A Systematic Review of Self-Management Interventions for Inflammatory Bowel Disease.

PURPOSE: To conduct a systematic review of self-management interventions for adults with inflammatory bowel disease (IBD) to (a) describe self-management skills in the interventions and (b) describe the effects of the interventions on the health-related outcomes measured.
DESIGN: Systematic review of self-management interventions for adults with IBD using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.
METHODS: The search was conducted using Medline, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Embase, and Proquest databases. Search terms were inflammatory bowel disease OR Crohn* disease OR ulcerative colitis AND self-management. We also used additional limits (adults ≥ 18 years of age and published in English). The self-management skills were organized according to Lorig and Holman's five self-management skills.
FINDINGS: Six reports met the inclusion criteria. One intervention contained all five of the self-management skills. Most interventions contained two skills. Four studies demonstrated positive effects of self-management on disease activity. Two interventions revealed positive effects on disease-specific health-related quality of life (HRQOL), and one intervention revealed positive effects on generic HRQOL. One study showed positive effects of symptoms.
CONCLUSIONS: The interventions reviewed varied in the approaches, theoretical perspectives, self-management skills, and outcomes measured. Additional research is needed to understand which are the active components of self-management. CLINICAL RELEVANCE: Support for self-management skills is an important component of nursing care for people with IBD.