Introduction: Previous studies have reported the effectiveness of inflammatory bowel disease (IBD) self-management. However, it is unclear which types of self-management interventions are effective. We conducted a systematic literature review to clarify the status and efficacy of self-management interventions for IBD. Methods: Searches were performed in databases including Embase, Medline, and Cochrane Library. Randomized, controlled studies of interventions in adult human participants with IBD involving a self-management component published in English from 2000 to 2020 were included. Studies were stratified based study design, baseline demographic characteristics, methodological quality and how outcomes were measured, and analyzed for statistically significant improvements in outcomes such as psychological health, quality of life, and healthcare resource usage. Results: Among 50 studies included, 31 considered patients with IBD and 14 and 5 focused on patients with ulcerative colitis and Crohn’s disease, respectively. Improvements in an outcome were reported in 33 (66%) studies. Most of the interventions that significantly improved an outcome index were based on symptom management and many of these were also delivered in combination with provision of information. We also note that among effective interventions, many were conducted with individualized and patient-participatory activities, and multidisciplinary healthcare practitioners were responsible for delivery of the interventions. Conclusion: Ongoing interventions that focus on symptom management with provision of information may support self-management behavior in patients with IBD. A participatory intervention targeting individuals was suggested as an effective intervention method.

The current standard-of-care for UC involves a treat-to-target approach, for which patients are regularly assessed to ensure that they are meeting disease control criteria. 2,8 Colonoscopy is a key component of this approach because it helps determine the extent and severity of UC, and helps guide the treatment strategy to achieve remission. 1,3,[8][9][10] For instance, Japanese guidelines 1,3 and other recommendations 9,11,12 state that colonoscopy should be regularly used to assess treatment response and improve disease management in patients with UC. Available treatments for UC consist of 5-aminosalicylic acid (5-ASA), immunomodulators, steroids, tofacitinib, and biologic therapies including vedolizumab, ustekinumab, and anti-tumor necrosis