Abstract
This paper describes the implementation of inflammatory bowel disease (IBD)-specific cognitive behavioural therapy (CBT) for IBD patients with poor quality of life (QoL), anxiety and depression, in four hospitals in the Netherlands. Treatment outcomes were compared with those of a previously published randomized control trial (RCT) of ‘IBD-specific CBT’, following a benchmark strategy. Primary outcome was IBD-specific QoL (IBDQ) completed before and after CBT, secondary outcomes were anxiety and depressive symptoms (HADS, CES-D). Semi-structured interviews were conducted among a pilot of gastroenterologists, nurse specialists and psychologists to evaluate ‘IBD-specific CBT’. 94 patients started treatment (280 screened). At follow-up, 63 participants (67% compared to 81% in the RCT benchmark) completed the IBDQ. Treatment effect sizes of the implementation study were comparable and slightly larger than those of RCT benchmark. Gastroenterologists, IBD nurses and psychologists found CBT necessary for IBD patients with poor QoL, depression and/or anxiety disorders. ‘IBD-specific CBT’ can be successfully implemented. Regular supervision of psychologists performing ‘IBD-specific CBT’ treatment is needed.
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Acknowledgements
First, we would like to thank all the participating patients with IBD who took part in this study. The research is funded by the Stomach Liver Bowel Foundation (Maag Lever Darm Stichting (MLDS)) from the Netherlands that carried out the peer review of the proposal (registration number: WO 17-07). We thank all medical specialists (gastroenterologists), support staff, managements of the departments of medical psychology of the Amsterdam UMC/location AMC, Noordwest Ziekenhuisgroep (Alkmaar), Isala (Zwolle) and Ziekenhuis Gelderse Vallei (Ede) for enabling the implementation study. Additionally, we thank all cognitive behavioural and clinical psychologists from the departments of medical psychology: Annelie Hooijer, Mieke Goossens, Amarins de Wagt (Isala Zwolle); Yvette van Dokkum, Irene Pot en Inge den Boer (Ziekenhuis Gelderse Vallei Ede); Floor Bennebroek Evertsz’, Annemarie Braamse, Marianne Kool (Amsterdam UMC/location AMC); Astrid Blok, Marielle ter Veldhuis, Machteld van Leeuwen (Noordwest Ziekenhuisgroep Alkmaar), who administered the ‘IBD-specific CBT’ intervention. We thank Ria Rochelle D’Abreo for her help in editing the manuscript. Lastly, we would like to thank the research assistants: Robine Slootmans, Brechtje Olgers, Sophie Pelt, Benjamin Nielsen, Mafalda van Dissel and Zwanet Young
Funding
The research is funded by the Stomach Liver Bowel Foundation (Maag Lever Darm Stichting (MLDS)) from the Netherlands that carried out the peer review of the proposal (registration number: WO 17–07). The sponsor of the study, the MLDS had no role in the study design, data gathering, data analysis, data interpretation or in writing the report.
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FBE was the chief investigator grant holder of the implementation QL!C study. She drafted the final manuscript (which was added and modified by all other authors), wrote the original treatment manual ‘IBD-specific CBT’ and was responsible for the training and supervision of the psychotherapists. The statistical analysis plan was set up by FBE, HK and PN are responsible for the statistical analysis and reporting. FBE, HK, CLHB, and ML were responsible for the funding. BO, SP, BN, MD and ZY supported in literature searches, reference preparation and reviewed early drafts of the article. All authors read and approved the final manuscript.
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Bennebroek Evertsz’, Bockting, Braamse, van Dissel, Duijvestein, Kager, Kool, Löwenberg, Mares, Nieuwkerk, Sipkema, Young, and Knoop declare that they have no competing interests.
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This implementation study design has been approved by the Medical Ethics Committee of the Amsterdam UMC (location AMC: dossier number: XT4-148).
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Bennebroek Evertsz’, F., Bockting, C.L., Braamse, A. et al. Implementation of ‘IBD-Specific Cognitive Behavioural Therapy’ for Patients with Inflammatory Bowel Diseases with Poor Mental Quality of Life, Anxiety and Depression. J Clin Psychol Med Settings 31, 258–278 (2024). https://doi.org/10.1007/s10880-023-09996-8
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DOI: https://doi.org/10.1007/s10880-023-09996-8