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Desperately seeking a cure: Treatment seeking and appraisal in irritable bowel syndrome

Research output: Contribution to journalArticle

J. Matthew Harvey, Alice Sibelli, Trudie Chalder, Hazel Everitt, Rona Moss-Morris, Felicity L. Bishop

Original languageEnglish
JournalBritish Journal of Health Psychology
Early online date1 Jan 2018
StateE-pub ahead of print - 2018

King's Authors


Objectives. Irritable bowel syndrome (IBS) is common and adversely affects patients’ quality of life. Multiple potential treatment options exist for patients (and clinicians) to choose from, with limited evidence to inform treatment selection. The aim was to explore how patients with IBS go about seeking and appraising different treatment modalities, with a view to elucidating the psychological processes involved and identifying opportunities to improve clinical practice.
Design. Qualitative study nested within a randomized controlled trial of therapist delivered and web-based cognitive behavioural therapy versus treatment-as-usual for IBS.
Methods. A total of 52 people participated in semi-structured interviews about their prior experiences of treatments for IBS. Transcripts were analysed using inductive thematic analysis.
Results. Key themes (desperation for a cure, disappointment at lack of cure, appraising the effects of diverse treatments, and hope for positive effects) clustered around an overarching theme of being trapped within a vicious cycle of hope and despair on treatment seeking. A desperation and willingness drove interviewees to try any treatment modality available that might potentially offer relief. Coming to accept there is no cure for IBS helped interviewees escape the vicious cycle. Treatments were appraised for their effects on symptoms and quality of life while also considering, but rarely prioritizing, other
aspects including convenience of the regimen itself, whether it addressed the perceived root causes of IBS, perceived side-effects, and cost.
Conclusion. Treatment seeking in IBS can be challenging for patients. Supportive
discussions with health care professionals about illness perceptions, treatment beliefs, and goals could improve patients’ experiences.

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