Patient EducationIBSNCT03466281
Patient Education for Patients With Irritable Bowel Syndrome (IBS)
A study testing Structured patient group education and Education via Internet in people with Patient Education and IBS - Irritable Bowel Syndrome, run by Sahlgrenska University Hospital at 1 site in Sweden.
Trial summary
In this randomized controlled study in patients with irritable bowel syndrome (IBS) the investigators plan to compare the effects of a structured patient group education (IBS School) with structured education provided via the internet. Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Patient Education, IBS - Irritable Bowel Syndrome
- What is being tested?
- Structured patient group education and Education via Internet
- Type of treatment
- Lifestyle or therapy programme
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 100 participants
- Where
- 1 siteSweden
- Study dates
- 1 Aug 2016to 20 Nov 2017
- Phase
- Interventional
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 years and older
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- IBS according to the Rome III criteria
Who cannot join
- organic GI disease and/or another disease potentially affecting the GI symptoms
- severe psychiatric disease due to potential problems to participate in a group intervention
- disability to communicate in the Swedish language
- disability to use a computer or not have access to a computer or internet
Trial locations and contacts
1 site in 1 country.
Sweden1 site
Dept of Internal Medicine, Sahlgrenska University Hospital
Gothenburg, S413-45
About this study
Official title: Structured Patient Group Education Versus Structured Patient Education Via the Internet for Patients With Irritable Bowel Syndrome (IBS)
In this randomized controlled study in patients with irritable bowel syndrome (IBS) the investigators plan to compare the effects of a structured patient group education (IBS School) with structured education provided via the internet. The effects of the interventions on GI and psychological symptom severity, knowledge and quality of life will be assessed with validated questionnaires at baseline, immediately after the intervention and 3 and 6 months after the intervention.
Read the detailed description
In this randomized controlled study in patients with irritable bowel syndrome (IBS) the investigators plan to compare the effects of a structured patient group education (IBS School), which previously has been evaluated and found to efficacious for symptom improvement (1-3), with a similar education provided via the internet in a non-inferiority design. The investigators hypothesize that structured patient education provided via the internet is not inferior compared to structured patient group education.
Men and women from 18 years of age, with IBS according to the Rome III criteria, who are referred from physicians in primary care and secondary/tertiary care to receive patient education will be included. The education, both the IBS School and the internet based version, will be managed at the GI outpatient clinic at Sahlgrenska University hospital in Gothenburg. Patients with an organic GI disease and/or with another disease potentially affecting the GI symptoms are excluded. Likewise, patients with a disability to communicate in the Swedish language or to use a computer and/or do not have access to a computer or internet are excluded.
Moreover, patients with a severe psychiatric disease are excluded due to potential problems to participate in a group intervention. In order to allocate an equal number of patients to both of the interventions during the study, a number of up to 20 patients will be invited in a block and the patients will be randomly divided into two groups with an equal number of patients in each group. The groups will then be randomized 1:1 to either start the IBS School or to start the patient education via internet within two to three weeks. After the randomization all patients will receive a personal login to the database and an e-mail with information on how to log in and complete the questionnaires online. All questionnaires will be completed by the patients on-line, i.e. all data will be registered directly into the database.
The interventions:
Both interventions in the study are designed based on the self-efficacy theory, and the general theory of nursing. Moreover, the education is performed based on a biopsychosocial model considered to be important in functional GI disorders. The IBS School consists of three, two hour sessions held once per week in a group setting with eight to ten patients in each group. A nurse and a dietician lead the education and issues are chosen with the aim to cover a wide spectrum of issues related to IBS. A lot of space is given for discussion within the group. At the first session, general information is provided about IBS, symptoms, pathophysiology and treatment options. At the second session, food related issues is discussed and at the third session the effects from other life style factors like stress, physical activity and relaxation is discussed.
The patient education provided via the internet covers the same areas of issues related to IBS that are covered in the structured group education. The participants in the internet group will receive and read information which is divided into three steps, once weekly. At the end of each treatment week the patients will have a contact via the internet with the nurse and dietician and thereby receive feedback on questions that were raised during the treatment week. The patients are also encouraged to attend (anonymously) a specific, closed internet forum where they have the opportunity to discuss and reflect over information material from the last week with other patients attending the internet based intervention. The time consumed to read the information and reflect is estimated to two hours weekly.
