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Defining Optimal Care for Functional Gut Disorders - Multi-Disciplinary Versus Standard Care: A Randomized Controlled Trial Protocol.
Contemp Clin Trials. 2019 09; 84:105828.CC

Abstract

BACKGROUND

Functional gastrointestinal disorders (FGIDs) are the commonest reason for gastroenterological consultation, with patients usually seen by a specialist working in isolation. There is a wealth of evidence testifying to the benefit provided by dieticians, behavioral therapists, hypnotherapists and psychotherapists in treating these conditions, yet they rarely form a part of the therapeutic team, and these treatment modalities are rarely offered as part of the therapeutic management. There has been little examination of different models of care for FGIDs. We hypothesize that multi-disciplinary integrated care is superior to standard specialist-based care in the treatment of functional gut disorders.

METHODS

The "MANTRA" (Multidisciplinary Treatment for Functional Gut Disorders) study compares comprehensive multi-disciplinary outpatient care with standard hospital outpatient care. Consecutive new referrals to the gastroenterology and colorectal outpatient clinics of a single secondary and tertiary care hospital of patients with an FGID, defined by the Rome IV criteria, will be included. Patients will be prospectively randomized 2:1 to multi-disciplinary (gastroenterologist, gut-hypnotherapist, psychiatrist, behavioral therapist ('biofeedback') and dietician) or standard care (gastroenterologist or colorectal surgeon). Patients are assessed up to 12 months after completing treatment. The primary outcome is an improvement on a global assessment scale at the end of treatment. Symptoms, quality of life, psychological well-being, and healthcare costs are secondary outcome measures.

DISCUSSION

There have been few studies examining how best to deliver care for functional gut disorders. The MANTRA study will define the clinical and cost benefits of two different models of care for these highly prevalent disorders.

TRIAL REGISTRATION NUMBER

Clinicaltrials.govNCT03078634 Registered on Clinicaltrials.gov, completed recruitment, registered on March 13th 2017. Ethics and Dissemination: Ethical approval has been received by the St Vincent's Hospital Melbourne human research ethics committee (HREC-A 138/16). The results will be disseminated in peer-reviewed journals and presented at international conferences. Protocol version 1.2.

Authors+Show Affiliations

Department of Gastroenterology, St Vincent's Hospital, Melbourne, Australia; University of Melbourne, Melbourne, Australia. Electronic address: Chamara.basnayake@svha.org.au.Department of Gastroenterology, St Vincent's Hospital, Melbourne, Australia; University of Melbourne, Melbourne, Australia. Electronic address: mkamm@unimelb.edu.au.University of Melbourne, Melbourne, Australia.Department of Gastroenterology, St Vincent's Hospital, Melbourne, Australia; University of Melbourne, Melbourne, Australia. Electronic address: Anglea.khera@svha.org.au.Monash University, Melbourne, Australia. Electronic address: Danny.liew@monash.edu.Department of Gastroenterology, St Vincent's Hospital, Melbourne, Australia. Electronic address: Kathryn.burrell@svha.org.au.Department of Gastroenterology, St Vincent's Hospital, Melbourne, Australia; University of Melbourne, Melbourne, Australia. Electronic address: amy.wilson-obrien@svha.org.au.Department of Gastroenterology, St Vincent's Hospital, Melbourne, Australia. Electronic address: Annalise.stanley@svha.org.au.University of Newcastle, Newcastle, Australia. Electronic address: nicholas.talley@newcastle.edu.au.Department of Gastroenterology, St Vincent's Hospital, Melbourne, Australia; University of Melbourne, Melbourne, Australia. Electronic address: Alexander.thompson@svha.org.au.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

