Mindfulness-based Cognitive Therapy for Patients With Inflammatory Bowel Disease
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| ClinicalTrials.gov Identifier: NCT04646785 |
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Recruitment Status :
Not yet recruiting
First Posted : November 30, 2020
Last Update Posted : November 30, 2020
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| Condition or disease | Intervention/treatment | Phase |
|---|---|---|
| Inflammatory Bowel Diseases | Behavioral: Mindfulness-based cognitive therapy + TAU Other: Treatment as usual (TAU) | Not Applicable |
Show detailed description
| Study Type : | Interventional (Clinical Trial) |
| Estimated Enrollment : | 136 participants |
| Allocation: | Randomized |
| Intervention Model: | Parallel Assignment |
| Intervention Model Description: | A randomized, multicenter, clinical trial with assessments at baseline, post treatment (3 months later) and follow-ups at 6, 9 and 12 months after baseline. |
| Masking: | None (Open Label) |
| Primary Purpose: | Supportive Care |
| Official Title: | Mindfulness-based Cognitive Therapy to Improve Stress and Sleep in Patients With Inflammatory Bowel Disease |
| Estimated Study Start Date : | May 1, 2021 |
| Estimated Primary Completion Date : | May 1, 2024 |
| Estimated Study Completion Date : | May 1, 2024 |
| Arm | Intervention/treatment |
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Experimental: Mindfulness-based cognitive therapy (MBCT) added to treatment as usual
Patients in the MBCT arm will in addition to their treatment as usual be invited to participate in MBCT.
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Behavioral: Mindfulness-based cognitive therapy + TAU
The proposed intervention is mindfulness-based cognitive therapy (MBCT), based on the protocol published by Segal, Williams and Teasdale. MBCT consists of eight weekly 2.5h group sessions, a six-hour silent day and daily home practice assignments guided by audio files. The program includes both formal and informal meditation exercises. Cognitive techniques include monitoring and scheduling of activities, identification of negative automatic thoughts and devising a relapse prevention plan. Psycho-education and interactive dialogue typically focus on stress management, balancing activities, and (lifestyle) strategies to stay well in the future (relapse prevention). |
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Active Comparator: Treatment as usual (TAU)
Patients in this arm will receive treatment as usual.
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Other: Treatment as usual (TAU)
Treatment as usual (TAU) according Dutch and European IBD treatment guidelines. TAU focuses on pharmacological and surgical disease control, and prevention of complications. |
- Psychological distress [ Time Frame: Change between baseline and 3 months ]Measured by the Hospital Anxiety and Depression Scale (HADS). The HADS consists of 14 items, 7 related to depression and 7 related to anxiety. Scoring for each item ranges from zero to three. Three denotes highest anxiety or depression level meaning that a person can score between 0 and 21 for either anxiety or depression.
- Psychological distress [ Time Frame: Change between 3 and 12 months ]Measured by the Hospital Anxiety and Depression Scale (HADS). The HADS consists of 14 items, 7 related to depression and 7 related to anxiety. Scoring for each item ranges from zero to three. Three denotes highest anxiety or depression level meaning that a person can score between 0 and 21 for either anxiety or depression.
- Objective sleep quality [ Time Frame: Change between baseline and 3 months ]operationalized as total sleep time, time spent in slow wave sleep, sleep continuity, all measured with wearable sleep EEG (iBand+/ Arenar and Fitbit activity tracker).
- Objective sleep quality [ Time Frame: Change between 3 and 12 months ]operationalized as total sleep time, time spent in slow wave sleep, sleep continuity, all measured with wearable sleep EEG (iBand+/ Arenar and Fitbit activity tracker).
- Subjective sleep quality [ Time Frame: Change between baseline and 3 months ]Measured by the Pittsburgh Sleep Quality Inventory (PSQI). The PSQI consist of 19 items offering 7 components scores and one composite score. Scoring for each component ranges from zero to three. The overall PSQI score is then calculated by totaling the seven component scores, providing an global score ranging from zero to twenty-one. Lower scores indicate a healthier sleep quality.
- Subjective sleep quality [ Time Frame: Change between 3 and 12 months ]Measured by the Pittsburgh Sleep Quality Inventory (PSQI). The PSQI consist of 19 items offering 7 components scores and one composite score. Scoring for each component ranges from zero to three. The overall PSQI score is then calculated by totaling the seven component scores, providing an global score ranging from zero to twenty-one. Lower scores indicate a healthier sleep quality.
- Fatigue [ Time Frame: Change between baseline and 3 months ]measured by the Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F).The FACIT-F is a 40-item self-reported measure that assesses fatigue and its impact on daily activities and function. Subdomains include: physical Well-Being, Social/Family Well-Being, Emotional Well-Being, Functional Well-Being and Fatigue. The subdomain fatigue consists of 13-items. Items are scored on a 0-4 response scale with anchors ranging from 'not at all' to 'very much so'. All items are summed to create a global fatigue score with a range from 0 to 52. Higher scores indicate increased fatigue.