- Conditions
- Patient Education, IBS - Irritable Bowel Syndrome
- Being tested
- Structured patient group education, Education via Internet
- Medical subject headings
- Irritable Bowel Syndrome
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Structured patient group educationBehavioural
Patient education in a group setting
Education via InternetBehavioural
Patient education via the internet
| Study group | Role | What they receive |
|---|---|---|
| IBS School | Active comparator | Patient education provided in a group setting Receives: Behavioral: Structured patient group education |
| Internet patient education | Active comparator | Patient education provided via the internet Receives: Behavioral: Education via Internet |
What is being measured
The primary outcome is the main question the study is designed to answer.
Change of GI symptoms
Measured with a questionnaire; Irritable Bowel Syndrome-severity scoring system (IBS-SSS). Five issues measure the severity of IBS symptoms on a scale, each ranging from 0 to 100. A total score is calculated ranging from 0 to 500. In this study the total score is used, the higher the score the worse severity of symptoms.
Measured: Measuring change from Baseline and up to six months after the education
Secondary outcomes (4)
Change of Quality of life
Measured with a questionnaires; Irritable Bowel Syndrome Quality Of Life (IBSQOL) is a disease-specific HRQOL instrument, including 30 items measuring nine dimensions of health, emotional functioning, mental health, sleep, energy, physical functioning, diet, social role, physical role and sexual relations. Raw scores are transformed into a scale of 0-100, with 100 representing the best possible quality of life scores for each of the nine dimensions.
Measured: Measuring change from Baseline and up to six months after the education
Change of Psychological symptoms
Measured with a questionnaire; Hospital Anxiety and Depression scale (HAD). This scale consists of 14 items with seven items relating to anxiety and seven to depression. A four-graded scale was used (0-3), giving a total range from 0 to 21 on each subscale. The higher the score, the more pronounced the symptom. HAD was developed for nonpsychiatric medical patients to detect anxiety and depression.
Measured: Measuring change from Baseline and up to six months after the education
Change of GI specific anxiety
Measured with a questionnaire; Visceral Sensitivity Index (VSI) which is a 15-item (each question ranging from 0 to 5) questionnaire designed to measure the degree of GI-specific anxiety in IBS. The total score ranges from 0 (no GI-specific anxiety) to 75 (severe GI-specific anxiety), and the higher the score, the higher the GI-specific anxiety
Measured: Measuring change from Baseline and up to six months after the education
Change of Perceived knowledge about IBS
Measured with a Visual Analogue scale (VAS). The patients were asked to rate their perceived knowledge of IBS on a Visual Analog Scale (VAS). The scale comprised a 100-mm straight line with the extremes labeled 'No knowledge at all' and 'Very much knowledge'. The score ranges from 0 to 100 and the higher the score the more perceived knowledge of IBS.
Measured: Measuring change from Baseline and up to six months after the education
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted15 Mar 2018
- Study start1 Aug 2016
- Primary completion30 Jun 2017
- Study completion20 Nov 2017
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (4)Papers the sponsor has linked to this study.
- Other trials for Patient EducationStudies of the same condition, open and under way.
- More trials run by Sahlgrenska University HospitalThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Model description
- Active Comparator: 1 Structured patients group intervention - IBS School Active Comparator: 2 Structured Patient education via Internet
- Masking
- Single blind
- Who is masked
- Outcomes assessor
- Enrolment
- 100 participants (actual)
Sponsor and investigators
- Lead sponsor
- Sahlgrenska University Hospital
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, Magnus Simrén, Sahlgrenska University Hospital
- Investigators
- Magnus Simren, MD, Prof, Principal investigator, Dept of internal medicine, Gothenburg University
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT03466281
- Sponsor's protocol ID
- IBS patient education
- Acronym
- IBS
- Status last verified
- Mar 2018
- First submitted
- 29 Nov 2017
- Last updated
- 15 Mar 2018
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No
Publications
Ringstrom G, Storsrud S, Lundqvist S, Westman B, Simren M. Development of an educational intervention for patients with Irritable Bowel Syndrome (IBS): a pilot study. BMC Gastroenterol. 2009 Feb 4;9:10. doi: 10.1186/1471-230X-9-10.
