Self-management in patients with inflammatory bowel disease: strategies, outcomes, and integration into clinical care

Abstract

Self-management, including medication adherence, is associated with improved health and outcomes for patients with inflammatory bowel disease. The concept of self-management is complex, but can be divided into those aspects that involve the individual patient, those that involve the provider–patient relationship, and those that encompass the social environment. At the individual level, enhancing problem-solving skills and self-efficacy have both been shown to improve self-management tasks, particularly adherence to treatment. However, it is critical to consider these domains from a lifespan perspective because these processes by which self-management can be improved are distinct for children, adolescents, young adults, and adults. A particular emphasis is placed on strategies to improve self-management of older adolescents and young adults as they transition from pediatric to adult providers. The review concludes with recommendations for providers, including rationale and techniques for assessing and promoting patient self-efficacy, encouraging the development of problem-solving skills, improving the patient–provider relationship, and enhancing social support. Providers are encouraged to utilize elements of problem-solving skills training, engage in collaborative relationships with their patients, and offer their patients recommendations for how to increase the quality of their social support networks as ways of increasing overall self-management.

Inflammatory bowel diseases

“…Therefore, there were defined interventions and group supports in order to enhance the ability of these patients to manage their condition and to self-controlling it by recognizing the early symptoms of a relapse. [24] …”

Systematic Review of Social Support on Psychological Symptoms and Self‐Management Behaviors Among Adults With Inflammatory Bowel Disease

“…Overall, there is some evidence for an inverse relationship between social support and psychological symptoms (Research Question 1). Although a wide variety of self‐management behaviors were described among the eight studies, the systematic review did not identify commonly used IBD self‐management behaviors such as diet modification, stress management, or physical activity (Conley & Redeker, ; Kane, ; Keefer & Kane, ). Even though individuals with IBD face a variety of gastrointestinal and systemic symptoms, this review did not identify any studies focusing on gastrointestinal symptoms.…”

“…Self-management is necessary for reducing inflammation, decreasing symptoms, and improving quality of life (Kamat, Ganesh Pai, Surulivel Rajan, & Kamath, 2017). Patients with IBD engage in a variety of selfmanagement behaviors, such as medication adherence, stress management, and diet modification, to manage their disease (Plevinsky, Greenley, & Fishman, 2016).…”

A Systematic Review of Self-Management Interventions for Children and Adolescents With Inflammatory Bowel Disease

“…Psychological well-being is an important aspect of managing IBD 13,37 . Five trials focused on improving psychological wellbeing, however, several different outcomes were assessed and no single outcome measure was used in more than two trials.…”

“…Proactive participation in IBD self-management, particularly among adolescents often aids a successful transition into adult care 12 . In collaboration with healthcare professionals it is likely to improve treatment adherence 13 and disease outcomes 1,14 .…”