TY - JOUR
T1 - Pain management in inflammatory bowel disease
T2 - feasibility of an online therapist-supported CBT-based self-management intervention
AU - Sweeney, Louise
AU - Moss-Morris, Rona
AU - Czuber-Dochan, Wladyslawa
AU - Norton, Christine
N1 - Funding Information:
Thank you to all the participating individuals and to Crohn?s and Colitis UK for funding this study and providing its charity members to take part. Thank you also for the Public and Patient Involvement and the research team who contributed to the design and development of the intervention. This paper presents the feasibility and acceptability of a 9-week, therapist-supported, online?CBT-based intervention for IBD-related chronic pain, and found?improvements in QoL and reductions in?psychological distress. The study contributes to the emerging area of psychological interventions for symptom management in IBD.
Funding Information:
Thank you to all the participating individuals and to Crohn’s and Colitis UK for funding this study and providing its charity members to take part. Thank you also for the Public and Patient Involvement and the research team who contributed to the design and development of the intervention.
Funding Information:
L.S. and R.M.M. received funding from the BRC for sample analyses. R.M.M. reports personal fees from training in irritable bowel syndrome intervention for Central and North West London NHS Foundation Trust and University of East Anglia, outside the submitted work. She has received payment for consultancy to Mahana Therapeutics and a private company has signed a licence agreement with King’s College London with the view to bringing the Regul8 website product to the NHS and other international markets. C.N. has received lecture fees from Tillotts Pharma, Abbvie and Ferring Pharmaceuticals. W.C.D. has received lecture fees from Dr Falk Pharma and EGIS Pharmaceuticals.
Funding Information:
Crohn’s and Colitis UK PhD Studentship (LS) and BRC for faecal calprotectin analysis. The IBD-BOOST study is funded by the National Institute for Health Research (NIHR) (Programme grant: RP-PG-0216-20001/PGfAR). The views expressed are those of the authors and not necessarily those of the NIHR or the Department of Health and Social Care. This paper represents independent research with RMM and LS partly funded by the National Institute for Health Research (NIHR) Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King’s College London.
Publisher Copyright:
© 2021, The Author(s).
Copyright:
Copyright 2021 Elsevier B.V., All rights reserved.
PY - 2021/4/16
Y1 - 2021/4/16
N2 - BACKGROUND: Chronic pain is a poorly managed symptom of inflammatory bowel disease (IBD). Cognitive behavioural therapy (CBT) has an evidence base in functional gastrointestinal conditions and chronic pain. This study aimed to test the feasibility and acceptability of a 9-week online facilitator-supported CBT intervention, tailored for people with chronic IBD-related pain.DESIGN: A single-arm pre-post design with nested qualitative interviews was used. Twenty individuals with IBD and chronic pain were recruited through an online IBD charity and had consented to research in a previous survey or responded to an online charity advert. Individuals who indicated a pain-interference score of ≥ 4/10 (Brief Pain Inventory) and met inclusion criteria were invited to take part. Outcomes included recruitment and retention rates, pain interference and severity, quality of life (QoL) and psychosocial measures.RESULTS: Of 145 individuals contacted, 55 (37.9%) responded. Two individuals were recruited from the study advertisement. Twenty out of 57 (35.1%) met screening and eligibility criteria. Eighty-five percent of the sample engaged with intervention sessions and 55% completed at least 5/9 sessions. Eighty percent of recruited participants completed the post-intervention questionnaire at week 9. The mean score for overall acceptability was 43.4 (0-70). Qualitative feedback demonstrated the value of thought monitoring and facilitator support. Scores improved for QoL and pain self-efficacy and reduced for depression, anxiety, pain catastrophising and avoidance resting behaviour.CONCLUSIONS: Online CBT for chronic IBD-related pain appears feasible and acceptable. The study suggests positive effects for improving QoL and reducing psychological distress; however, online and face-to-face recruitment methods are recommended and establishing efficacy through larger randomised controlled trials is required.
AB - BACKGROUND: Chronic pain is a poorly managed symptom of inflammatory bowel disease (IBD). Cognitive behavioural therapy (CBT) has an evidence base in functional gastrointestinal conditions and chronic pain. This study aimed to test the feasibility and acceptability of a 9-week online facilitator-supported CBT intervention, tailored for people with chronic IBD-related pain.DESIGN: A single-arm pre-post design with nested qualitative interviews was used. Twenty individuals with IBD and chronic pain were recruited through an online IBD charity and had consented to research in a previous survey or responded to an online charity advert. Individuals who indicated a pain-interference score of ≥ 4/10 (Brief Pain Inventory) and met inclusion criteria were invited to take part. Outcomes included recruitment and retention rates, pain interference and severity, quality of life (QoL) and psychosocial measures.RESULTS: Of 145 individuals contacted, 55 (37.9%) responded. Two individuals were recruited from the study advertisement. Twenty out of 57 (35.1%) met screening and eligibility criteria. Eighty-five percent of the sample engaged with intervention sessions and 55% completed at least 5/9 sessions. Eighty percent of recruited participants completed the post-intervention questionnaire at week 9. The mean score for overall acceptability was 43.4 (0-70). Qualitative feedback demonstrated the value of thought monitoring and facilitator support. Scores improved for QoL and pain self-efficacy and reduced for depression, anxiety, pain catastrophising and avoidance resting behaviour.CONCLUSIONS: Online CBT for chronic IBD-related pain appears feasible and acceptable. The study suggests positive effects for improving QoL and reducing psychological distress; however, online and face-to-face recruitment methods are recommended and establishing efficacy through larger randomised controlled trials is required.
UR - http://www.scopus.com/inward/record.url?scp=85104515175&partnerID=8YFLogxK
U2 - 10.1186/s40814-021-00829-9
DO - 10.1186/s40814-021-00829-9
M3 - Article
C2 - 33863398
SN - 2055-5784
VL - 7
SP - 95
JO - Pilot and Feasibility Studies
JF - Pilot and Feasibility Studies
IS - 1
M1 - 95
ER -