PubMed 19192312Ringstrom G, Storsrud S, Posserud I, Lundqvist S, Westman B, Simren M. Structured patient education is superior to written information in the management of patients with irritable bowel syndrome: a randomized controlled study. Eur J Gastroenterol Hepatol. 2010 Apr;22(4):420-8. doi: 10.1097/MEG.0b013e3283333b61.
PubMed 19923998Ringstrom G, Storsrud S, Simren M. A comparison of a short nurse-based and a long multidisciplinary version of structured patient education in irritable bowel syndrome. Eur J Gastroenterol Hepatol. 2012 Aug;24(8):950-7. doi: 10.1097/MEG.0b013e328354f41f.
PubMed 22617366Lindfors P, Axelsson E, Engstrand K, Storsrud S, Jerlstad P, Tornblom H, Ljotsson B, Simren M, Ringstrom G. Online Education Is Non-Inferior to Group Education for Irritable Bowel Syndrome: A Randomized Trial and Patient Preference Trial. Clin Gastroenterol Hepatol. 2021 Apr;19(4):743-751.e1. doi: 10.1016/j.cgh.2020.04.005. Epub 2020 Apr 11.
PubMed 32289541
Study at a glance
From the registry record, last updated by the sponsor on 15 Mar 2018. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Structured Patient Group Education Versus Structured Patient Education Via the Internet for Patients With Irritable Bowel Syndrome (IBS)
- ClinicalTrials.gov ID
- NCT03466281
- Acronym / sponsor ID
- IBS / IBS patient education
- Conditions
- Patient Education, IBS - Irritable Bowel Syndrome
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 100 participants (actual)
- Lead sponsor
- Sahlgrenska University HospitalUniversity, hospital or other
- Study start
- 1 Aug 2016 (actual)
- Primary completion
- 30 Jun 2017 (actual)
- Study completion
- 20 Nov 2017 (actual)
- First posted
- 15 Mar 2018 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
In this randomized controlled study in patients with irritable bowel syndrome (IBS) the investigators plan to compare the effects of a structured patient group education (IBS School) with structured education provided via the internet. The effects of the interventions on GI and psychological symptom severity, knowledge and quality of life will be assessed with validated questionnaires at baseline, immediately after the intervention and 3 and 6 months after the intervention.
Detailed description
In this randomized controlled study in patients with irritable bowel syndrome (IBS) the investigators plan to compare the effects of a structured patient group education (IBS School), which previously has been evaluated and found to efficacious for symptom improvement (1-3), with a similar education provided via the internet in a non-inferiority design. The investigators hypothesize that structured patient education provided via the internet is not inferior compared to structured patient group education.
Men and women from 18 years of age, with IBS according to the Rome III criteria, who are referred from physicians in primary care and secondary/tertiary care to receive patient education will be included. The education, both the IBS School and the internet based version, will be managed at the GI outpatient clinic at Sahlgrenska University hospital in Gothenburg. Patients with an organic GI disease and/or with another disease potentially affecting the GI symptoms are excluded. Likewise, patients with a disability to communicate in the Swedish language or to use a computer and/or do not have access to a computer or internet are excluded.
Moreover, patients with a severe psychiatric disease are excluded due to potential problems to participate in a group intervention. In order to allocate an equal number of patients to both of the interventions during the study, a number of up to 20 patients will be invited in a block and the patients will be randomly divided into two groups with an equal number of patients in each group. The groups will then be randomized 1:1 to either start the IBS School or to start the patient education via internet within two to three weeks. After the randomization all patients will receive a personal login to the database and an e-mail with information on how to log in and complete the questionnaires online. All questionnaires will be completed by the patients on-line, i.e. all data will be registered directly into the database.
The interventions:
Both interventions in the study are designed based on the self-efficacy theory, and the general theory of nursing. Moreover, the education is performed based on a biopsychosocial model considered to be important in functional GI disorders. The IBS School consists of three, two hour sessions held once per week in a group setting with eight to ten patients in each group. A nurse and a dietician lead the education and issues are chosen with the aim to cover a wide spectrum of issues related to IBS. A lot of space is given for discussion within the group. At the first session, general information is provided about IBS, symptoms, pathophysiology and treatment options. At the second session, food related issues is discussed and at the third session the effects from other life style factors like stress, physical activity and relaxation is discussed.
