Improving Food-Related Quality of Life in Inflammatory Bowel Disease through a Novel Web Resource: A Feasibility Randomised Controlled Trial

Selina R Cox, Wladyslawa Czuber-Dochan, Catherine L Wall, Hazel Clarke, Candice Drysdale, Miranda C Lomer, James O Lindsay, Kevin Whelan, Selina R Cox, Wladyslawa Czuber-Dochan, Catherine L Wall, Hazel Clarke, Candice Drysdale, Miranda C Lomer, James O Lindsay, Kevin Whelan

Abstract

Food-related quality of life (FR-QoL) is impaired in inflammatory bowel disease (IBD) and education and support on food-related issues in IBD is needed. This feasibility trial aimed to investigate the effectiveness and acceptability of a web resource in enhancing FR-QoL in newly diagnosed IBD. Patients diagnosed with Crohn's disease or ulcerative colitis in the preceding 12 months, with an impaired FR-QoL, were recruited and randomised to either receive access to the web resource (covering IBD-specific diet concerns) or no access (control group) for 12 weeks, while receiving usual clinical care. FR-QoL, health-related quality of life, psychological outcomes, and clinical disease activity were assessed. Web resource usage was assessed, and patients' experiences of the web resource were investigated in semi-structured interviews. Of 81 patients screened, 50 participants were randomised, 30 to the web resource and 20 to control. FR-QoL increased more in the web resource (+11.7 SD 18.2) than control group (+1.4 SD 20.4) (p = 0.067), while IBD distress reduced in the web resource (-6.8 SD 26.6) and increased in the control group (+8.3 SD 25.5) (p = 0.052), albeit not statistically significantly. End of trial Crohn's disease clinical activity (PRO-2) was significantly lower in the web resource than control group (p = 0.046). Participants most frequently accessed web resource content discussing dietary management of gut symptoms and in semi-structured interviews, reported the website to contain relevant information. This feasibility study demonstrates potential effectiveness of the web resource on improving FR-QoL and psychological outcomes in IBD. An adequately powered effectiveness RCT is feasible to conduct and is now warranted. NCT03884686.

Keywords: eHealth; food-related quality of life; inflammatory bowel disease.

Conflict of interest statement

S.R.C., W.C.-D., C.L.W., H.C., C.D., M.C.L. and J.O.L. have no relevant disclosures. K.W. is the co-inventor of VOC in the detection and management of IBS and has received research funding from the Almond Board of California, Danone, and International Dried Fruit and Nut Council. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript; or in the decision to publish the results.

Figures

Figure 1
Figure 1
CONSORT diagram showing patient flow during the trial.
Figure 2
Figure 2
(A) Baseline and end of trial FR-QoL-29 scores; (B) End of trial FR-QoL-29 scores.

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