| Title: |
Randomised clinical trial: Psychological intervention improves work productivity and daily activity by reducing abdominal pain and fatigue in Crohn's disease |
| Authors: |
Regev, Shirley; Schwartz, Doron; Sarid, Orly; Goren, Ganit; Slonim‐Nevo, Vered; Friger, Michael; Sergienko, Ruslan; Greenberg, Dan; Monsonego, Alon; Nemirovsky, Anna; Odes, Shmuel |
| Contributors: |
Leona M. and Harry B. Helmsley Charitable Trust |
| Source: |
Alimentary Pharmacology & Therapeutics ; volume 57, issue 8, page 861-871 ; ISSN 0269-2813 1365-2036 |
| Publisher Information: |
Wiley |
| Publication Year: |
2023 |
| Collection: |
Wiley Online Library (Open Access Articles via Crossref) |
| Description: |
Summary Background Chronic abdominal pain and fatigue are characteristics of Crohn's disease (CD) and contribute to functional impairments. Aims To examine whether CD‐tailored cognitive‐behavioural and mindfulness intervention (COBMINDEX) is effective in reducing abdominal pain and fatigue in patients with CD and whether changes in abdominal pain and fatigue mediate any beneficial effects of COBMINDEX on impairments in work productivity and daily activities. Methods This is a secondary analysis of a parallel‐group multicentre randomised controlled trial. Patients with mild‐to‐moderate CD ( n = 142) were randomised into either intervention group receiving COBMINDEX, or control group receiving treatment‐as‐usual for 3 months followed by COBMINDEX. Complete data were collected from 120 patients (34.0 ± 10.7 years, 62.5% female, intervention = 60, control = 60). Analysis of covariance assessed group differences in 3‐month follow‐up scores, controlling for baseline scores. Multiple parallel mediation analysis assessed the proposed mechanisms for the entire sample. Results The intervention group demonstrated significantly lower levels of abdominal pain ( F = 17.46, p < 0.001, η 2 p = 0.13), fatigue ( F = 7.26, p = 0.008, η 2 p = 0.06) and impairments at work ( F = 4.82, p = 0.032, η 2 p = 0.07) and daily activities ( F = 6.26, p = 0.014, η 2 p = 0.05), compared with treatment‐as‐usual. Moreover, changes in abdominal pain and fatigue significantly mediated the beneficial effects of COBMINDEX on patients' work productivity ( b = −9.90, SE = 2.86, 95% CI: −16.11 to −4.94) and daily activities ( b = −9.65, SE = 1.91, 95% CI: −13.77 to 6.35), independent of changes in disease activity. Conclusions COBMINDEX is effective at reducing abdominal pain and fatigue in patients with CD, which in turn leads to improvement in functioning. Clinicians should incorporate screening for severe abdominal pain and fatigue and consider offering cognitive‐behavioural and mindfulness training. ClinicalTrials.gov , Number: NCT05085925. ... |
| Document Type: |
article in journal/newspaper |
| Language: |
English |
| DOI: |
10.1111/apt.17399 |
| Availability: |
https://doi.org/10.1111/apt.17399; https://onlinelibrary.wiley.com/doi/pdf/10.1111/apt.17399; https://onlinelibrary.wiley.com/doi/full-xml/10.1111/apt.17399 |
| Rights: |
http://creativecommons.org/licenses/by-nc-nd/4.0/ |
| Accession Number: |
edsbas.F84EC532 |
| Database: |
BASE |