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

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.