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Patients’ perspectives on GP interactions after CBT for refractory IBS (Moss-Morris, Chalder)

Discussion in 'Other Health News and Research' started by Dolphin, Aug 4, 2018.

  1. Dolphin

    Dolphin Senior Member (Voting Rights)

    Perhaps there is something interesting or more likely annoying (!) in this.

    Free full text: https://bjgp.org/content/early/2018/07/30/bjgp18X698321

    Patients’ perspectives on GP interactions after cognitive behavioural therapy for refractory IBS: a qualitative study in UK primary and secondary care
    Alice Sibelli, Rona Moss-Morris, Trudie Chalder, Felicity L Bishop, Sula Windgassen and Hazel Everitt
    Br J Gen Pract 30 July 2018; bjgp18X698321. DOI: https://doi.org/10.3399/bjgp18X698321

    Background Previous studies have identified issues with the doctor–patient relationship in irritable bowel syndrome (IBS) that negatively impact symptom management. Despite this, little research has explored interactions between GPs and patients with refractory IBS. National guidelines suggest cognitive behavioural therapy (CBT) as a treatment option for refractory symptoms.

    Aim To explore perceptions of interactions with GPs in individuals with refractory IBS after receiving CBT for IBS or treatment as usual (TAU).

    Design and setting This qualitative study was embedded within a trial assessing CBT in refractory IBS. Fifty-two participants took part in semi-structured interviews post-treatment in UK primary and secondary care.

    Method Inductive and/or data-driven thematic analysis was conducted to identify themes in the interview data.

    Results Two key themes were identified: perceived paucity of GPs’ IBS knowledge and lack of empathy from GPs, but with acknowledgement that this has improved in recent years. These perceptions were described through three main stages of care: reaching a ‘last-resort diagnosis’; searching for the right treatment through a trial-and-error process, which lacked patient involvement; and unsatisfactory long-term management. Only CBT participants reported a shared responsibility with their doctors concerning symptom management and an intention to reduce health-seeking behaviour.

    Conclusion In this refractory IBS group, specific doctor–patient communication issues were identified. Increased explanation of the process of reaching a positive diagnosis, more involvement of patients in treatment options (including a realistic appraisal of potential benefit), and further validation of symptoms could help. This study supports a role for CBT-based IBS self-management programmes to help address these areas and a suggestion that earlier access to these programmes may be beneficial.
  2. Hutan

    Hutan Moderator Staff Member

    New Zealand
    Sadly hilarious.
    CBT participants have been so beaten down that they have given up seeking health?
    CBT participants have finally realised that modern medicine has nothing to offer them and have given up seeing doctors?
    CBT participants are so brainwashed that they have accepted that their illness is their own fault and so there is no point seeing a doctor?
  3. NelliePledge

    NelliePledge Moderator Staff Member

    UK West Midlands
    oh great moss-morris AND chalder :rolleyes: :eek:
    fivetowns, Hutan and Woolie like this.
  4. Sly Saint

    Sly Saint Senior Member (Voting Rights)

    Snow Leopard likes this.

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