title: Intervening on cognitions and behavior in irritable bowel syndrome: A feasibility trial using PDAs.
abstract: OBJECTIVE
  Irritable bowel syndrome (IBS) is a common, chronic, and often disabling disorder. Cognitive-behavioral therapy (CBT) has been shown to be effective in alleviating IBS symptoms. The aim of this study was to establish the feasibility and the efficacy of a cognitive-behavioral e-intervention using personal digital assistants (PDAs) on the self-management of IBS patients.
  
  
  METHODS
  A feasibility trial was conducted with 38 control group patients receiving standard care and 37 intervention group patients receiving standard care supplemented with a 4-week CBT intervention on PDAs. All patients fulfilled the diagnostic Rome III criteria for IBS. At baseline, 4-week, and 3-month follow-up, patients' abdominal pain, dysfunctional cognitions, IBS quality of life, and pain catastrophizing thoughts were assessed using written questionnaires.
  
  
  RESULTS
  Between-group comparisons between baseline and 4 weeks showed more overall quality of life improvement, more improvement in catastrophizing thoughts, and more pain improvement in the intervention group. Only improvement in catastrophizing thoughts persisted in the long-term. No significant differences between groups were found for dysfunctional cognitions. As all 37 intervention group patients completed the intervention and completed diaries three times a day for 4 weeks, the e-health intervention seems feasible.
  
  
  CONCLUSIONS
  A cognitive-behavioral intervention on pocket-type computers appears feasible and efficacious for improving IBS-related complaints and cognitions in the short-term. The intervention group improved on several aspects, but most on catastrophizing thoughts, and these improvements even persisted after 3 months. Future studies should focus on unravelling the effective components of this innovative e-health intervention.
authors.affiliation: NIVEL (Netherlands Institute for Health Services Research), Utrecht, The Netherlands.
authors.forename: Simone
authors.initials: S
authors.lastname: Oerlemans
authors.forename: Oda
authors.initials: O
authors.lastname: van Cranenburgh
authors.forename: Pieter-Jan
authors.initials: PJ
authors.lastname: Herremans
authors.forename: Peter
authors.initials: P
authors.lastname: Spreeuwenberg
authors.forename: Sandra
authors.initials: S
authors.lastname: van Dulmen
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D001521:Behavior Therapy / Q000295:instrumentation*; D058443:Catastrophization / Q000523:psychology*; D034201:Computers, Handheld; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D043183:Irritable Bowel Syndrome / Q000523:psychology* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000523:psychology*; D059408:Pain Management; D010147:Pain Measurement / Q000523:psychology; D011788:Quality of Life / Q000523:psychology*; D012648:Self Care; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D016896:Treatment Outcome