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Abstract

Background
Self-management of inflammatory bowel disease is complex. Children and adolescents (CA) with inflammatory bowel disease (IBD) often have difficulty with managing aspects of their condition, resulting in treatment non-adherence and impaired psychosocial function. Self-management interventions are developed to help support patients and their parents/carers to effectively self-manage. The aim of this systematic review was to evaluate the efficacy of self-management interventions in children and adolescents with IBD.

Methods
The review was conducted in accordance with PRISMA guidelines. A systematic literature search of the following databases; Medline, Embase, Cochrane, CINAHL and PsychINFO was conducted to identify controlled trials of interventions aiming to enhance IBD self-management in CA. Two reviewers screened articles for inclusion.

Results
Nine trials (eleven articles) met the inclusion criteria. Most were underpowered with seven recruiting fewer than 50 participants. The interventions aimed to enhance psychological wellbeing (n=5), medication adherence (n=3) or calcium intake (n=1). There was considerable heterogeneity in intervention content and outcomes assessment. Some benefits were reported in disease activity, adherence and psychological well-being but findings were inconsistent.

Conclusions
Self-management is difficult for CA with IBD, however this review identified only a small number of interventions to support self-management, most of which were under-powered and only one that was conducted outside the US. Clinical consensus is required on which self-management activities should be recommended to patients and targeted in interventions and which core outcomes should be assessed. Adequately powered trials of interventions are required to identify how best to support self-management in CA with IBD.

Publication Type:	Article
Additional Information:	This is a pre-copyedited, author-produced version of an article accepted for publication in Inflammatory Bowel Diseases following peer review. The version of record Tran, L. and Mulligan, K. (2018). A systematic review of self-management interventions for children and adolescents with inflammatory bowel disease. Inflammatory Bowel Diseases, will be available online at: https://doi.org/10.1093/ibd/izy299
Publisher Keywords:	Inflammatory Bowel Disease, Self-management, Children, Adolescents
Subjects:	R Medicine > RC Internal medicine R Medicine > RJ Pediatrics
Departments:	School of Health & Psychological Sciences > Healthcare Services Research & Management
SWORD Depositor:	Symplectic Administrator

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