors' methods: Randomised controlled trial
Details
Project Status: Completed
URL for project: http://www.hta.ac.uk/1075
Year Published: 2003
English language abstract: An English language summary is available
Publication Type: Not Assigned
Country: England, United Kingdom
MeSH Terms
  • Inflammatory Bowel Diseases
  • Patient Education as Topic
  • Patient-Centered Care
  • Physician-Patient Relations
  • Self Care
Contact
Organisation Name: NIHR Health Technology Assessment programme
Contact Address: NIHR Journals Library, National Institute for Health and Care Research, Evaluation, Trials and Studies Coordinating Centre, Alpha House, University of Southampton Science Park, Southampton SO16 7NS, UK
Contact Name: journals.library@nihr.ac.uk
Contact Email: journals.library@nihr.ac.uk
Copyright: 2009 Queen's Printer and Controller of HMSO
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