Acceptability of Identifying and Managing distress in IBD
Research type
Research Study
Full title
Acceptability of identifying and managing psychological distress in inflammatory bowel disease: The COMPASS-IBD Study
IRAS ID
312818
Contact name
Rona Moss-Morris
Contact email
Sponsor organisation
King's College London
Clinicaltrials.gov Identifier
Duration of Study in the UK
1 years, 4 months, 17 days
Research summary
Summary of Research
Psychological distress (depression and/or anxiety) within IBD is common, and known to lead to worse symptoms, more complications, and increased healthcare costs (by up to 45-75%). There is therefore a need for psychological therapy to support patients with IBD. COMPASS is an existing digital psychological therapy created by King’s College London, which has been found to improve psychological distress for patients with a range of long-term health conditions, including IBD. COMPASS uses a form of psychological therapy called cognitive behavioural therapy to help patients manage their psychological distress and long-term condition. COMPASS could therefore be implemented into IBD services to support psychological distress and improve patient wellbeing in IBD.
Therefore, the main objective of this study is to examine how feasible and acceptable it is to identify patients with psychological distress in an IBD service and to provide COMPASS to these patients as psychological support within routine NHS care. We will examine changes in patients’ psychological and physical health outcomes from before to after receiving COMPASS. The study will include individuals with IBD in the Guy's and St Thomas' NHS Foundation Trust (GSTT) IBD service. The e-IMPARTS screening process which will be implemented into routine care at GSST IBD service, will help to identify people with psychological distress who may be eligible for COMPASS. Patients will receive COMPASS for 12-weeks. They will complete questionnaires at study recruitment (baseline), 12-weeks (post-COMPASS), and 6 months. Participants can also choose to 1) provide stool samples as part of their participation (to help us understand changes in physical health outcomes) and/or 2) to take part in an interview about their experience of COMPASS. Healthcare providers who are delivering e-IMPARTS screening and COMPASS will also be invited to be interviewed.
Summary of Results
The COMPASS-IBD project explored the a) practicality of screening people’s levels of anxiety and depression (distress) using online questionnaires before clinic appointments in a large NHS outpatient gastroenterology service in the UK b) offering those shown to be distressed a therapist supported digital therapy designed specifically for Inflammatory Bowel Disease (IBD) and c) whether those who undertook COMPASS IBD showed significant changes in distress.
The team worked alongside people living with IBD to make IBD specific changes to the programme, ensuring the programme addressed key concerns of people with lived experience of IBD.
827 out of approximately 3324 (26%) patients in the service completed online screening. Around 26% of this group had significant depression and/or anxiety symptoms and were assessed to see if COMPASS-IBD would be a useful treatment for them.
Sixty-five patients took part in the COMPASS-IBD treatment. They were asked to complete a set of questionnaires about their mood, symptoms and how they feel about their IBD, before they started COMPASS-IBD, 12 weeks and 6 months later. The study found a significant reduction in psychological distress and improvement in IBD-related quality of life and confidence in managing their IBD over the 12 weeks. This suggests that COMPASS-IBD is a useful treatment for people living with IBD and distress. Of the people that used COMPASS-IBD, 32% completed 5 or more online sessions and 66% attended at least 3 therapist contacts.
In interviews, both patients and healthcare professionals thought it was important to ask about mental health and that COMPASS-IBD was a good treatment for IBD distress. For some patients, it was difficult to engage with the program as they had other events going on in their lives and often wanted more time with the therapist.
These results are promising. Asking people about their mental health can help identify people who need support. COMPASS-IBD can help to improve mood and help people with IBD cope better with their condition. Use of COMPASS was lower than expected so it may have an even bigger impact if we can find ways to encourage people to use more of the online sessions.
Has the registry been updated to include summary results?: No
If yes - please enter the URL to summary results:
If no – why not?: The clinicaltrials.gov registry has been regularly updated throughout the study process. The results will be added and updated to the registry when the papers outlining the results have been published. The papers are both currently submitted into journals and therefore the research team aim to have updated the registry by October 2025 to allow time for the publication process.
