A new randomized Swedish study has found that those with IBS who underwent exposure therapy as well as online internet-based cognitive behavioral therapy (ICBT) saved money in the long run on medical costs. In fact, after six months of treatment, a return on investment was found to be $5.64 for every $1 spent. In addition, 66% of patients experienced a clinical improvement in their IBS compared to 52% in the control group. Not only was clinical improvement seen, but over the 6 months, those who had both forms of therapy decreased their societal cost (medical care, appointments, and medication) from $2,020.10 down to $602.60. A difference of $1,417.50, saving over a grand!
So, you may be thinking, “Why isn’t everyone with IBS doing this?” The short answer is that while the return on investment is almost 6:1, the patient’s initial costs went up by 20%. Some patients may simply not have the resources to increase direct expense by 20%, even though it would save money long term. You might think that added time could also be a hindrance as the patient now has two therapy sessions. However, it was noted that “non-significant increases were found”. For patients, it was only an increase of 6.2 hours, and for therapists less than 1 hour.
With the mass increase in online medical care, therapy sessions were sure to follow suit, and Internet-based Cognitive Behavioral Therapy is no exception. This type of therapy resonates well with those who have IBS, as it focuses to help regulate emotions, develop coping strategies, and challenge cognitive behaviors. On the other hand, Exposure therapy is aimed at treating anxiety disorders by exposing the patient to what causes anxiety and showing them, they are in fact safe. Those with IBS are more likely to have negative mental health including anxiety and depression, so it is thought that this addition may be addressing more root causes of mental health issues.
Since the brain and gut are so interconnected, having better-coping strategies and reducing anxiety can positively impact IBS symptoms, and we have seen this in this particular study. This combination therapy saw a 12.97-point decrease in the Gastrointestinal Symptom Rating Scale (GSRS)-IBS score. This is compared to 9.09 points in the control group. These point decreases were then put into an incremental cost ratio. It was found that each point reduction on the GSRS-IBS Score equated to $301.69 in savings! Overall, that’s almost $4,000 the patient could save by participating in ICBT and exposure therapy.
In the U.S. alone direct IBS healthcare costs are estimated to be $2 billion a year. If we add indirect costs for IBS patients that number jumps to $30 billion annually. This is a huge chunk of change and can be debilitating for individual IBS patients to keep up with. As CBT therapy had been shown beneficial for IBS patients, the goal of this study was to assess the economic impact and effects of this combined therapy. The researchers then created a CBT protocol for IBS based on gastrointestinal symptom-specific anxiety (GSA). High GSA numbers were associated with reduced quality of life as well as avoidance behaviors that provoke IBS symptoms. This GSA-CBT approach has four main areas; mindfulness training, exposure to IBS stimuli, psychoeducation, and values-based behavioral change. The goal of this approach is to ultimately reduce anxiety and symptoms of IBS. This study shows that including exposure therapy had a positive incremental effect and was in fact able to reduce GSA scores leading to a better quality of life.
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