A Qualitative Template Analysis to Understand Patient and Practitioner Perspectives on a Psychological Intervention for Fatigue in Inflammatory Bowel Disease.

Aims: Fatigue in IBD is pervasive, with very few intervention options available to patients. Research has indicated that psychological therapies are a promising strategy for managing IBD fatigue. However, no such intervention is available to date. This study aimed to evaluate the opinion of patients and health professionals on a potential psychological intervention for IBD fatigue. Methods and Results: A total of seven patients (Crohn's disease = 5, ulcerative colitis = 2) and seven health professionals participated in semi-structured interviews. Results were derived by using a template analysis, revealing four key themes and associated subthemes: (1) it's a trade-off; (2) buy-in, trust and credibility; (3) accountability; and (4) accessibility and equity. Important factors identified were a self-led online intervention, where patients can converse with other patients. Patients determined a facilitator with IBD-specific knowledge to be important. Health professionals were concerned with the cost-effectiveness and duration of an intervention, whereas patients were less concerned about the financial cost if there is perceived benefit to the intervention. Conclusion: Findings indicate the need to balance support with accessibility for patients. The lack of consensus of who can deliver an intervention by health professionals is significant and underscores the need for mental health care to be integrated into IBD health services. Nurses were recommended as an alternative to mental health professionals. However, the nurses interviewed emphasized the impact this would pose on their workloads. As such, there needs to be a diversity of supporting staff in IBD health care teams to ensure that future psychological interventions are feasible.