Can a smartphone app replace in-person hypnotherapy for IBS? Trial finds non-inferiority not demonstrated, but response rates suggest a viable alternative
A recently published randomised controlled trial (RCT) comparing in-person therapist-delivered hypnotherapy with a smartphone-based self-guided hypnotherapy app for irritable bowel syndrome (IBS) has failed to demonstrate non-inferiority for the primary endpoint of abdominal pain response. Despite this, the smartphone intervention achieved substantial response rates and remained superior to a psychoeducation control group at longer follow-up, suggesting it could expand access to evidence-based therapy.
Key Points
In-person hypnotherapy met FDA abdominal pain response (≥30% reduction) in 48% of patients, smartphone self-guided hypnotherapy in 33%, and psychoeducation in 22%.
Non-inferiority of the smartphone app to in-person therapy was not shown (absolute difference −14.7%, 95% CI −29.3% to 0.9%; margin 10%).
Both hypnotherapy groups were superior to psychoeducation at 6-month follow-up (OR 3.11 and 4.68, p<0.01).
No significant between-group differences in psychological symptom changes were observed.
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