Identifying patients with benign chronic intestinal failure on home parenteral nutrition in whom a psychological support intervention may improve Quality of Life

Summary Rationale Home parenteral nutrition (HPN) is the ultimate treatment for patients who suffering from chronic intestinal failure (CIF). We tested the feasibility and effects of Mindfulness Based Cognitive Therapy (MBCT) in patients on HPN. Because of the high dropout rate, however, we were next urged to develop and test a web-based coaching program (web-based MBCT). The aim of the present study was to compare the effects of MBCT with this web-based MBCT. Methods A quasi-experimental pilot study was conducted in a tertiary referral center for CIF in the Netherlands to evaluate the feasibility of both a MBCT and the internet-based MBCT intervention. In 2016 we included 17 patients in the MBCT group. These patients followed MBCT training. End of 2016 an internet-based online MBCT program was constructed for which we invited 14 patients and their caregivers. Results In the MBCT 5 out of 17 patients (29%) completed their therapy. Patients attributed positive effects to their acquired mindfulness skills and reported a better QoL. In the internet-based mindfulness therapy group 2 out of 14 patients (14%) fulfilled the training sessions. Also, six caregivers started the training in this latter group and one caregiver fulfilled the training. Conclusion The study suggests that both MBCT and the internet-based MBCT are no feasible strategies to decrease disease burden and improve QoL for CIF patients and their caregivers due to the intensity of these programs on one side and the experienced physical limitations on the other. The patients who fulfilled the program were positive and use MBCT in daily practice.