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. 2023 Oct 30;6(3):314-331.
doi: 10.3138/canlivj-2022-0045. eCollection 2023 Oct.

The feasibility and acceptability of an online mind-body wellness program for patients with primary biliary cholangitis

Makayla Watt  1 , Ashley Hyde  1 , John C Spence  2 , Gail M Wright  3 , Shauna Vander Well  3 , Emily Johnson  1 , Andrew Mason  1 , Magnus McLeod  4 , Puneeta Tandon  1
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The feasibility and acceptability of an online mind-body wellness program for patients with primary biliary cholangitis

Makayla Watt et al. Can Liver J. .

Abstract

Background: Persons with primary biliary cholangitis (PBC) experience significantly higher rates of mental distress and impaired health related quality of life (HrQoL) than the general population. Given limited evidence, but a high need, our primary aim was to assess feasibility and acceptability of a 12-week, online, mind-body wellness program in people with PBC.

Methods: This was a single-group, sequential mixed-methods, pre-post feasibility, and acceptability study. Core program components included follow-along movement, meditation and breathwork videos, and cognitive behavioural therapy informed activities. This was supplemented by weekly phone check-ins. Feasibility was assessed by recruitment, adherence, and retention. The pre-post exploratory efficacy assessment included surveys for fatigue, perceived stress, anxiety, depression, HrQoL, and resilience. A qualitative descriptive approach with semi-structured interviews evaluated study experiences.

Results: Thirty-two participants were recruited within 30 days and 29 (91%) were retained to end-of-study. Of these, 25 (86%) adhered to carrying out the mind-body practice at least 2-3 days per week. Feedback supported acceptability (satisfaction score 90%). Significant improvements were observed in fatigue (13%, p = 0.004), anxiety (30%, p = 0.005), depression (28%, p = 0.004), and five PBC-40 domains (itch, fatigue, cognitive, emotional, general symptoms). Qualitative interviews revealed improved stress management, better coping, and a more positive mindset. Fatigue and self-sabotaging thoughts were cited as barriers to participation.

Conclusions: These findings suggest that a 12-week online mind-body intervention is feasible and acceptable in patients with PBC. After iterative refinement, a randomized controlled trial will be designed using this feedback.

Keywords: COM-B model; behaviour change wheel; liver disease; mind-body intervention; primary biliary cholangitis.

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Figures

Figure 1:
Figure 1:
Patient recruitment and flow through the study
Figure 2:
Figure 2:
Participant satisfaction with core and optional elements of the peace power pack program, scored using a 5-Point Likert scale from very satisfied to very dissatisfied
Figure 3:
Figure 3:
Estimated mean PBC-40, HADS, MFIS, and COM-B domain scores by timepoint where * indicated statistical significance using alpha = 0.05
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