A Cochrane review [Abstract] 1 included 1 study with 100 inflammatory bowel disease (IBD) patients receiving a specialist nurse delivered counselling package (n = 50) or routine outpatient clinic follow-up (n = 50), with assessments at entry and 6 and 12 months. The counselling package consisted of information provision and a psychological intervention (a stress management programme of relaxation exercises and coping mechanisms). Disease remission, patient compliance, clinical improvement, utilisation of nurse-led services, patient satisfaction, hospital admission, outpatient attendance, progression to surgery, length of hospital stay and cost effectiveness data were not reported. Pooled mean mental health scores at 6 months were higher in patients who received nurse-led counselling compared to patients who received routine follow-up. However, this difference was not statistically significant (WMD 3.67, 95% CI -0.44 to 7.77). Other pooled assessments of physical and psychological well-being showed no statistically significant differences.
Comment: The quality of evidence is downgraded by study quality (unclear allocation concealment and lack of blinding), by indirectness (lack of data on many important outcomes, e.g. remission), and by imprecise results (few patients and wide confidence intervals).
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