Affiliation:
1. Division of Gastroenterology Massachusetts General Hospital and Harvard Medical School Boston Massachusetts USA
2. Center for Neurointestinal Health Massachusetts General Hospital Boston Massachusetts USA
3. Mahana™ IBS San Francisco California USA
Abstract
AbstractBackgroundMahana™ IBS is a Food and Drug Administration‐cleared prescription mobile application designed to deliver 3 months of gut‐directed cognitive behavioral therapy (CBT) to adults ≥22 years old with irritable bowel syndrome (IBS). We assessed whether gut‐directed CBT delivered digitally improved outcomes in IBS management.MethodsWe studied users who had a dispensed physician prescription for Mahana™ IBS between August 2021 and August 2023. The primary outcome was change in IBS symptom severity (IBS‐SSS) score.Key ResultsFor the 843 patients, 324 (38%) completed half of the program up to session 5, and 162 (19%) of participants completed the full program up to session 10. Median age was 41 years, median IBS‐SSS was 270 (moderate severity), IBS‐mixed subtype was most common (23%) followed by IBS‐C (20%) and IBS‐D (19%). The change in IBS‐SSS was −81.0 (p = < 0.001) after session 5 and − 104.4 (p = < 0.001) after session 10. In multivariate analyses, a higher baseline IBS‐SSS (OR 1.59; 95% CI 1.26–2.01) and high baseline Perceived Stress Scale (PSS) score predicted non‐response (OR 0.95; 95% CI 0.91–0.98) while older age (OR 1.10 per decade; 95% CI 1.01–1.20), prescription source from a healthcare provider (as opposed to third party telehealth encounter, OR 1.48; 95% CI 1.07–2.05), and payment for the app (OR 1.93; 95% CI 1.41–2.63) predicted adherence.Conclusions & InferencesUse of a digital mobile application for gut‐directed CBT improved symptoms of IBS. Digital health applications have the potential to democratize CBT and allow integrated care to scale for patients with IBS.