Long-term treatment outcomes of mindfulness-based cognitive therapy for fatigue in patients with inflammatory bowel disease: Results of a randomized controlled trial.

Objectives: Fatigue is prevalent in patients with inflammatory bowel disease (IBD) in remission. Previously, we showed that fatigued IBD patients experienced a significant decrease in fatigue after receiving mindfulness-based cognitive therapy (MBCT). The current study examined to what extent these short-term beneficial effects of MBCT on fatigue were maintained over nine months follow-up, and whether patient characteristics were associated with clinically relevant improvement in fatigue.
Methods: A randomized controlled trial, including an MBCT and waiting-list control condition, was performed in fatigued IBD patients in remission. For this study, we analysed long-term outcomes of 108 patients who received MBCT (either directly or after three months waiting). The primary outcome was fatigue, assessed with the Checklist Individual Strenght-20. Secondary outcomes included fatigue interference, depression, anxiety, and quality of life.
Results: The reduced level of fatigue post-treatment did not change significantly during follow-up (F(2,76) = 1.68, p = 0.19). In total, 29% of patients reported clinically relevant improvement from pre-treatment to nine months follow-up. We found few significant differences in baseline characteristics between those reporting clinically relevant improvement and those not, except that patients who improved were significantly more often unemployed (χ ² (1, n = 73) = 4.40, p = 0.04). Secondary outcomes, which did not change significantly during MBCT, also remained stable during follow-up.
Conclusion: Findings suggest that reductions in IBD-related fatigue after receiving MBCT are sustained over nine months follow-up, with around one-third of patients reporting clinically relevant improvement from pre-treatment to follow-up. Employment status might be related to improvements in fatigue. Future research is needed to confirm these long-term outcomes.
Preregistration: ClinicalTrials.gov ID: NCT03162575.
Competing Interests: Declaration of competing interest All authors have completed the Unified Competing Interest form as required by the International Committee of Medical Journal Editors (ICMJE) and declare the following competing interests: Gerard Dijkstra reports grant from DSM Nutritional Products LTD and speakers fees from Janssen Pharmaceuticals, AbbVie and Takeda, outside the submitted work. Marijn Visschedijk reports speakers fee from Janssen-Cilag and Galapagos, and participation in the advisory board of Ferring bv, outside the submitted work. The other authors declare that they have no conflicts of interest to report.
(Copyright © 2024. Published by Elsevier Inc.)