Evidence map›Paper›PMID 36661110›Full record

Observational studyNeurogastroenterology and motility2023

Nurse practitioner-delivered cognitive-behavioral treatment as a novel implementation route for irritable bowel syndrome: A proof of concept.

Helen Burton Murray, Imani Weeks, Andrea Thurler, Samantha Calabrese, Mary Kate Lapinel, Elizabeth N Madva, Kyle Staller, Laurie Keefer, Braden Kuo

Abstract readObservational Study
In one paragraph

Observational study in Neurogastroenterology and motility, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Trial
  3. Article
  4. Management of irritable bowel syndrome: a narrative review.Translational gastroenterology and hepatology · 2024
    Review
  5. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Helen Burton MurrayDepartment of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA.ORCID 0000-0003-2059-3256
Imani WeeksDivision of Gastroenterology, Massachusetts General Hospital, Boston, Massachusetts, USA.
Andrea ThurlerDivision of Gastroenterology, Massachusetts General Hospital, Boston, Massachusetts, USA.
Samantha CalabreseDivision of Gastroenterology, Massachusetts General Hospital, Boston, Massachusetts, USA.
Mary Kate LapinelDivision of Gastroenterology, Massachusetts General Hospital, Boston, Massachusetts, USA.
Elizabeth N MadvaDepartment of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA.ORCID 0000-0003-2194-2032
Kyle StallerCenter for Neurointestinal Health, Massachusetts General Hospital, Boston, Massachusetts, USA.ORCID 0000-0003-4925-4290
Laurie KeeferIcahn School of Medicine at Mount Sinai, New York, New York, USA.
Braden KuoCenter for Neurointestinal Health, Massachusetts General Hospital, Boston, Massachusetts, USA.

Funding

A Biobehavioral Approach to Understand Problematic Avoidant/Restrictive Eating in Adults with Functional DyspepsiaK23DK131334 · NIDDK · MASSACHUSETTS GENERAL HOSPITAL · PI BURTON MURRAY, HELEN · 2021 to 2025
$1.1M
The Role of Fiber in the Etiopathogenesis of Fecal IncontinenceK23DK120945 · NIDDK · MASSACHUSETTS GENERAL HOSPITAL · PI STALLER, KYLE · 2020 to 2024
$1.0M
NIDDK NIH HHS K23 DK120945NIDDK NIH HHS K23 DK131334
6 · The paper itself

Abstract

backgroundExposure-based cognitive-behavioral therapy (exposure-CBT) is efficacious for irritable bowel syndrome (IBS). However, few patients receive exposure-CBT due to a lack of behavioral health providers trained in brain-gut behavior therapies. Nurse practitioners (NPs) could fill a critical need for scalable delivery methods. In a pragmatic investigation of a 5-session NP-delivered exposure-CBT for adults with Rome IV-defined IBS, we evaluated treatment feasibility and acceptability and explored changes clinical outcomes.

methodsExposure-CBT was delivered as part of routine care involving four sessions every other week and a 2-month booster session. Patients could electively participate in an observational study including pre-, mid-, and post-treatment surveys and a post-treatment qualitative interview. Independently coded ratings of NP treatment protocol adherence and competence ratings were completed from audio recordings, rated on a 1 (not at all) to 5 (completely) scale.

resultsTwenty-five patients consented (ages 22-67 years; 76% female; 48% IBS-diarrhea predominant). There was high feasibility-adherence average = 4.1, NP competence average = 4.8, 72% treatment completion, 93% satisfaction scores ≥3. Treatment satisfaction was high (rated as 4/4 "very satisfied" by n = 9 and as 3/4 "mostly satisfied" by n = 5). There were improvements in clinical outcomes across treatment with large effects for IBS-symptom severity (-53%; Hedge's g = 1.0; 95% confidence interval [CI] = 0.5, 1.5) and IBS quality of life (+31%; Hedge's g = 0.8; 95% CI = 0.4, 1.2).

conclusionsNP-delivered exposure-CBT for IBS was initially feasible and acceptable with promising clinical improvements. Findings will inform a future NIH Stage 1B/ORBIT Phase IIB pilot randomized control trial.

Indexed as

Cognitive Behavioral TherapyIrritable Bowel SyndromeAdultAgedCognitionFemaleHumansMaleMiddle AgedQuality of LifeTreatment OutcomeYoung Adultcognitive-behavioral therapydisorders of gut-brain interactionfunctional gastrointestinal disordersirritable bowel syndromenurse practitionersnurses

Identifiers

PMID36661110
PMCPMC10823562

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.