Barlow and colleagues examined self-management and educational interventions developed to support people with inflammatory bowel disease (IBD), and identified which type of intervention seems to be most effective. The search was deliberately over inclusive to capture studies that evaluated educational and self-management interventions. The following databases were searched: MEDLINE, Embase, CINAHL, PsycINFO, the National Research Register, and Cochrane. Twenty-three studies were included; thirteen of these were randomized controlled trials. The content of the interventions varied widely. Three studies that explicitly labeled themselves as self-management interventions incorporated the greatest number of self-management techniques. Two of these studies reported the greatest number of improved outcomes in relation to symptom reporting, psychological wellbeing, and healthcare resource use. There is clearly a role for information in IBD, but the review supports research in other conditions that shows that education cannot be assumed to lead to improvements in health and well being. Much of the research in this area focuses on education rather than self-management.

WHAT THE STUDY MAY MEAN TO YOU AS A HEALTH CARE PROVIDER: Where self-management techniques were applied, the findings tend to be more promising. Gastroenterology nurses (or in the United Kingdom, IBD specialist nurses) may be best placed to facilitate self-management in this group.

WHAT THE STUDY MAY MEAN TO YOU AS A PATIENT: Self-management skills only work if patients use them. While education is required to teach patients the skills, determining the long-term performance of self-management by patients can only assess the success. While the authors suggest that nurses would be best to teach self-management courses, this recommendation is not supported by the literature.

C Barlow et al. A Critical Review of Self-Management and Educational Interventions in Inflammatory Bowel Disease. Gastroenterology Nursing, 2010;33:11-18.