P332 Mindfulness-based stress reduction and cognitive intervention improve the health-related quality-of-life and ability to work in Crohn’s disease patients: A randomised controlled trial
D. Schwartz1, R. Sergienko2, G. Goren3, S. Reggev3, M. Friger2, A. Nemirovsky4, A. Monsonego4, D. Greenberg5, O. Sarid3, V. Slonim-Nevo3, S. Odes6, Israeli IBD NUcleua IIRN
1Department of Gastroenterology, Soroka Medical Center, Beer Sheva, Israel, 2Department of Public Health, Ben-Gurion University of the Negev, Beer Sheva, Israel, 3Department of Social Work, Ben-Gurion University of the Negev, Beer Sheva, Israel, 4Department of Bacteriology and Immunology, Ben-Gurion University of the Negev, Beer Sheva, Israel, 5Department of Health Systems Management, Ben-Gurion University of the Negev, Beer Sheva, Israel, 6Department of Health Sciences, Ben-Gurion University of the Negev, Metar, Israel
Background
Crohn’s disease (CD) patients have reduced quality-of-life (QoL) in physical, emotional and social domains, and diminished work and leisure activities. We examined whether Mindfulness-Based Stress Reduction and Cognitive Intervention (‘Intervention’) can improve QoL and ability to work.
Methods
Patients (≥18 years), Harvey–Bradshaw Index (HBI) >4 and <16, were randomised to Intervention or Control groups. Intervention was taught in 8 weekly sessions by social workers via SKYPETM with twice-daily practice and back-report required. Medications were not controlled. HBI was completed at entry (T1) and 12 weeks (T2), and these questionnaires: (1) Short inflammatory bowel disease questionnaire (SIBDQ), disease-specific HRQoL measure. (2) Short-Form 12 (SF-12) questionnaire, generic HRQoL measure of physical health (PH) and mental health (MH). (3) EQ-5D-3L HRQoL questionnaire. (4) Work Productivity and Activity Impairment (WPAI) questionnaire, measuring absenteeism, presenteeism (reduced productivity), work impairment (composite of absenteeism and presenteeism), and leisure activity impairment. Statistics: Pearson Chi-squared, Wilcoxon signed-rank test.
Results
There were 39 Intervention and 43 Control patients. Demographic and medical characteristics (median, %) were: age 30 y; women 65%, married/partner 48%; higher education 83%; BMI 22; non- or past-smokers 92%; disease duration 5 y; HBI 8 (range 5–15); past surgery 17%; Montreal A2 89%, L2+L3 89%, B1+B2 89%, perianal disease 18%; drugs: corticosteroids 4%, 5-ASA 5%, immunomodulators 21%, biologics 43%; (
Conclusion
Mindfulness-Based Stress Reduction and Cognitive Intervention led to increased QoL and less work and activity impairment. If confirmed in a large cohort the intervention may be offered to all CD patients.