The Library
Habit training versus habit training with direct visual biofeedback in adults with chronic constipation : a randomized controlled trial
Tools
Norton, Christine, Bannister, Sybil, Booth, Lesley, Brown, Steve R., Cross, Samantha, Eldridge, Sandra, Emmett, Christopher, Grossi, Ugo, Jordan, Mary, Lacy‐Colson, Jon, Mason, James, McLaughlin, John, Moss‐Morris, Rona, Scott, S. Mark, Stevens, Natasha, Taheri, Shiva, Taylor, Stuart A., Yiannakou, Yan and Knowles, Charles H. (2023) Habit training versus habit training with direct visual biofeedback in adults with chronic constipation : a randomized controlled trial. Colorectal Disease, 25 (11). pp. 2243-2256. doi:10.1111/codi.16738 ISSN 1462-8910.
|
PDF
WRAP-Habit-training-adults-chronic-constipation-randomized-controlled-trial-23.pdf - Published Version - Requires a PDF viewer. Available under License Creative Commons Attribution 4.0. Download (4Mb) | Preview |
Official URL: https://doi.org/10.1111/codi.16738
Abstract
Aim: The aim was to determine whether specialist‐led habit training using Habit Training with Biofeedback (HTBF) is more effective than specialist‐led habit training alone (HT) for chronic constipation and whether outcomes of interventions are improved by stratification to HTBF or HT based on diagnosis (functional defaecation disorder vs. no functional defaecation disorder) by radio‐physiological investigations (INVEST). Method: This was a parallel three‐arm randomized single‐blinded controlled trial, permitting two randomized comparisons: HTBF versus HT alone; INVEST‐ versus no‐INVEST‐guided intervention. The inclusion criteria were age 18–70 years; attending specialist hospitals in England; self‐reported constipation for >6 months; refractory to basic treatment. The main exclusions were secondary constipation and previous experience of the trial interventions. The primary outcome was the mean change in Patient Assessment of Constipation Quality of Life score at 6 months on intention to treat. The secondary outcomes were validated disease‐specific and psychological questionnaires and cost‐effectiveness (based on EQ‐5D‐5L). Results: In all, 182 patients were randomized 3:3:2 (target 384): HT n = 68; HTBF n = 68; INVEST‐guided treatment n = 46. All interventions had similar reductions (improvement) in the primary outcome at 6 months (approximately −0.8 points of a 4‐point scale) with no statistically significant difference between HT and HTBF (−0.03 points; 95% CI −0.33 to 0.27; P = 0.85) or INVEST versus no‐INVEST (0.22; −0.11 to 0.55; P = 0.19). Secondary outcomes showed a benefit for all interventions with no evidence of greater cost‐effectiveness of HTBF or INVEST compared with HT. Conclusion: The results of the study at 6 months were inconclusive. However, with the caveat of under‐recruitment and further attrition at 6 months, a simple, cheaper approach to intervention may be as clinically effective and more cost‐effective than more complex and invasive approaches.
Item Type: | Journal Article | ||||||||
---|---|---|---|---|---|---|---|---|---|
Subjects: | R Medicine > RC Internal medicine | ||||||||
Divisions: | Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Clinical Trials Unit Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School |
||||||||
SWORD Depositor: | Library Publications Router | ||||||||
Library of Congress Subject Headings (LCSH): | Constipation, Fecal incontinence -- Treatment, Biofeedback training | ||||||||
Journal or Publication Title: | Colorectal Disease | ||||||||
Publisher: | Wiley-Blackwell Publishing, Inc. | ||||||||
ISSN: | 1462-8910 | ||||||||
Official Date: | November 2023 | ||||||||
Dates: |
|
||||||||
Volume: | 25 | ||||||||
Number: | 11 | ||||||||
Page Range: | pp. 2243-2256 | ||||||||
DOI: | 10.1111/codi.16738 | ||||||||
Status: | Peer Reviewed | ||||||||
Publication Status: | Published | ||||||||
Re-use Statement: | ** Article version: VoR ** From Wiley via Jisc Publications Router ** History: received 21-02-2023; rev-recd 08-06-2023; accepted 30-06-2023; epub 08-09-2023. ** Licence for VoR version of this article: http://creativecommons.org/licenses/by/4.0/ | ||||||||
Access rights to Published version: | Open Access (Creative Commons) | ||||||||
Copyright Holders: | © 2023 The Authors. Colorectal Disease published by John Wiley & Sons Ltd on behalf of Association of Coloproctology of Great Britain and Ireland. | ||||||||
Date of first compliant deposit: | 24 October 2023 | ||||||||
Date of first compliant Open Access: | 24 October 2023 | ||||||||
RIOXX Funder/Project Grant: |
|
||||||||
Related URLs: |
Request changes or add full text files to a record
Repository staff actions (login required)
View Item |
Downloads
Downloads per month over past year