Patient-Centred Brain–Gut Therapy Outcomes – EMJ

PATIENT priorities for treatment outcomes following brain–gut behavioural therapy (BGBT) differ from outcomes traditionally prioritised in clinical trials, such as anxiety and depression, according to a new US study highlighting the importance of involving patients in the development of gastropsychology programmes. 

BGBTs  

BGBTs, used to treat disorders of gut–brain interaction (DGBIs) and inflammatory bowel disease (IBD), focus on decreasing symptom severity and improving anxiety, depression, and quality of life. However, these outcomes may not accurately reflect patients’ priorities because they have had limited involvement in programme development. 

Rapid qualitative analysis was used to analyse interviews with patients with DGBI and IBD, both with and without BGBT experience in a 1:1 ratio. The study also utilised focus groups to assess the qualitative findings, verify their accuracy, identify high-priority and missing constructs, and develop recommendations for clinical use. Patient perspectives and existing literature informed developments of measure recommendations. 

Patient Priorities  

Qualitative interviews (N=20) revealed five themes, which included lived experience of disease, how to cope with illness, perceived value of behavioural intervention, outcomes and measurement, and behavioural intervention effects.  

General agreement among focus group participants (n=14) confirmed that these domains accurately reflected their experiences with BGBTs, specifically prioritising confidence in symptom management, social connectedness, lived experience with disease, and mental/behavioural health symptoms. Additionally, participants noted the importance of brief measures, semi-regular re-evaluation, and access to their results.  

Five measures were recommended following the qualitative interviews: the Brief Illness Perception Questionnaire, PROMIS Self-Efficacy for Managing Chronic Conditions–Symptoms, the UCLA Loneliness Scale, IBD DISK (adapted), and PHQ-2/GAD-2. 

Conclusion 

Overall, the treatment targets identified by patients differed from those commonly prioritised in clinical trials. Existing DGBI and IBD literature recognises many of these patient-identified outcomes as more meaningful than traditional outcomes such as anxiety and depression. 

The authors stated that the findings from this study could support the inclusion of patient-reported outcome measures into gastrointestinal behavioural health programmes and reinforce the importance of involving patients in programme development to improve treatment effectiveness. 

Reference 

Brady RE et al. Patient Identification of the most important outcomes in a gastrointestinal behavioral health program. J Patient Rep Outcomes. 2026;DOI:10.1186/s41687-026-01125-x.  

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