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

Fatigue is common among people with inflammatory bowel disease (IBD) in remission. A randomized controlled trial tested whether fatigue reductions from mindfulness-based cognitive therapy (MBCT) lasted nine months. Among 108 fatigued IBD patients who received MBCT, the reduced fatigue level post-treatment did not change significantly during follow-up. 29% of patients reported clinically relevant improvement from before treatment to nine months. Secondary outcomes (fatigue interference, depression, anxiety, quality of life) remained stable. Patients who improved were significantly more often unemployed. The findings suggest that MBCT's fatigue reductions are sustained over nine months, with about one-third of patients experiencing clinically meaningful improvement.

Study at a glance

Abstract

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. 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. 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 (χ2(1, n = 73) = 4.40, p = 0.04). Secondary outcomes, which did not change significantly during MBCT, also remained stable during follow-up. 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. ClinicalTrials.gov ID: NCT03162575.