A mixed methods feasibility study to evaluate the use of a low-intensity, nurse-delivered cognitive behavioural therapy for the treatment of irritable bowel syndrome

Introduction: Irritable bowel syndrome (IBS) is characterised by symptoms such as abdominal pain, constipation, diarrhoea and bloating. These symptoms impact on health-related quality of life, result in excess service utilisation and are a significant burden to healthcare systems. Certain mechanisms which underpin IBS can be explained by a biopsychosocial model which is amenable to psychological treatment using techniques such as cognitive behavioural therapy (CBT). While current evidence supports CBT interventions for this group of patients, access to these treatments within the UK healthcare system remains problematic. Methods and analysis: A mixed methods feasibility randomised controlled trial will be used to assess the feasibility of a low-intensity, nurse-delivered guided self-help intervention within secondary care gastrointestinal clinics. A total of 60 participants will be allocated across four treatment conditions consisting of: high-intensity CBT delivered by a fully qualified cognitive behavioural therapist, low-intensity guided self-help delivered by a registered nurse, self-help only without therapist support and a treatment as usual control condition. Participants from each of the intervention arms of the study will be interviewed in order to identify potential barriers and facilitators to the implementation of CBT interventions within clinical practice settings. Quantitative data will be analysed using descriptive statistics only. Qualitative data will be analysed using a group thematic analysis.

Introduction: Irritable bowel syndrome (IBS) is
characterised by symptoms such as abdominal pain,
constipation, diarrhoea and bloating. These symptoms
impact on health-related quality of life, result in excess
service utilisation and are a significant burden to
healthcare systems. Certain mechanisms which
underpin IBS can be explained by a biopsychosocial
model which is amenable to psychological treatment
using techniques such as cognitive behavioural therapy
(CBT). While current evidence supports CBT
interventions for this group of patients, access to these
treatments within the UK healthcare system remains
problematic.
Methods and analysis: A mixed methods feasibility
randomised controlled trial will be used to assess the
feasibility of a low-intensity, nurse-delivered guided
self-help intervention within secondary care
gastrointestinal clinics. A total of 60 participants will be
allocated across four treatment conditions consisting
of: high-intensity CBT delivered by a fully qualified
cognitive behavioural therapist, low-intensity guided
self-help delivered by a registered nurse, self-help only
without therapist support and a treatment as usual
control condition. Participants from each of the
intervention arms of the study will be interviewed in
order to identify potential barriers and facilitators to the
implementation of CBT interventions within clinical
practice settings. Quantitative data will be analysed
using descriptive statistics only. Qualitative data will be
analysed using a group thematic analysis.

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