Fatigue management in patients with IBD: a randomised controlled trial

Gut. 2014 Jun;63(6):911-8. doi: 10.1136/gutjnl-2013-305191. Epub 2013 Jul 24.

Abstract

Objective: To assess the effectiveness of solution-focused therapy (SFT) on fatigue and quality of life (QoL) in patients with fatigued inflammatory bowel disease (IBD).

Design: Randomised controlled trial in two Dutch hospitals. Patients with IBD with quiescent IBD and with a Checklist Individual Strength--Fatigue (CIS--fatigue) score of ≥ 35 were enrolled. Patients were 1:1 randomised to receive SFT or care as usual (CAU) for 3 months. Patients were followed for a further 6 months after the SFT. Primary endpoint was defined as changes in fatigue and QoL during follow-up. Secondary endpoints included change in anxiety and depression, medication use, side effects to medication, disease activity, laboratory parameters (C-reactive protein, leucocytes and haemoglobin) and sleep quality.

Results: Ninety-eight patients were included, of whom 63% were women, mean age was 40.1 years. After the SFT course, 17 (39%) patients in the SFT group had a CIS-fatigue score below 35 compared with eight (18%) of patients in the CAU group (p=0.03). The SFT group also showed a greater reduction in fatigue across the first 6 months compared with the CAU group (CIS-fatigue: p=<0.001 and CIS-total: p=0.001). SFT was associated with a significant higher mean IBD questionnaire change at 3 months (p=0.020). At 9 months, no significant differences between the two groups were observed.

Conclusions: SFT has a significant beneficial effect on the severity of fatigue and QoL in patients with quiescent IBD. However, this effect diminished during follow-up.

Keywords: Ibd Clinical; Inflammatory Bowel Disease.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Anxiety / etiology
  • Anxiety / psychology
  • C-Reactive Protein / metabolism
  • Depression / etiology
  • Depression / psychology
  • Fatigue / etiology
  • Fatigue / psychology
  • Fatigue / therapy*
  • Female
  • Gastrointestinal Agents / adverse effects
  • Hemoglobins / metabolism
  • Humans
  • Inflammatory Bowel Diseases / drug therapy
  • Inflammatory Bowel Diseases / psychology*
  • Leukocyte Count
  • Male
  • Middle Aged
  • Psychiatric Status Rating Scales
  • Psychotherapy, Group*
  • Quality of Life* / psychology
  • Severity of Illness Index
  • Sleep

Substances

  • Gastrointestinal Agents
  • Hemoglobins
  • C-Reactive Protein