The patient education provided via the internet covers the same areas of issues related to IBS that are covered in the structured group education. The participants in the internet group will receive and read information which is divided into three steps, once weekly. At the end of each treatment week the patients will have a contact via the internet with the nurse and dietician and thereby receive feedback on questions that were raised during the treatment week. The patients are also encouraged to attend (anonymously) a specific, closed internet forum where they have the opportunity to discuss and reflect over information material from the last week with other patients attending the internet based intervention. The time consumed to read the information and reflect is estimated to two hours weekly.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Single blind (outcomes assessor)
- Number of arms
- 2
- Model description
- Active Comparator: 1 Structured patients group intervention - IBS School Active Comparator: 2 Structured Patient education via Internet
| Arm | Type | Receives |
|---|---|---|
| IBS School | Active comparator | Behavioral: Structured patient group educationPatient education provided in a group setting |
| Internet patient education | Active comparator | Behavioral: Education via InternetPatient education provided via the internet |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (1 listed)
- IBS according to the Rome III criteria
Key exclusion criteria (4 listed)
- organic GI disease and/or another disease potentially affecting the GI symptoms
- severe psychiatric disease due to potential problems to participate in a group intervention
- disability to communicate in the Swedish language
- disability to use a computer or not have access to a computer or internet
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Structured patient group educationPatient education in a group setting | Behavioural | IBS School |
| Education via InternetPatient education via the internet | Behavioural | Internet patient education |
Primary outcome
Change of GI symptoms
Time frame: Measuring change from Baseline and up to six months after the education
Measured with a questionnaire; Irritable Bowel Syndrome-severity scoring system (IBS-SSS). Five issues measure the severity of IBS symptoms on a scale, each ranging from 0 to 100. A total score is calculated ranging from 0 to 500. In this study the total score is used, the higher the score the worse severity of symptoms.
4 secondary outcomes
Change of Quality of life
Time frame: Measuring change from Baseline and up to six months after the education
Change of Psychological symptoms
Time frame: Measuring change from Baseline and up to six months after the education
Change of GI specific anxiety
Time frame: Measuring change from Baseline and up to six months after the education
Change of Perceived knowledge about IBS
Time frame: Measuring change from Baseline and up to six months after the education
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 15 Mar 2018.
- Results publication: PubMed 19192312Ringstrom G, Storsrud S, Lundqvist S, Westman B, Simren M. Development of an educational intervention for patients with Irritable Bowel Syndrome (IBS): a pilot study. BMC Gastroenterol. 2009 Feb 4;9:10. doi: 10.1186/1471-230X-9-10.
- Results publication: PubMed 19923998Ringstrom G, Storsrud S, Posserud I, Lundqvist S, Westman B, Simren M. Structured patient education is superior to written information in the management of patients with irritable bowel syndrome: a randomized controlled study. Eur J Gastroenterol Hepatol. 2010 Apr;22(4):420-8. doi: 10.1097/MEG.0b013e3283333b61.
- Results publication: PubMed 22617366Ringstrom G, Storsrud S, Simren M. A comparison of a short nurse-based and a long multidisciplinary version of structured patient education in irritable bowel syndrome. Eur J Gastroenterol Hepatol. 2012 Aug;24(8):950-7. doi: 10.1097/MEG.0b013e328354f41f.
- Derived from this study: PubMed 32289541Lindfors P, Axelsson E, Engstrand K, Storsrud S, Jerlstad P, Tornblom H, Ljotsson B, Simren M, Ringstrom G. Online Education Is Non-Inferior to Group Education for Irritable Bowel Syndrome: A Randomized Trial and Patient Preference Trial. Clin Gastroenterol Hepatol. 2021 Apr;19(4):743-751.e1. doi: 10.1016/j.cgh.2020.04.005. Epub 2020 Apr 11.
- Individual participant dataSharing planned: No
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Magnus Simren, MD, Prof principal investigator
Dept of internal medicine, Gothenburg University
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Structured patient group education and Education via Internet in people with Patient Education and IBS - Irritable Bowel Syndrome, run by Sahlgrenska University Hospital at 1 site in Sweden.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 1 inclusion and 4 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 15 Mar 2018. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in Sweden. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Change of GI symptoms (time frame: Measuring change from Baseline and up to six months after the education). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT03466281, which also lists 4 linked publications.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 15 Mar 2018.