- Fatigue [ Time Frame: Change between 3 and 12 months ]measured by the Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F).
- IBD-related quality of life [ Time Frame: Change between baseline and 3 months ]measured by the Inflammatory Bowel Disease Quality of Life Questionnaire (IBDQ). The IBDQ has 32 items scored on a 7-point Likert scale, ranging from 1 (worst health) to 7 (best health). Overall score range from 32 to 224, with higher scores reflecting better quality of life.
- IBD-related quality of life [ Time Frame: Change between 3 and 12 months ]measured by the Inflammatory Bowel Disease Quality of Life Questionnaire (IBDQ). The IBDQ has 32 items scored on a 7-point Likert scale, ranging from 1 (worst health) to 7 (best health). Overall score range from 32 to 224, with higher scores reflecting better quality of life.
- Perceived control over IBD [ Time Frame: Change between baseline and 3 months ]measured by the IBD-Control questionnaire. The IBD-Control Questionnaire consists of eight items, which generate an overall score ranging from 0 (worst control) to 16 (best control).
- Perceived control over IBD [ Time Frame: Change between 3 and 12 months ]Measured by the IBD-Control questionnaire. The IBD-Control Questionnaire consists of eight items, which generate an overall score ranging from 0 (worst control) to 16 (best control).
- Calprotectin [ Time Frame: Change between baseline and 3 months ]Assessed in accordance with regular medical procedures. Having higher levels of calprotectin generally means that there is active inflammation in the body or intestines. For a calprotectin test, a normal reading is less than 100 mcg/g.
- Calprotectin [ Time Frame: Change between 3 and 12 months ]Assessed in accordance with regular medical procedures. Having higher levels of calprotectin generally means that there is active inflammation in the body or intestines. For a calprotectin test, a normal reading is less than 100 mcg/g.
- C-reactive protein levels [ Time Frame: Change between baseline and 3 months ]Assessed in accordance with regular medical procedures. Also having higher levels of c-reactive protein generally means that there is active inflammation in the body or intestines. For a CRP test, a normal reading is less than 10 milligram per liter (mg/L).
- C-reactive protein levels [ Time Frame: Change between 3 and 12 months ]Assessed in accordance with regular medical procedures. Also having higher levels of c-reactive protein generally means that there is active inflammation in the body or intestines. For a CRP test, a normal reading is less than 10 milligram per liter (mg/L).
- Clinical disease activity [ Time Frame: change between baseline and 3 months ]Assessed by a clinician with the Harvey Brashaw Index (HBI) for Crohn's disease and the Simple Clinical Colitis Activity Index
- Clinical disease activity [ Time Frame: change between 3 and 12 months ]Assessed by a clinician with the Harvey Brashaw Index (HBI) for Crohn's disease and the Simple Clinical Colitis Activity Index
- Repetitive negative thinking [ Time Frame: Change between baseline and 3 months ]measured by the 15-item Perseverative Thinking Questionnaire (PTQ). The PTQ is a 15-item self-report questionnaire. Respondents are asked to describe how they typically think about negative experiences or problems. They rate each item on a 5-point Likert scale from 0 (never) to 4 (almost always) the extent to which each statement applies to them when they think about negative experiences or problems. All items are summed to create a global repetitive negative thinking score ranging from 0 to 60. Higher scores indicate increased repetitive negative thinking.
- Repetitive negative thinking [ Time Frame: Change between 3 and 12 months ]measured by the 15-item Perseverative Thinking Questionnaire (PTQ). The PTQ is a 15-item self-report questionnaire. Respondents are asked to describe how they typically think about negative experiences or problems. They rate each item on a 5-point Likert scale from 0 (never) to 4 (almost always) the extent to which each statement applies to them when they think about negative experiences or problems. All items are summed to create a global repetitive negative thinking score ranging from 0 to 60. Higher scores indicate increased repetitive negative thinking.
- Mindfulness skills [ Time Frame: Change between baseline and 3 months ]24-item Five Facet Mindfulness Questionnaire Short Form (FFMQ-SF). This questionnaire is divided into the subscales observing, describing, acting with awareness, non-judging and non-reactivity.
- Mindfulness skills [ Time Frame: Change between 3 and 12 months ]24-item Five Facet Mindfulness Questionnaire Short Form (FFMQ-SF). This questionnaire is divided into the subscales observing, describing, acting with awareness, non-judging and non-reactivity.
- Positive mental health [ Time Frame: Change between baseline and 3 months ]Measured by the Mental Health Continuum-Short Form (MHC-SF). MHC-SF consists of 14-items and assesses emotional, psychological and social well-being. All items are summed and then a mean score is calculated, which represents a global positive mental health score ranging from 0 to 5. Higher scores indicate a better positive mental health.
- Positive mental health [ Time Frame: Change between 3 and 12 months ]Measured by the Mental Health Continuum-Short Form (MHC-SF). MHC-SF consists of 14-items and assesses emotional, psychological and social well-being. All items are summed and then a mean score is calculated, which represents a global positive mental health score ranging from 0 to 5. Higher scores indicate a better positive mental health.
