Department of General Practice and Elderly Care Medicine, University Medical Centre Groningen, Groningen, The Netherlands.
Department of Epidemiology, University Medical Centre Groningen, Groningen, The Netherlands.
BMJ Open. 2023 May 8;13(5):e069653. doi: 10.1136/bmjopen-2022-069653.
Children often present to primary care with functional abdominal pain (FAP) or irritable bowel syndrome (IBS), and around half still have abdominal complaints 1 year later. Hypnotherapy is an evidence-based treatment that is used in specialist care, but it lacks evidence in primary care. This study will investigate the (cost) effectiveness of home-based guided hypnotherapy for children with FAP or IBS in primary care.
We report the design of a pragmatic randomised controlled trial among children aged 7-17 years, diagnosed with FAP or IBS by their general practitioner (GP), with assessments over 12 months. The control group will receive care as usual (CAU) by their GP (eg, communication, education and reassurance), while the intervention group will receive CAU plus 3 months of home-based guided hypnotherapy via a website. The primary outcome will be the proportion of children with adequate relief from abdominal pain/discomfort at 12 months, analysed on an intention-to-treat basis. Secondary outcomes will include the adequacy of pain relief at 3 and 6 months, pain/discomfort severity, pain frequency and intensity, daily functioning and impact on function, anxiety and depression, pain beliefs, sleep disturbances, school absence, somatisation, and healthcare use and costs. We must include 200 children to determine a 20% difference in those with adequate relief (55% control vs 75% intervention).
The Medical Ethics Review Committee of the University Medical Center Groningen, the Netherlands, approved this study (METc2020/237). The results will be disseminated to patients, GPs and other stakeholders via email, a dedicated website, peer-reviewed publications and presentations at national and international conferences. We plan to collaborate with the Dutch Society of GPs to implement the results in clinical practice.
NCT05636358.
儿童常因功能性腹痛(FAP)或肠易激综合征(IBS)到基层医疗机构就诊,其中约有一半的儿童在 1 年后仍有腹部不适。催眠疗法是一种基于证据的治疗方法,已在专科治疗中使用,但在基层医疗中缺乏证据。本研究将调查家庭为基础的指导式催眠疗法对基层医疗机构中 FAP 或 IBS 儿童的(成本)有效性。
我们报告了一项实用随机对照试验的设计,该试验纳入了年龄在 7-17 岁之间的儿童,由全科医生(GP)诊断为 FAP 或 IBS,评估时间为 12 个月。对照组将接受 GP 的常规护理(CAU)(例如,沟通、教育和安抚),而干预组将在 CAU 的基础上额外接受 3 个月的家庭为基础的指导式催眠治疗,通过一个网站进行。主要结局是 12 个月时腹痛/不适缓解充分的儿童比例,采用意向治疗进行分析。次要结局包括 3 个月和 6 个月时疼痛缓解的充分性、疼痛/不适严重程度、疼痛频率和强度、日常功能和功能影响、焦虑和抑郁、疼痛信念、睡眠障碍、缺课、躯体化以及医疗保健的使用和费用。我们必须纳入 200 名儿童,以确定缓解充分的儿童比例有 20%的差异(对照组为 55%,干预组为 75%)。
荷兰格罗宁根大学医学中心医学伦理审查委员会批准了这项研究(METc2020/237)。研究结果将通过电子邮件、专门的网站、同行评议的出版物以及在国家和国际会议上的演讲,向患者、全科医生和其他利益相关者传播。我们计划与荷兰全科医生协会合作,将研究结果应用于临床实践。
NCT05636358。