S1448 Both Low (TECH) and High (TEAM) Touch Interventions Improve Behavioral Health, IBD Symptoms, and Quality of Life: A Randomized Control Trial
Introduction: Patients with inflammatory bowel disease (IBD) can have impaired mental and physical health, decreased quality of life, and increased healthcare services utilization related to their IBD. The specialty medical home (SMH) model, which integrates physical, nutritional, and psychosocial treatment for a patient-centered approach, has the potential to provide whole-person care that improves IBD and behavioral health (BH) symptom severity and other patient-centered outcomes. Methods: Patients aged 18-60 with an IBD diagnosis and moderate-to-severe anxiety and depression across 3 academic centers were randomized to one of 2 evidence-based SMH care approaches. TECH participants received a low-human touch intervention supported by use of a digital cognitive behavioral therapy (dCBT) mobile application (app) with embedded health coaches, while TEAM participants received high-human touch multidisciplinary treatment. Primary outcomes were intervention impact on BH (PHQ8 + GAD7 score) and IBD (complexity score) symptom severity, with secondary outcomes of quality of life, functional impairment, and disease self-efficacy, at 6 and 12 months. IBD complexity score was calculated by adding the value of the patient’s PRO-2 ulcerative colitis (UC) or Crohn’s disease (CD) to the cumulative raw PROMIS-GI score, with lower scores indicating lower symptom severity. Results: 657 participants (330 TEAM and 327 TECH) enrolled in the study between July 2019 and March 2025. Participants were mostly women (65%) and diagnosed with Crohn’s disease (67%) with no significant differences between the groups. Mean age (34.7, SD 10.7) and disease duration (10.4 years, SD 8.3) were similar between groups. Participants in each study group had significant improvements (P < 0.001) in both BH and IBD symptom severity after 6 months in the study, which was sustained at 12 months. Additionally, participants saw improvements in quality of life, functional impairment, and self-efficacy. Conclusion: In the first large, randomized effectiveness trial comparing low (TECH) vs high (TEAM) human touch behavioral interventions within a SMH, patients in both groups demonstrated significant improvement in BH and IBD symptom severity as well as quality of life, functional, and self-efficacy outcomes. Further work is ongoing to identify which patients may benefit most from which interventions.
Authors
- Cara Nikolajski (ORCID: https://orcid.org/0000-0002-4922-6663)
- Jane Kogan
- Jeffrey Dueker
- Marla C. Dubinsky (ORCID: https://orcid.org/0000-0003-4968-5795)
- Ashley L. Taylor (ORCID: https://orcid.org/0000-0001-9975-7596)
- Szigethy Eva
- Benjamin L. Cohen (ORCID: https://orcid.org/0000-0003-1444-7877)
- Stephen Lupe (ORCID: https://orcid.org/0000-0002-4285-6216)
- Meredith L. Wallace (ORCID: https://orcid.org/0000-0003-3951-890X)
- Nina Oryshkewych
- Benjamin Click (ORCID: https://orcid.org/0000-0001-9048-7972)
- Miguel Regueiro
- Laurie Keefer
Publication Details
- Journal
- The American Journal of Gastroenterology
- Published
- 2025-10-01
- DOI
- https://doi.org/10.14309/01.ajg.0001133252.50159.af
- Primary Topic
- Inflammatory Bowel Disease
- Type
- article
- Field-Weighted Citation Impact
- 0.00