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Randomized Controlled Trial
. 2024 Jun 3;30(6):911-921.
doi: 10.1093/ibd/izad122.

Feasibility, Acceptability, and Preliminary Efficacy of Acceptance Commitment Therapy for Adults Living With Inflammatory Bowel Disease and Distress

Daniel Romano  1 , Susan Chesterman  1 , Matthew Fuller-Tyszkiewicz  1 , Subhadra Evans  1 , Madeleine Dober  1 , Richard Gearry  2 , Peter R Gibson  3 , Simon Knowles  4 , Andrew McCombie  5 , Eric O  6 , Lisa Olive  1 , Leanne Raven  7 , Leesa Van Niekerk  8 , Antonina Mikocka-Walus  1
Affiliations
Randomized Controlled Trial

Feasibility, Acceptability, and Preliminary Efficacy of Acceptance Commitment Therapy for Adults Living With Inflammatory Bowel Disease and Distress

Daniel Romano et al. Inflamm Bowel Dis. .

Abstract

Background: The bidirectional relationship between inflammatory bowel disease (IBD) flare-ups and depression/anxiety symptoms has prompted investigations into psychotherapy to improve health-related quality of life (HRQoL) by targeting depression and anxiety. Acceptance commitment therapy (ACT) is effective in improving symptoms of depression and anxiety in people with chronic diseases, yet minimal research has examined ACT's effectiveness for IBD. This study examines the feasibility, acceptability, and preliminary efficacy of the ACTforIBD program, an online program codesigned with consumers to deliver ACT to those with IBD.

Methods: Adults with IBD and symptoms of mild-moderate distress were randomized to ACTforIBD or an active control (psychoeducation) condition. Participants completed 8 weekly, 1-hour sessions, 4 of which were therapist facilitated. Feasibility was based on recruitment and retention and acceptability was derived from postprogram satisfaction measures. Preliminary efficacy was determined by group differences in rate of change in study outcomes from baseline to postprogram.

Results: Of 62 participants (89% women, 11% men; mean age 33 years), 55 completed the program (ACTforIBD: n = 26 [83.9%]; active control: n = 29 [93.5%]). Adherence and acceptability were high in the ACTforIBD group, with 80% of participants completing all self-directed modules and 78% of participants expressing satisfaction with the program. Significant and marginally significant group × time interactions were found for anxiety symptoms (b = -1.89; 95% confidence interval, -3.38 to -0.42) and psychological HRQoL (b = -0.04; 95% confidence interval, -0.07 to 0.01), showing decreased anxiety and increased psychological HRQoL in the intervention group.

Conclusions: ACTforIBD is feasible, acceptable, and improved anxiety symptoms, and psychological HRQoL. This highlights the need for a full-scale randomized controlled trial to further examine the program's efficacy.

Keywords: acceptance commitment therapy; distress; feasibility; preliminary efficacy; randomized controlled trial.

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Conflict of interest statement

The authors do not have any conflicts of interest in relation to the present study, however, outside this work, SK has served as an educational speaker for Janssen, Ferring and Takeda. PG has served as a speaker, a consultant and an advisory board member for Allergan, Janssen, MSD, Pfizer, Anatara, Atmo Biosciences, Immunic Therapeutics, Novozymes and Takeda and Bristol-Meyers Squibb, and has received research funding from from MSD and Atmo Biosciences; and RG owns stocks and shares in Atmo Biosciences. LR served on the Roche International Patient Advisory Council and the Takeda IBD Patient Expert Council. RG has served on advisory boards for AbbVie New Zealand and Australia, Zespri New Zealand and Jannsen New Zealand and has received research funding from AbbVie. AM-W has served as an educational speaker for Janssen and Ferring.

Figures

Figure 1.
Figure 1.
CONSORT diagram showing recruitment and participant progress through the study.
See this image and copyright information in PMC

References

    1. Knowles SR, Graff LA, Wilding H, Hewitt C, Keefer L, Mikocka-Walus A.. Quality of life in inflammatory bowel disease: a systematic review and meta-analyses—part I. Inflamm Bowel Dis. 2018;24(4):742-751. - PubMed
    1. Mikocka-Walus A, Knowles SR, Keefer L, Graff L.. Controversies revisited: a systematic review of the comorbidity of depression and anxiety with inflammatory bowel diseases. Inflamm Bowel Dis. 2016;22(3):752-762. - PubMed
    1. Gracie DJ, Guthrie EA, Hamlin PJ, et al.Bi-directionality of brain–gut interactions in patients with inflammatory bowel disease. Gastroenterology. 2018;154(6):1635-1646.e3. - PubMed
    1. Fairbrass KM, Lovatt J, Barberio B, Yuan Y, Gracie DJ, Ford AC.. Bidirectional brain–gut axis effects influence mood and prognosis in IBD: a systematic review and meta-analysis. Gut. 2022;71(9):1773-1780. - PubMed
    1. Gracie DJ, Irvine AJ, Sood R, et al.Effect of psychological therapy on disease activity, psychological comorbidity, and quality of life in inflammatory bowel disease: a systematic review and meta-analysis. Lancet Gastroenterol Hepatol. 2017;2(3):189-199. - PubMed

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