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

Authors Plevinsky J, Greenley R, Fishman L

Received 12 February 2016

Accepted for publication 13 June 2016

Published 23 August 2016 Volume 2016:9 Pages 259—267

DOI https://doi.org/10.2147/CEG.S106302

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Lucy Goodman

Peer reviewer comments 3

Editor who approved publication: Professor Andreas M Kaiser

Jill M Plevinsky,1 Rachel N Greenley,1 Laurie N Fishman2

1Department of Psychology, Rosalind Franklin University of Medicine and Science, North Chicago, IL, 2Department of Gastroenterology, Boston Children’s Hospital, Harvard Medical School, Boston, MA, USA

Abstract: 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.

Keywords: adherence, self-efficacy, communication, social support, Crohn’s disease, ulcerative colitis

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