A Novel Digital Self-management Intervention for Symptoms of Fatigue, Pain, and Urgency in Inflammatory Bowel Disease, 2022, Moss-Morris et al

A Novel Digital Self-management Intervention for Symptoms of Fatigue, Pain, and Urgency in Inflammatory Bowel Disease: Describing the Process of Development

Abstract
Background: Empirical studies and systematic reviews have demonstrated the role of biological, cognitive, behavioral, and emotional factors in fatigue, pain, and urgency in inflammatory bowel disease (IBD). Behavioral management that addresses the cognitive, behavioral, and emotional factors offered alongside medical treatment is seldom available to people with IBD. Digital interventions provide a potentially scalable and cost-effective way of providing behavioral support to patients.

Objective: This paper aimed to describe the process of developing a supported digital self-management intervention for fatigue, pain, and urgency in IBD using theory and evidence-based approaches and stakeholder input.

Methods: The Medical Research Council framework for complex health interventions and a person-based approach were used to guide intervention development, consulting with 87 patients with IBD and 60 nurses. These frameworks informed the selection and use of a theoretical model that subsequently guided cognitive behaviorally based intervention content. They also guided the design of tailored digital intervention pathways for individuals with IBD that matched the predominant symptoms.

Results: A transsymptomatic cognitive behavioral framework of symptom perpetuation was developed for the symptoms of fatigue, pain, and urgency in IBD. A logic model was used to define the intervention techniques. Patient feedback and qualitative interviews refined the website content and functionalities, including the use of visual aids, email reminders, and graphical tracking of symptoms. Nurse focus groups informed the volume and delivery model of the therapist facilitator support. Ratings of acceptability out of 10 following feasibility testing (31/87, 36%) demonstrated accessibility (scoring 9.43, SD 1.040), ease (scoring 8.07, SD 3.205), clarity, and the relevant tone of the intervention. The final intervention comprised 12 web-based sessions (8 core and 4 symptom-specific), with one 30-minute facilitator phone call following session 1 and subsequent on-site messaging.

Conclusions: The use of theory and integration of stakeholders’ views throughout informed the development of an evidence-based digital intervention for fatigue, pain, and urgency in IBD. This is the first web-based self-management intervention designed to address these multiple symptoms with the aim of improving the quality of life and reducing the symptom burden of IBD. The intervention is being tested in a large multicenter randomized controlled trial.

Trial Registration: ISRCTN Registry ISRCTN71618461; https://www.isrctn.com/ISRCTN71618461

https://formative.jmir.org/2022/5/e33001

 

Novel? what did I miss?

Ah, right. If you got urgency, run to the washroom.

If your pants are brown, wash them. If your pants are clean, return to your normal activities.

(I hope no one is offended by my potty humor. It is meant to explain how logic researchers are. We do not need a decision tree on how to behave with IBD)
Head-desk head-desk.

 

One could call their logic assinine.

 

"Novel". "Theory".

The "theory", somehow "novel", is the exact same as usual:

Their "theory", the same as usual, has the "potential" to do something. How compelling. Einstein had nothing on those geniuses.

The joke is that this is an actual field of medicine that has immense power over a captive audience deprived of rights and protections against quackery. It's outrageous that this mediocrity is actually funded with public resources.

And by their own description of their "theory", they are basing it on the usual biased pragmatic trials. So not even a theory, it's the same nonsense they pushed in pragmatic trials, then pretend it's a theory because oh who even gives a crap?

But basically this is ACTIB, as far as I can tell, as a model. So it's about sales. They are selling this crap and making money because charlatanism is now normal and good in medicine.

 

A supported online self-management for symptoms of fatigue, pain and urgency/incontinence in people with inflammatory bowel disease: the IBD-BOOST trial

see Mahana Therapeutics.

@dave30th