Multimodal Lifestyle Intervention Improves Fatigue in Quiescent Inflammatory Bowel Disease: A Controlled Study.

IF 1.8 Q3 GASTROENTEROLOGY & HEPATOLOGY Crohn's & Colitis 360 Pub Date : 2025-02-08 eCollection Date: 2025-01-01 DOI:10.1093/crocol/otaf009

Roberta Loveikyte, Lola J M Koppelman, Mirjam J H Blijleven, Nathalie Wilmsen, Mar D M Rodríguez-Girondo, Sjaak Bloem, Philip W Voorneveld, Andrea E van der Meulen-de Jong, Sander van der Marel, P W Jeroen Maljaars

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Abstract

Background: Lifestyle factors are significant contributors to fatigue, affecting ~45% of patients with inflammatory bowel disease (IBD). Hence, we evaluated the effect of a multimodal lifestyle intervention on fatigue in patients with IBD.

Methods: Patients with quiescent IBD were enrolled in this multicenter, non-randomized, controlled interventional study. The intervention group followed a 12-month lifestyle program, which included digital group meetings with a nutritionist and a lifestyle coach focusing on nutrition, exercise, sleep, and relaxation. The program also encouraged patients to exercise more self-control over personal health. The control group received standard clinical care. Clinical data and patient-reported outcomes were collected. Fatigue was measured with the Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F); any increase in FACIT-F was considered a positive response to the intervention. Inverse probability treatment weighting was used to correct confounding by indication.

Results: Thirty-six patients in the intervention group and 32 in the control group were compared. More patients in the intervention group (82.1%) than in the control group (54.2%) experienced improvement in fatigue, P = .029, standardized mean difference (SMD) -0.624. Over 70% of patients in the intervention group achieved a clinically relevant improvement in fatigue. Compared to the control group, quality of life improved in the intervention group. Acceptance of the health status was a significant factor for fatigue improvement (β = 7.899, SE = 1.913, P < .001).

Conclusions: Multimodal lifestyle intervention improves fatigue in patients with IBD. Acceptance appears essential for fatigue improvement; instruments evaluating acceptance could help to personalize treatment and maximize its effectiveness.

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背景：生活方式是导致疲劳的重要因素，约45%的炎症性肠病（IBD）患者会因此而感到疲劳。因此，我们评估了多模式生活方式干预对 IBD 患者疲劳的影响：这项多中心、非随机对照干预研究招募了静止期 IBD 患者。干预组采用为期 12 个月的生活方式计划，包括与营养师和生活方式指导员举行数字小组会议，重点讨论营养、运动、睡眠和放松等问题。该计划还鼓励患者加强对个人健康的自我控制。对照组则接受标准的临床治疗。我们收集了临床数据和患者报告的结果。疲劳通过慢性疾病治疗功能评估-疲劳（FACIT-F）进行测量；FACIT-F的任何增加都被认为是对干预的积极反应。采用反概率治疗加权法校正适应症的混杂因素：对干预组的 36 名患者和对照组的 32 名患者进行了比较。干预组（82.1%）比对照组（54.2%）更多患者的疲劳状况有所改善，P = 0.029，标准化平均差（SMD）为-0.624。干预组中超过 70% 的患者的疲劳状况得到了临床相关的改善。与对照组相比，干预组的生活质量有所改善。对健康状况的认可是改善疲劳的一个重要因素（β = 7.899，SE = 1.913，P 结论：多模式生活方式干预可改善疲劳：多模式生活方式干预可改善 IBD 患者的疲劳状况。接受度似乎是改善疲劳的关键；评估接受度的工具有助于个性化治疗并最大限度地提高治疗效果。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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