A Pilot Study of the Real-World Impact of Digital Cognitive Behavioral Therapy for Inflammatory Bowel Disease (COMPASS-IBD) on Inflammation, Disease Activity, and Healthcare Use

Abstract

Objective: – Inflammatory bowel disease (IBD) is commonly accompanied by psychological distress, which may worsen disease activity through gut-brain axis mechanisms. Psychological interventions including cognitive behavioral therapy (CBT) seem to reduce distress and inflammation in IBD. However, accessibility to psychological care remains limited. COMPASS-IBD, a digital CBT intervention tailored to IBD, aims to address these gaps. This nested exploratory, real-world study (NCT05330299) assessed the effectiveness of COMPASS-IBD in reducing inflammation, disease activity, and health care use in IBD patients. In addition, it examined relationships between changes in psychological distress and disease indicators. Methods: – Adults with IBD experiencing psychological distress were recruited from a large gastroenterology service, and enrolled in COMPASS-IBD. Disease-related primary outcomes were faecal calprotectin (FCP), C-reactive protein (CRP), and self-reported disease activity (SRDA). Secondary outcomes included other inflammatory biomarkers (neutrophils, monocytes, lymphocytes, white blood cells (WBC), ferritin, flare frequency, and health care usage. The Patient Health Questionnaire-Anxiety and Depression Scale (PHQ-ADS) measured distress. Mixed-effects models evaluated outcomes at baseline, 12 weeks, and 6 months. Results: – Sixty-five participants were included. There were significant reductions in CRP (d range: −0.47 to −0.53, P