Did you follow your dissemination plan submitted in the IRAS application form (Q A51)?: Yes
If yes, describe or provide URLs to disseminated materials: Several pieces of work have been presented on the COMPASS-IBD work at international academic conferences, including American Psychosomatic Society 2024 and the European Health Psychology Society conference in 2023/4. We have published the study protocol for this work and have two further papers currently submitted to journals for publication outlining the results (URL links and references for presentations and papers below). The outcomes paper is in submission, expected to be published by 30/09/2025.‘The feasibility of implementing digital screening and treatment for distress in inflammatory bowel disease (IBD) in routine health care: The COMPASS-IBD study protocol. Annie S. K. Jones, Sophie Harding, Natasha Seaton, Joanna L. Hudson, Alexa Duff, Abigail Wroe, Harinder Singh, Sam Norton, Federica Picariello and Rona-Moss-Morris https://gbr01.safelinks.protection.outlook.com/?url=https%3A%2F%2Ftrack.pstmrk.it%2F3ts%2Fwww.sciencedirect.com%252Fscience%252Farticle%252Fpii%252FS1551714424002416%2FNBTI%2FjcG_AQ%2FAQ%2Fb7c954e7-db18-4987-b44b-8971ff715019%2F4%2FVmJK_Ya4W9&data=05%7C02%7Cgmeast.rec%40hra.nhs.uk%7Cff0a73c7e97b4db2d24008ddc5d74414%7C8e1f0acad87d4f20939e36243d574267%7C0%7C0%7C638884250517349716%7CUnknown%7CTWFpbGZsb3d8eyJFbXB0eU1hcGkiOnRydWUsIlYiOiIwLjAuMDAwMCIsIlAiOiJXaW4zMiIsIkFOIjoiTWFpbCIsIldUIjoyfQ%3D%3D%7C0%7C%7C%7C&sdata=VLLiC3Ecuf0LDcG7FA7uvwIAPLse9w0WSZcOIjEEWWo%3D&reserved=0
S. Harding, H. Singh, R. Moss-Morris, K. Hulme, A. Wroe, N. Seaton, J. Hudson, A. Jones, A, Duff. ‘Using the person-centered approach to adapt a digital therapy for inflammatory bowel disease’. 37th Annual Conference of the European Health Psychology Society; Bremen, Germany; 4th-8th Sept 2023; https://gbr01.safelinks.protection.outlook.com/?url=https%3A%2F%2Ftrack.pstmrk.it%2F3ts%2F2023.ehps.net%252Fwp-content%252Fuploads%252F2023%252F09%252FEHPS_2023_Abstracts_UPLOAD.pdf%252C%2FNBTI%2FjcG_AQ%2FAQ%2Fb7c954e7-db18-4987-b44b-8971ff715019%2F5%2FEomLtI3g1p&data=05%7C02%7Cgmeast.rec%40hra.nhs.uk%7Cff0a73c7e97b4db2d24008ddc5d74414%7C8e1f0acad87d4f20939e36243d574267%7C0%7C0%7C638884250517363260%7CUnknown%7CTWFpbGZsb3d8eyJFbXB0eU1hcGkiOnRydWUsIlYiOiIwLjAuMDAwMCIsIlAiOiJXaW4zMiIsIkFOIjoiTWFpbCIsIldUIjoyfQ%3D%3D%7C0%7C%7C%7C&sdata=qDQx1j8IQqorIvMWwSP5n4HXYkxp4Dnet%2BPBICbmzbo%3D&reserved=0 pg 621
A. Jones, S. Harding , N. Seaton , C. Frew , J. Hudson , R. Moss-Morris , A. Duff. ‘An implementation plan for delivering mental health screening and digital CBT in inflammatory bowel disease’. 37th Annual Conference of the European Health Psychology Society; Bremen, Germany; 4th-8th Sept 2023; https://gbr01.safelinks.protection.outlook.com/?url=https%3A%2F%2Ftrack.pstmrk.it%2F3ts%2F2023.ehps.net%252Fwp-content%252Fuploads%252F2023%252F09%252FEHPS_2023_Abstracts_UPLOAD.pdf%252C%2FNBTI%2FjcG_AQ%2FAQ%2Fb7c954e7-db18-4987-b44b-8971ff715019%2F5%2FEomLtI3g1p&data=05%7C02%7Cgmeast.rec%40hra.nhs.uk%7Cff0a73c7e97b4db2d24008ddc5d74414%7C8e1f0acad87d4f20939e36243d574267%7C0%7C0%7C638884250517376400%7CUnknown%7CTWFpbGZsb3d8eyJFbXB0eU1hcGkiOnRydWUsIlYiOiIwLjAuMDAwMCIsIlAiOiJXaW4zMiIsIkFOIjoiTWFpbCIsIldUIjoyfQ%3D%3D%7C0%7C%7C%7C&sdata=3Z%2FxNuy4rG7NAQ0Yll%2B6YkzFiR3Ae%2FM6ESXf5xokFls%3D&reserved=0 pg 496
