Interventions for fatigue in inflammatory bowel disease (Protocol) (original) (raw)
Related papers
Targets for health interventions for inflammatory bowel disease-fatigue
Journal of Crohn's & colitis, 2016
Fatigue is a complex, multifactorial and multidimensional phenomenon. Recognition of modifiable correlates of fatigue can provide a further understanding of this phenomenon in patients with inflammatory bowel disease (IBD) and aid in the development of interventions tailored towards fatigue with potential for efficacy. To systematically search and synthesize available evidence on potentially modifiable factors contributing to IBD-fatigue and what advances in the management of fatigue in individuals with IBD have been made. The process of selection of citations was based on an earlier review by Czuber-Dochan et al. (2013) and was undertaken in two phases: i) searching for new studies published since August 2012, using seven electronic databases; ii) reselection of papers included in previous review according to the aims of the current review. Forty-three studies met the inclusion criteria. IBD-fatigue was consistently associated with disease activity, depression, anxiety and sleep di...
Fatigue management in patients with IBD: a randomised controlled trial
Gut, 2013
Objective To assess the effectiveness of solutionfocused 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 (CISfatigue: 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.
Review article: description and management of fatigue in inflammatory bowel disease
Alimentary Pharmacology & Therapeutics, 2013
This uncommissioned review article was subject to full peer-review. SUMMARY Background Fatigue is a common and leading concern for patients with inflammatory bowel disease (IBD). It is managed inadequately in IBD, and there is little evidence to support interventions. Aim To examine patients' experience of and factors contributing to IBD-fatigue, and to appraise its management by patients and healthcare professionals. Methods Seven electronic databases were searched. Subject headings and free-text searching were used, with no time limit set. Reference lists of retrieved papers were searched manually. Results Twenty-eight papers were reviewed. Researchers used terms including 'fatigue', 'low energy', 'tiredness', 'decline in vitality and vigour' and 'reduced energy and vitality'. Different definitions were used to conceptualise fatigue. None of the reviewed studies asked patients to describe the experience of fatigue in their own words. Numerous physical, psychological and situational factors associated with fatigue were identified. Three small randomised control trials reported a favourable effect of infliximab and adalimumab on fatigue. One intervention study reported benefit from a stress management programme and one from solution-focused therapy. Conclusions Inconsistent use of terminology, lack of data from patients' perspective on inflammatory bowel disease-fatigue and lack of evidence to support its management contribute to fatigue being largely ignored or overlooked by healthcare professionals. Future research should explore the experience of IBD-fatigue from the individual patient perspective. Further studies are required to fully explore the factors associated with fatigue and to develop patient-centred interventions to reduce fatigue.
Alimentary Pharmacology & Therapeutics, 2021
Background: Fatigue is the inability to achieve or maintain an expected work output resulting from central or peripheral mechanisms. The prevalence of inflammatory bowel disease (IBD) fatigue can reach 86% in active disease, persisting in 50%-52% of patients with mild to inactive disease. Fatigue is the commonest reason for work absence in IBD, and patients often report fatigue burden to be greater than that of primary disease symptoms. Relatively few evidence-based treatment options exist, and the aetiology is poorly understood. Aim: To review the available data and suggest a possible aetiology of IBD fatigue and to consider the efficacy of existing management strategies and highlight potential future interventions. Methods: We reviewed fatigue-related literature in IBD using PubMed database. Results: Disease related factors such as inflammation and pharmacological treatments negatively impact skeletal muscle and brain physiology, likely contributing to fatigue symptoms. Secondary factors such as malnutrition, anaemia, sleep disturbance and psychological comorbidity are potential determinants. Immune profile, faecal microbiota composition and physical fitness differ significantly between fatigued and non-fatigued patients, suggesting these may be aetiological factors. Solution-focused therapy, high-dosage thiamine supplementation and biological therapy may reduce fatigue perception in IBD. The effect of physical activity interventions is inconclusive. Conclusions: A multimodal approach is likely required to treat IBD fatigue. Established reversible factors like anaemia, micronutrient deficiencies and active disease should initially be resolved. Psychosocial intervention shows potential efficacy in reducing fatigue perception in quiescent disease. Restoring physical deconditioning by exercise training intervention may further improve fatigue burden.
Journal of Crohn's and Colitis
Background and Aims Although fatigue is common in inflammatory bowel disease [IBD], its pathogenesis remains unclear. This study aimed to determine the prevalence of fatigue and its associated factors in a cohort of patients newly diagnosed with IBD. Methods Patients ≥18 years old were recruited from the Inflammatory Bowel Disease South-Eastern Norway [IBSEN III] study, a population-based, observational inception cohort. Fatigue was assessed using the Fatigue Questionnaire and compared with data from a Norwegian general population. Univariate and multivariate linear and logistic regression analyses were performed to evaluate the associations of total fatigue [TF; continuous score] and substantial fatigue [SF; dichotomized score ≥4] with sociodemographic, clinical, endoscopic, laboratory, and other relevant patient data. Results In total, 983/1509 [65.1%] patients with complete fatigue data were included (ulcerative colitis [UC], 68.2%; Crohn’s disease [CD], 31.8%). The prevalence of...
The experience of fatigue in people with inflammatory bowel disease: an exploratory study
Journal of Advanced Nursing, 2012
Aims. To explore fatigue, the impact it has on daily life and the strategies used to ameliorate the symptom, as described by people with inflammatory bowel disease. Background. Fatigue is the most troublesome symptom during remission of inflammatory bowel disease. Fatigue affects people's daily functioning, impacting on quality of life. There is limited understanding of the nature of and the ways fatigue in inflammatory bowel disease is experienced and managed in everyday adult life. Design. An epistemological interpretive approach to understand participants' selfreported experiences of disease-related fatigue. Methods. A convenience sample of 46 participants was recruited from the Crohn's and Colitis UK member database. Five focus group interviews (November 2008-February 2009) were conducted, audio-recorded, transcribed, and analysed using an inductive thematic framework. Findings. Five themes were identified: the experience of fatigue, causes of fatigue, managing fatigue, consequences of fatigue, and seeking support. Fatigue had a debilitating effect on the social and emotional well-being of participants and limited their employment opportunities. People used a range of strategies to cope and reported that fatigue-related issues seemed to be poorly understood by clinicians and were not addressed in medical consultations. Conclusion. Fatigue was an inextricable part of daily life for some people with inflammatory bowel disease. Specialist nurses and medical colleagues need to address the personal, social, and economic consequences of fatigue, whilst further nursing research would improve understanding of the impact of fatigue and help develop appropriate intervention strategies for people with inflammatory bowel disease.