Abstract
Individuals with irritable bowel syndrome (IBS) are more likely to miss work (absenteeism), have reduced work effectiveness (presenteeism) and experience activity impairment. This study compared the effect of a comprehensive self-management (CSM) intervention program (incorporating cognitive behavioral therapy, diet education and relaxation) versus usual care on work- and activity-impairments in adults with IBS. This secondary data analysis used daily diaries and Work Productivity and Activity Impairment in Irritable Bowel Syndrome (WPAI-IBS) questionnaire data collected at baseline, 3, 6 and 12 months post-randomization from 160 adults with IBS. Mixed-effects modeling was used to compare the effect of CSM versus usual care on work- and activity-related outcomes. The effect of CSM was shown to be superior to usual care in improving WPAI-IBS and diary-measured presenteeism, overall work productivity loss and activity impairment with sustained effects up to 12 months post-randomization (all p < 0.05). Moreover, the CSM intervention was found to be particularly beneficial for IBS patients with greater baseline work and activity impairments (all p < 0.05). The CSM intervention may bring benefits to individuals and society through improving symptoms and reducing presenteeism associated with IBS.
Highlights
Introduction published maps and institutional affilIrritable bowel syndrome (IBS) is a disorder of Gut–Brain Interaction which highlights the link between emotional and cognitive brain systems with peripheral intestinal function [1]
Our findings show that, compared to usual care, our cognitive behavioral therapy (CBT)-based comprehensive self-management (CSM) intervention led to greater improvements in presenteeism, work productivity loss and activity impairment measured by WPAI-irritable bowel syndrome (IBS) and daily diaries
IBS patients with diarrhea who were randomized to a low fermentable oligo, di- and monosaccharides and polyols (FODMAP) diet showed a greater reduction in WPAI-IBSmeasured presenteeism, work productivity loss and activity impairment after the 28-day intervention [30]
Summary
Introduction published maps and institutional affilIrritable bowel syndrome (IBS) is a disorder of Gut–Brain Interaction which highlights the link between emotional and cognitive brain systems with peripheral intestinal function [1]. It is estimated to affect 10~15% of the US and European populations, and it usually occurs among the working population aged 15~65 [2]. Persons with IBS often experience gastrointestinal symptoms, such as abdominal pain/discomfort, constipation and/or diarrhea, abdominal bloating and distension [4], and other non-gastrointestinal symptoms, such as somatic symptoms (i.e., fatigue and sleep disturbance) and/or psychological distress (i.e., anxiety and depression) [5]. These IBS symptoms can lead to impaired physical and role functioning, which, in turn, limit individual work performance and/or interfere with engagement iations
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