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Area of Science:

  • Gastroenterology
  • Psychiatry
  • Digital Health

Background:

  • Cognitive behavioral therapy (CBT) can improve health-related quality of life (HRQOL) in inflammatory bowel disease (IBD) patients.
  • Access to traditional CBT is limited, making computerized CBT (CCBT) a potential alternative.
  • CCBT offers a self-administered intervention for IBD patients to enhance HRQOL.

Purpose of the Study:

  • To evaluate the effectiveness of a self-administered CCBT intervention for improving HRQOL in IBD patients.
  • To compare HRQOL outcomes in patients receiving CCBT versus treatment as usual.
  • To identify predictors of dropout from the CCBT intervention.

Main Methods:

  • A randomized controlled trial allocated IBD patients to CCBT (n=113) or treatment as usual (n=86).
  • The primary outcome was the IBD Questionnaire at 12 weeks; secondary outcomes included generic HRQOL, anxiety, depression, coping, stress, and IBD symptoms.
  • Outcomes were assessed at 12 weeks and 6 months, with dropout predictors also analyzed.

Main Results:

  • Only 25.7% of CCBT participants completed the intervention.
  • CCBT completers showed significant improvements in the IBD Questionnaire and mental health scores at 12 weeks compared to the control group.
  • These improvements were not sustained at the 6-month follow-up.

Conclusions:

  • While CCBT showed short-term benefits for IBD patients' HRQOL, these gains were not maintained long-term.
  • Low adherence rates present a challenge for CCBT effectiveness in IBD.
  • CCBT may not be suitable for IBD patients with comorbid depression, suggesting a need for improved adherence strategies.