Online Mindfulness Intervention for Inflammatory Bowel Disease: Adherence and Efficacy

Abstract

The impact of stress and other psychological variables on Inflammatory Bowel Disease (IBD) prognosis, treatment response, and functional level is well-established; however, typical IBD treatment focuses on the physiological pathology of the disease and neglects complementary stress-reducing interventions. Recent pilot studies report the benefits of mindfulness-based interventions (MBIs) in people living with IBD, but are limited by small sample sizes. Recruitment challenges to in-person studies may be in part due to the difficulty IBD patients often have adhering to fixed schedules and travel as a result of IBD symptoms such as pain, fatigue, and incontinence. The current study aimed to address this barrier by offering participants access to online mindfulness training, allowing individuals to engage with intervention materials to fit their own schedule. Online mindfulness programs have gained popularity in recent years, as they increase access and flexibility and decrease cost to the user; however, the dropout rate tends to be high. The current study compared the rate of adherence and efficacy of mindfulness training as a function of level of support: self-guided versus supported. Analysis revealed no significant difference in the benefits received between participants in the two groups; however, a significant difference group (χ2 = 15.75; p = 0.000, r = 0.38) was found in terms of rate of completion, with 44.1% of the supportive group completing the protocol compared to 11.7% of the self-guided. Common challenges to meditation were measured, but did not significantly predict adherence to the intervention, and experience of these challenges did not significantly change (increase or decrease) over the duration of the study. Implications of the current research, future directions for the use of MBI for IBD patients, and a discussion of methodological considerations are provided.

Moving Towards Acceptance and Values: A Qualitative Study of ACTforIBD Compared to IBD Psychoeducation

“…The rationale for online blended delivery of psychological interventions, such as those in the current study, is to bridge barriers to accessing psychological support such as unpredictable symptoms and lack of resources including appropriately trained staff (Dober et al, 2021 ; Forbes & Johnson, 2021 ; Mikocka-Walus et al, 2020 ). Previous qualitative research which explored perspectives of both consumers and health professionals found the inclusion of both therapist-led and self-directed modules maximizes exposure to subject matter experts while circumnavigating possible non-adherence with fully self-directed programs (Dober et al, 2021 ; Hanlon et al, 2022 , Mikocka-Walus et al, 2017 ).…”

Efficacy and feasibility of the minimal therapist-guided four-week online audio-based mindfulness program ‘Mindful Senses’ for burnout and stress reduction in medical personnel: A randomized controlled trial

“…A previous RCT that supported our hypothesis found that MBI group that participants received welcome emails, inquiry responses, and practice reminder emails had a lower dropout rate than an MBI group without these supports. The control group also received some benefit from active control condition (PSA), probably contributing to fewer dropouts [56].…”

Efficacy and Feasibility of the Minimal Therapist-Guided Four-Week Online Audio-Based Mindfulness Program ‘Mindful Senses’ for Burnout and Stress Reduction in Medical Personnel: A Randomized Controlled Trial

“…A previous RCT that supported our hypothesis found that the MBI group in which participants received welcome emails, inquiry responses, and practice reminder emails had a lower dropout rate than an MBI group without these supports. The control group also received some benefit from active control condition (PSA), probably contributing to fewer dropouts [ 56 ]. A previous study [ 57 ] that supported our hypothesis reported that increased waitlist time was a predictor of a higher dropout rate.…”