Investigating the delivery of an acceptance and commitment therapy (ACT) smartphone app intervention on symptomology in adult IBS patients: A feasibility study

Abstract

Background

Irritable Bowel Syndrome (IBS) significantly impacts patients and healthcare systems. While digital therapeutics show promise for IBS self-management, the feasibility of an Acceptance and Commitment Therapy (ACT) smartphone app remains unexplored.

Methods

This feasibility study recruited 53 participants across three UK Health Services to use an ACT app over 8 weeks. Pre- and post-treatment outcomes were assessed using standardized self-report questionnaires and analyzed with repeated-measures t-tests.

Results

Of 53 participants, 44 downloaded the app, and 29 completed follow-ups. Participants were predominantly female, with an average IBS duration of 14.6 years, and 90.9% had moderate-to-severe symptoms. Feasibility was demonstrated through successful recruitment (64% of identified eligible participants) and retention (66% of those who accessed the app). Acceptability showed variability, in terms of user engagement and attrition rates. Significant improvements were observed in IBS acceptance, quality of life, and gastrointestinal-related anxiety, though changes in IBS-related behaviours were not significant. Improvements in physical symptoms were noted but did not reach statistical significance.

Discussion

ACT-based self-help apps may benefit individuals with mild-to-moderate IBS symptoms. Recommendations include enhancing intervention acceptability through gamification, improved content delivery, and tailoring to symptom severity. Baseline screening of gastrointestinal symptoms could inform a stepped-care approach, optimizing intervention intensity. Despite limitations such as a small sample size and attrition, this study supports the feasibility of ACT apps for IBS and highlights their potential to improve access to psychological therapies while reducing healthcare burdens.