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Original article
Fatigue management in patients with IBD: a randomised controlled trial
  1. Lauran Vogelaar1,
  2. Adriaan van't Spijker2,
  3. Reinier Timman2,
  4. Antonie J P van Tilburg3,
  5. DirkJan Bac4,
  6. Ton Vogelaar2,
  7. Ernst J Kuipers1,5,
  8. Jan J V van Busschbach2,
  9. Christien J van der Woude1
  1. 1Department of Gastroenterology and Hepatology, Erasmus MC, Rotterdam, The Netherlands
  2. 2Department of Psychology and Psychotherapy, Erasmus MC, Rotterdam, The Netherlands
  3. 3Department of Gastroenterology and Hepatology, Sint Franciscus Gasthuis, Rotterdam, The Netherlands
  4. 4Department of Gastroenterology and Hepatology, Gelderse Vallei, Ede, The Netherlands
  5. 5Department of Internal Medicine, Erasmus MC, Rotterdam, The Netherlands
  1. Correspondence to Lauran Vogelaar, Department of Gastroenterology and Hepatology, Erasmus MC, ‘s Gravendijkwal 230, Room HS 306, Rotterdam 3000 CA, The Netherlands; l.vogelaar{at}erasmusmc.nl

Abstract

Objective To assess the effectiveness of solution-focused therapy (SFT) on fatigue and quality of life (QoL) in patients with fatigued inflammatory bowel disease (IBD).

Design Randomised controlled trial in two Dutch hospitals. Patients with IBD with quiescent IBD and with a Checklist Individual Strength—Fatigue (CIS—fatigue) score of ≥35 were enrolled. Patients were 1:1 randomised to receive SFT or care as usual (CAU) for 3 months. Patients were followed for a further 6 months after the SFT. Primary endpoint was defined as changes in fatigue and QoL during follow-up. Secondary endpoints included change in anxiety and depression, medication use, side effects to medication, disease activity, laboratory parameters (C-reactive protein, leucocytes and haemoglobin) and sleep quality.

Results Ninety-eight patients were included, of whom 63% were women, mean age was 40.1 years. After the SFT course, 17 (39%) patients in the SFT group had a CIS-fatigue score below 35 compared with eight (18%) of patients in the CAU group (p=0.03). The SFT group also showed a greater reduction in fatigue across the first 6 months compared with the CAU group (CIS-fatigue: p=<0.001 and CIS-total: p=0.001).

SFT was associated with a significant higher mean IBD questionnaire change at 3 months (p=0.020). At 9 months, no significant differences between the two groups were observed.

Conclusions SFT has a significant beneficial effect on the severity of fatigue and QoL in patients with quiescent IBD. However, this effect diminished during follow-up.

  • Ibd Clinical
  • Inflammatory Bowel Disease

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