S. Harding, F. Siklosi, N, Seaton, A, Duff, J. Hudson, A. Jones, R. Moss-Morris. ‘Healthcare professionals' perceptions of the barriers and facilitators to implementing routine mental health screening and digital therapy for patients living with Inflammatory Bowel Disease’ 81st Annual Meeting of the American Psychosomatic Society; Brighton, UK; 20th – 23rd Mar 2024
S. Harding, F. Siklosi, A. Jones, N, Seaton, A, Duff, J. Hudson, R. Moss-Morris. ‘Implementing digital screening and treatment for distress in inflammatory bowel disease (IBD): Healthcare providers' perspective.’ 38th Annual Conference of the European Health Psychology Society; Cascais, Portugal, 3rd- 6th Sept 2024; https://gbr01.safelinks.protection.outlook.com/?url=https%3A%2F%2Ftrack.pstmrk.it%2F3ts%2F2024.ehps.net%252Fwp-content%252Fuploads%252F2024%252F09%252Fehps-2024_abstracts-1.pdf%252C%2FNBTI%2FjcG_AQ%2FAQ%2Fb7c954e7-db18-4987-b44b-8971ff715019%2F6%2Fe7dGxId6fY&data=05%7C02%7Cgmeast.rec%40hra.nhs.uk%7Cff0a73c7e97b4db2d24008ddc5d74414%7C8e1f0acad87d4f20939e36243d574267%7C0%7C0%7C638884250517390635%7CUnknown%7CTWFpbGZsb3d8eyJFbXB0eU1hcGkiOnRydWUsIlYiOiIwLjAuMDAwMCIsIlAiOiJXaW4zMiIsIkFOIjoiTWFpbCIsIldUIjoyfQ%3D%3D%7C0%7C%7C%7C&sdata=4dNFJ94Y6we%2BL%2Bh1u7%2BFgmStXmX39IpcV2W1iF8tzps%3D&reserved=0 pg 433
R. Moss-Morris. ‘State Of The Art Presentation: Facilitating adjustment to long term medical conditions: A bench to (almost) bedside story’. 38th Annual Conference of the European Health Psychology Society; Cascais, Portugal, 3rd- 6th Sept 2024; https://gbr01.safelinks.protection.outlook.com/?url=https%3A%2F%2Ftrack.pstmrk.it%2F3ts%2F2024.ehps.net%252Fbook-of-abstracts%252F%2FNBTI%2FjcG_AQ%2FAQ%2Fb7c954e7-db18-4987-b44b-8971ff715019%2F7%2Fs5knn0P_hl&data=05%7C02%7Cgmeast.rec%40hra.nhs.uk%7Cff0a73c7e97b4db2d24008ddc5d74414%7C8e1f0acad87d4f20939e36243d574267%7C0%7C0%7C638884250517403650%7CUnknown%7CTWFpbGZsb3d8eyJFbXB0eU1hcGkiOnRydWUsIlYiOiIwLjAuMDAwMCIsIlAiOiJXaW4zMiIsIkFOIjoiTWFpbCIsIldUIjoyfQ%3D%3D%7C0%7C%7C%7C&sdata=v%2BgAkzcZn4O7o%2BhH1Uuq63QNGoMKq5Jt4k0%2BcxN%2BmsI%3D&reserved=0 p.1.
We have also disseminated a summary of findings to our PPI group via a feedback email and had several meetings with healthcare professionals including an overview of the IMPARTS screening service with accompanying training on mental health discussions and managing suicidal thoughts, and a presentation of the study’s key findings, their relevance for clinicians and patients, implementation challenges, and next steps. The sessions also provided an opportunity for clinicians to share their perspectives on priorities for future digital interventions.
A summary of the study and the results has also been published via a web blog on Crohn’s and Colitis UK, the charity who provided funding for the study:
https://gbr01.safelinks.protection.outlook.com/?url=https%3A%2F%2Ftrack.pstmrk.it%2F3ts%2Fcrohnsandcolitis.org.uk%252Four-work%252Fresearch-and-evidence%252Four-past-research-projects%252Fcompass-programme-for-anxiety-and-low-mood%2FNBTI%2FjcG_AQ%2FAQ%2Fb7c954e7-db18-4987-b44b-8971ff715019%2F8%2FALvCusE01P&data=05%7C02%7Cgmeast.rec%40hra.nhs.uk%7Cff0a73c7e97b4db2d24008ddc5d74414%7C8e1f0acad87d4f20939e36243d574267%7C0%7C0%7C638884250517416928%7CUnknown%7CTWFpbGZsb3d8eyJFbXB0eU1hcGkiOnRydWUsIlYiOiIwLjAuMDAwMCIsIlAiOiJXaW4zMiIsIkFOIjoiTWFpbCIsIldUIjoyfQ%3D%3D%7C0%7C%7C%7C&sdata=wCWEBu0TWk1umqkGZyh4A%2BgkJopBrLIBCKDvmtCCxI4%3D&reserved=0
REC name
North West - Greater Manchester East Research Ethics Committee
REC reference
22/NW/0224
Date of REC Opinion
25 Jul 2022
REC opinion
Favourable Opinion