Randomised clinical trial: individual versus group hypnotherapy for irritable bowel syndrome

Abstract

Summary Background Gut‐directed hypnotherapy improves symptoms for patients with irritable bowel syndrome (IBS). Group hypnotherapy, as well as hypnotherapy administered by nurses, can increase treatment availability, but there are few comparisons between individual and group‐based hypnotherapy. Aim We aimed to evaluate and compare the effectiveness of nurse‐administered hypnotherapy for IBS delivered individually or in groups. Methods IBS patients were randomised to individual or group hypnotherapy (8 sessions, 12 weeks). The primary endpoint was changes in severity of IBS symptoms. A responder was defined as reduction of IBS severity scoring system (IBS‐SSS) ≥50 points at the end of treatment compared to baseline. The effects on extracolonic and psychological symptoms, and quality of life were also assessed. Symptoms were also followed up 6 months after treatment start. Results A total of 119 patients were randomised (61 individual, 58 group hypnotherapy). Patients reported improvements in IBS symptoms (IBS‐SSS) (individual: 332 (273–401) (median, IQR), versus 216 (140–308), (p < 0.0001), group: 315 (239–382), versus 217 (149–314), (p < 0.0001)), with no differences between the groups (p = 0.16). Extracolonic symptoms, psychological symptoms and quality of life also improved, without clear differences between the groups. Sixty‐nine percent of the individual hypnotherapy patients were responders after treatment versus 57% of the group hypnotherapy patients (p = 0.25). Symptom improvements were also seen at follow‐up. Conclusions Nurse‐administered gut‐directed hypnotherapy, delivered individually or in groups, relieves IBS symptoms, improves psychological symptoms and quality of life. Group hypnotherapy can be an efficacious alternative, enabling more patients to benefit from the treatment (http://clinicaltrials.gov ID no of study: NCT03432078).

Nurse practitioner‐delivered cognitive–behavioral treatment as a novel implementation route for irritable bowel syndrome: A proof of concept

“…In an attempt to increase access to brain-gut behavior therapies for IBS, they have been delivered online, 9,41 via bibliotherapy, 42 via telephone, 43,44 via groups, [45][46][47][48] and more recently in mobile applications. 49 While some of these delivery methods may be helpful and effective for many patients, there may still be barriers to accessing them, or the delivery method is appropriate for some patients but not all.…”

Improving access to gut‐directed hypnotherapy for irritable bowel syndrome in the digital therapeutics' era: Are mobile applications a “smart” solution?

“…There is also recent evidence that group-GDH can be just as effective as individualized therapy in primary and secondary care patients with IBS. 32,33 The group approach therefore allows greater access to GDH, potentially allowing individualized therapy to be reserved for those with more complex, and refractory forms of IBS in tertiary care, which are likely to require an individualized approach. Finally, remote, individualized GDH, delivered by a therapist via video has been shown to have comparable results to face-to-face therapy, 34 which has also improved access and is also potentially more costeffective to deliver.…”

“…Recent developments in improving access to GDH have included trial data which have confirmed that shorter courses of individualized GDH with six‐sessions have non‐inferior outcomes to 12‐sessions, meaning that the throughput of a single therapist or department could be effectively doubled without altering outcomes. There is also recent evidence that group‐GDH can be just as effective as individualized therapy in primary and secondary care patients with IBS 32,33 . The group approach therefore allows greater access to GDH, potentially allowing individualized therapy to be reserved for those with more complex, and refractory forms of IBS in tertiary care, which are likely to require an individualized approach.…”

Editorial: group‐based hypnotherapy as good as individually delivered hypnotherapy for symptoms of irritable bowel syndrome

“…Lövdahl et al 6 concluded that nurse‐administered group hypnotherapy could serve as an effective treatment option in IBS. However, it might also be interesting to compare nurse‐ versus mental health practitioner‐delivered gut‐directed hypnotherapy in future studies to identify if any differences exist.…”

“…Lövdahl et al 6 concluded that nurse-administered group hypnotherapy could serve as an effective treatment option in IBS.…”