Self-management in patients with inflammatory bowel disease: strategies, outcomes, and integration into clinical care

• Published in: Clinical and experimental gastroenterology 2016-01, Vol.9, p.259-267
• Main Authors: Plevinsky, Jill M, Greenley, Rachel N, Fishman, Laurie N
• Format: Article
• Language: English
• Subjects: adherence; Adolescents; Care and treatment; Child development; Chronic illnesses; communication; Crohn's disease; Crohns disease; Families & family life; Gastroenterology; Gastrointestinal diseases; Inflammatory bowel disease; Lifestyles; Medical research; Patient compliance; Patient outcomes; Patients; Pediatrics; Problem solving; Quality of life; Review; self efficacy; Skills; Social networks; Social support; Teenagers; ulcerative colitis; Young adults; Youth
• ISSN: 1178-7023; 1178-7023
• DOI: 10.2147/CEG.S106302

Self-management, including medication adherence, is associated with improved health and outcomes for patients with inflammatory bowel disease. The concept of self-management is complex, but can be divided into those aspects that involve the individual patient, those that involve the provider-patient relationship, and those that encompass the social environment. At the individual level, enhancing problem-solving skills and self-efficacy have both been shown to improve self-management tasks, particularly adherence to treatment. However, it is critical to consider these domains from a lifespan perspective because these processes by which self-management can be improved are distinct for children, adolescents, young adults, and adults. A particular emphasis is placed on strategies to improve self-management of older adolescents and young adults as they transition from pediatric to adult providers. The review concludes with recommendations for providers, including rationale and techniques for assessing and promoting patient self-efficacy, encouraging the development of problem-solving skills, improving the patient-provider relationship, and enhancing social support. Providers are encouraged to utilize elements of problem-solving skills training, engage in collaborative relationships with their patients, and offer their patients recommendations for how to increase the quality of their social support networks as ways of increasing overall self-management.