31437539

Citation

Basnayake, Chamara, et al. "Defining Optimal Care for Functional Gut Disorders - Multi-Disciplinary Versus Standard Care: a Randomized Controlled Trial Protocol." Contemporary Clinical Trials, vol. 84, 2019, p. 105828.
Basnayake C, Kamm MA, Salzberg M, et al. Defining Optimal Care for Functional Gut Disorders - Multi-Disciplinary Versus Standard Care: A Randomized Controlled Trial Protocol. Contemp Clin Trials. 2019;84:105828.
Basnayake, C., Kamm, M. A., Salzberg, M., Khera, A., Liew, D., Burrell, K., Wilson-O'Brien, A., Stanley, A., Talley, N. J., & Thompson, A. J. (2019). Defining Optimal Care for Functional Gut Disorders - Multi-Disciplinary Versus Standard Care: A Randomized Controlled Trial Protocol. Contemporary Clinical Trials, 84, 105828. https://doi.org/10.1016/j.cct.2019.105828
Basnayake C, et al. Defining Optimal Care for Functional Gut Disorders - Multi-Disciplinary Versus Standard Care: a Randomized Controlled Trial Protocol. Contemp Clin Trials. 2019;84:105828. PubMed PMID: 31437539.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Defining Optimal Care for Functional Gut Disorders - Multi-Disciplinary Versus Standard Care: A Randomized Controlled Trial Protocol. AU - Basnayake,Chamara, AU - Kamm,Michael A, AU - Salzberg,Michael, AU - Khera,Angela, AU - Liew,Danny, AU - Burrell,Kathryn, AU - Wilson-O'Brien,Amy, AU - Stanley,Annalise, AU - Talley,Nicholas J, AU - Thompson,Alexander J, Y1 - 2019/08/19/ PY - 2019/04/18/received PY - 2019/08/06/revised PY - 2019/08/13/accepted PY - 2019/8/23/pubmed PY - 2019/8/23/medline PY - 2019/8/23/entrez SP - 105828 EP - 105828 JF - Contemporary clinical trials JO - Contemp Clin Trials VL - 84 N2 - BACKGROUND: Functional gastrointestinal disorders (FGIDs) are the commonest reason for gastroenterological consultation, with patients usually seen by a specialist working in isolation. There is a wealth of evidence testifying to the benefit provided by dieticians, behavioral therapists, hypnotherapists and psychotherapists in treating these conditions, yet they rarely form a part of the therapeutic team, and these treatment modalities are rarely offered as part of the therapeutic management. There has been little examination of different models of care for FGIDs. We hypothesize that multi-disciplinary integrated care is superior to standard specialist-based care in the treatment of functional gut disorders. METHODS: The "MANTRA" (Multidisciplinary Treatment for Functional Gut Disorders) study compares comprehensive multi-disciplinary outpatient care with standard hospital outpatient care. Consecutive new referrals to the gastroenterology and colorectal outpatient clinics of a single secondary and tertiary care hospital of patients with an FGID, defined by the Rome IV criteria, will be included. Patients will be prospectively randomized 2:1 to multi-disciplinary (gastroenterologist, gut-hypnotherapist, psychiatrist, behavioral therapist ('biofeedback') and dietician) or standard care (gastroenterologist or colorectal surgeon). Patients are assessed up to 12 months after completing treatment. The primary outcome is an improvement on a global assessment scale at the end of treatment. Symptoms, quality of life, psychological well-being, and healthcare costs are secondary outcome measures. DISCUSSION: There have been few studies examining how best to deliver care for functional gut disorders. The MANTRA study will define the clinical and cost benefits of two different models of care for these highly prevalent disorders. TRIAL REGISTRATION NUMBER: Clinicaltrials.govNCT03078634 Registered on Clinicaltrials.gov, completed recruitment, registered on March 13th 2017. Ethics and Dissemination: Ethical approval has been received by the St Vincent's Hospital Melbourne human research ethics committee (HREC-A 138/16). The results will be disseminated in peer-reviewed journals and presented at international conferences. Protocol version 1.2. SN - 1559-2030 UR - https://www.unboundmedicine.com/medline/citation/31437539/Defining_Optimal_Care_for_Functional_Gut_Disorders_-_Multi-Disciplinary_Versus_Standard_Care:_A_Randomized_Controlled_Trial_Protocol L2 - https://linkinghub.elsevier.com/retrieve/pii/S1551-7144(19)30543-9 DB - PRIME DP - Unbound Medicine ER -