Cognitive behavior therapy reduces mood symptoms in patients with functional GI disorders
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Implementation of a digital cognitive behavioral therapy tool during the COVID-19 pandemic reduced mood symptoms among patients with functional gastrointestinal disorders who also have anxiety or depression.
“Patients with functional GI disorders (FGID) exhibit increased sensitivity to stressors which can lead to anxiety and depression. Cognitive behavioral therapy (CBT) is known to help improve mood, increase stress resiliency and reduce FGID symptom severity,” Aylin Tansel, MD, MPH, University of Pittsburgh Medical Center, said. “Unfortunately, there are substantial barriers to implementation; integrating behavioral health technology into the medical clinic workflows could potentially overcome these barriers. We face the additional challenge of a global pandemic that diverted many healthcare resources, disrupted outpatient care delivery and had a significant impact on everyone, including our patients with FGID.”
To evaluate the feasibility and initial impact of a digital CBT (dCBT) tool as a first-line intervention for reducing emotional distress, researchers offered 298 FGID patients (mean age 43 years; 73.2% women) access to an app called RxWell. The app, which consists of 40 CBT techniques and is supported by digital health coaches, administered anxiety (GAD4) and depression (PHQ8) testing at baseline and measured scores at monthly visits. Researchers noted sessions with behavioral providers supplemented dCBT.
Over a 3-month period, 54% of patients used RxWell for more than three dCBT techniques (mean 15 techniques) and 43% of users communicated with their digital health coach. GAD7 scores and PHQ8 scores improved significantly (mean change = 3.7 and 3.4, respectively) and users who used a health coach demonstrated greater improvement.
“CBT and mindfulness practices are well recognized as safe and effective interventions; the use of the dCBT app is, as well, associated with clinically and statistically significant mood symptom reductions within 3 months, supplementation with digital health coaching further enhance these benefits,” Tansel concluded. “These preliminary results suggest that dCBT is a viable strategy to improve access to effective behavioral therapy for patients with FGIDs. Results from this project will need to be confirmed with a larger randomized control trial.”
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Tansel A, et al. Abstract 511. Presented at: Digestive Disease Week; May 21-23, 2021 (virtual meeting).
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