- Self-compassion [ Time Frame: Change between baseline and 3 months ]We will use the 12-item Dutch short-form version of the SCS-SF to measure self-compassion. The scale consists of six components, including self-kindness, self-judgment, common humanity, isolation, mindfulness and over-identification. In the short form, each scale consists of 2 items scored between 1 ((almost) never) to 7 ((almost) always) and subscale score ranges between 2 and 14. A higher score indicates a higher level of self-kindness, common humanity, and mindfulness, and lower scores of self-judgment, isolation, and over-identification. Total scores range from 12 to 84 (summed subscale scores), a higher score indicates a higher level of self-compassion.
- Self-compassion [ Time Frame: Change between 3 and 12 months ]We will use the 12-item Dutch short-form version of the SCS-SF to measure self-compassion. The scale consists of six components, including self-kindness, self-judgment, common humanity, isolation, mindfulness and over-identification. In the short form, each scale consists of 2 items scored between 1 ((almost) never) to 7 ((almost) always) and subscale score ranges between 2 and 14. A higher score indicates a higher level of self-kindness, common humanity, and mindfulness, and lower scores of self-judgment, isolation, and over-identification. Total scores range from 12 to 84 (summed subscale scores), a higher score indicates a higher level of self-compassion.
- Costs [ Time Frame: 12 months ]This will be investigated by using the Trimbos iMTA Questionnaire for Costs associated with Psychiatric Illness (TiC-P) as a measure of healthcare utilization. Unit cost estimates are derived from the national manual for cost prices in the healthcare sector.
- Health-related quality of life [ Time Frame: 12 months ]This will be assessed by using the EuroQol-5D (EQ-5D-5L). The EQ-5D-5L consist of five dimensions: mobility, self-care, usual activities, pain/discomfort and anxiety/depression. Each dimension has 5 levels: no problems, slight problems, moderate problems, severe problems and extreme problems. This short self-report instrument is used to assess quality adjusted life years.
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the contacts provided below. For general information, Learn About Clinical Studies.
| Ages Eligible for Study: | 18 Years and older (Adult, Older Adult) |
| Sexes Eligible for Study: | All |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Confirmed IBD diagnosis of Crohn's disease (CD), Ulcerative colitis (UC) or Indeterminate colitis (IC)
- Current IBD remission (Calprotectin < 250 mg/kg) since at least three months
- Hospital Anxiety and Depression Scale-score of >=11, indicating at least mild levels of psychological distress (Vodermaier 2011).
- Age of 18 or older
- Taking no IBD medication or on a stable dose of 5-ASA products, immunosuppressive medication, or biologics for at least three months prior to enrollment.
Exclusion Criteria:
- Severe psychiatric disorders (e.g. acute suicidality, psychosis)
- Current alcohol or drug dependency
- Untreated anemia
- Prior participation in an 8-week MBSR or MBCT-programme
To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.
Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT04646785
| Contact: Marloes Huijbers, dr. | (024) 361 0405 | marloes.huijbers@radboudumc.nl | |
| Contact: Annelieke van Velthoven, MSc. | 024-3668456 | annelieke.vanvelthoven@radboudumc.nl |
| Principal Investigator: | Anne Speckens, Dr. | Radboud University Medical Center | |
| Study Chair: | Loes Nissen, Dr. | Jeroen Bosch Ziekenhuis | |
| Study Chair: | Marloes Huijbers, Dr. | Radboud University Medical Center |
| Responsible Party: | Anne Speckens, Principal Investigator and Director of Radboudumc Centre for Mindfulness, Radboud University Medical Center |
| ClinicalTrials.gov Identifier: | NCT04646785 |
| Other Study ID Numbers: |
MBCT-IBD-2020-2024 |
| First Posted: | November 30, 2020 Key Record Dates |
| Last Update Posted: | November 30, 2020 |
| Last Verified: | November 2020 |
| Individual Participant Data (IPD) Sharing Statement: | |
| Plan to Share IPD: | Yes |
| Plan Description: | The authors intend to make the data available to other researchers after completion of the study and will comply with open access procedures, including open access publishing, as much as possible. |
| Supporting Materials: |
Study Protocol Statistical Analysis Plan (SAP) Analytic Code |
| Time Frame: | we expect the final report of the primary endpoint of the study December 2024, and we will have an embargo period of 6 months after publication. |
| Access Criteria: | We will use restricted access, such that interested researchers are welcome to contact us with requests for data. The project team will review the quality of the request and grant permission if the request is in accordance with the terms of use drafted by the Radboudumc. |
| URL: | https://www.lcrdm.nl/ |
| Studies a U.S. FDA-regulated Drug Product: | No |
| Studies a U.S. FDA-regulated Device Product: | No |
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randomized controlled trial mindfulness-based cognitive therapy effectiveness |
psychological distress sleep fatigue |
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Intestinal Diseases Inflammatory Bowel Diseases Gastrointestinal Diseases Digestive System Diseases Gastroenteritis |

