Irritable bowel syndrome is a functional bowel disorder that affects many Canadians. The syndrome involves abdominal pain and change in frequency or form of bowel movements, and these symptoms can lead to a decreased quality of life for patients. Primary care physicians are dissatisfied with current referral processes, and patients may wait a long time to receive the correct diagnosis. Diet is known to exacerbate symptoms of IBS. In Canada, accessing dietary treatment for IBS is a challenge due to lack of resources. Some patients lack access to dietary interventions, and others are given advice that is not evidenced based. Use of eHealth technology, such as virtual education delivered by a dietician, may allow for more widespread access to dietary interventions for IBS. Virtual education can include one on one dietary education, online group-based education, and the use of apps. Currently, there is a gap in knowledge whether dietary intervention for IBS, delivered virtually by a dietician, is effective in treating IBS.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
HEALTH_SERVICES_RESEARCH
Masking
NONE
Enrollment
76
Participants will receive virtual one on one consults with a dietitian who has training in the dietary management of IBS.
IBS online group session run by Happy Bellies Nutrition
QEII Health Sciences Centre
Halifax, N.S., Canada
RECRUITINGIBS Symptom Severity
IBS Symptom Severity as measured by the "IBS Symptom Severity Score". Minimum: 75, Maximum: \>300. Mild, moderate and severe cases are indicated by scores of 75 to 175, 175 to 300 and \> 300 respectively.
Time frame: Baseline
IBS Symptom Severity
IBS Symptom Severity as measured by the "IBS Symptom Severity Score". Minimum: 75, Maximum: \>300. Mild, moderate and severe cases are indicated by scores of 75 to 175, 175 to 300 and \> 300 respectively.
Time frame: 5 months post-randomization
IBS Specific Quality of Life
IBS Specific Quality of Life as measured by the "IBS Quality of Life Questionnaire". Minimum: 0, Maximum: 100. Higher scores indicating better IBS specific quality of life.
Time frame: Baseline
IBS Specific Quality of Life
IBS Specific Quality of Life as measured by the "IBS Quality of Life Questionnaire". Minimum: 0, Maximum: 100. Higher scores indicating better IBS specific quality of life.
Time frame: 5 months post-randomization
Patient Quality of Life
Patient Quality of Life as measured by the "EQ 5D 5L Questionnaire". This questionnaire comprises the following five dimensions (ie. five questions): mobility, self-care, usual activities, pain/discomfort and anxiety/depression. Each dimension (question) has 5 levels (possible answers): 1-no problems, 2-slight problems, 3-moderate problems, 4-severe problems and 5-extreme problems. The patient is asked to indicate his/her health state by ticking the box next to the most appropriate statement. This results in a 1-digit number that expresses the level selected for that dimension, and the digits for the five dimensions are combined into a 5-digit number that describes the patient's health state. There is also a visual analog scale which asks the patient to rate their overall health from 0-100, with 0 being the worst, and 100 being best possible health.
Time frame: Baseline
Patient Quality of Life
Patient Quality of Life as measured by the "EQ 5D 5L Questionnaire". This questionnaire comprises the following five dimensions (ie. five questions): mobility, self-care, usual activities, pain/discomfort and anxiety/depression. Each dimension (question) has 5 levels (possible answers): 1-no problems, 2-slight problems, 3-moderate problems, 4-severe problems and 5-extreme problems. The patient is asked to indicate his/her health state by ticking the box next to the most appropriate statement. This results in a 1-digit number that expresses the level selected for that dimension, and the digits for the five dimensions are combined into a 5-digit number that describes the patient's health state. There is also a visual analog scale which asks the patient to rate their overall health from 0-100, with 0 being the worst, and 100 being best possible health.
Time frame: 5 months post-randomization
Total number Inpatient services in the last 3 months
Total number of inpatient services (admissions) in the last 3 months the patient has received, using an adaptation of the Client Services Receipt Inventory (CSRI). The PI will create a questionnaire containing the Service Receipt (Section 4) questions of the CSRI.
Time frame: Baseline
Total number Inpatient services in the last 3 months
Total number of inpatient services (admissions) in the last 3 months the patient has received, using an adaptation of the Client Services Receipt Inventory (CSRI). The PI will create a questionnaire containing the Service Receipt (Section 4) questions of the CSRI.
Time frame: 5 months post randomization
Total number Outpatient appointments in the last 3 months
Total number of outpatient services (outpatient appointments) in the last 3 months the patient has received, using an adaptation of the Client Services Receipt Inventory (CSRI). The PI will create a questionnaire containing the Service Receipt (Section 4) questions of the CSRI.
Time frame: baseline
Total number Outpatient appointments in the last 3 months
Total number of outpatient services (outpatient appointments) in the last 3 months the patient has received, using an adaptation of the Client Services Receipt Inventory (CSRI). The PI will create a questionnaire containing the Service Receipt (Section 4) questions of the CSRI.
Time frame: 5 months post randomization
Volume of referrals to Dietician
Volume of referrals sent to the Virtual Dietician led 1 on 1 education session
Time frame: 5 months post-randomization
Volume of referrals to Online Group Session
Volume of referrals sent to the online IBS group session, run by Happy Bellies Nutrition
Time frame: 5 months post-randomization
Patient satisfaction with the Virtual Dietician led 1 on 1 education session
Patient satisfaction with the Virtual Dietician led 1 on 1 education session measured via questionnaires that were written by the study PI. The following statements will be presented, answers will follow a 5-point Likert scale where 1-strongly disagree 2-disagree 3-neutral 4-agree 5-strongly agree: 1. I feel confident managing my IBS 2. Overall, I was satisfied receiving dietary education through telehealth 3. It was easy to ask questions and get answers 4. I felt comfortable communicating with the dietitian using the telehealth system 5. It was easy to use the technology to access the services 6. I had no concerns about the privacy of my personal data 7. I would recommend this service to friends and family
Time frame: 5 weeks post-randomization
Volume of 1 on 1 dietary consults completed
Volume of 1 on 1 dietary consults completed, records kept by study dieticians
Time frame: 5 months post-randomization
Number of online modules competed for Online Group Session
Number of online modules competed for Online Group Session
Time frame: 5 months post-randomization
Number of sessions compared to proposed
Number of virtual dietician led 1 on 1 education sessions compared to proposed
Time frame: 5 months post-randomization
Number of Modules accessed
Number of Modules accessed for Online group session program run by Happy Bellies Nutrition
Time frame: 5 months post-randomization
Number of Modules completed
Number of Modules completed for Online group session program run by Happy Bellies Nutrition
Time frame: 5 months post-randomization
Percentage participation in group session
Percentage of participation for Online group session program run by Happy Bellies, Nutrition measured by how many participants contributed
Time frame: 5 months post-randomization
Quality Adjusted Life Years
Quality adjusted life years as measured using the EQ 5D and client service receipt inventory
Time frame: 5 months post-randomization
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