2017 Grant Awards
The posters and papers listed below each grant arise from work facilitated through the grant funding.
Pilot study of Mindfulness-Based Stress Reduction (MBSR) in patients with rheumatoid arthritis (RA) that still screen depressed using the Centre for Epidemiologic Studies-Depression (CES-D) questionnaire, despite adequate control of systemic and joint inflammation
Principal Investigators: Boire, G; Dobkin, P; Gaboury, I.
Co-investigators: Gervais, F; Beaulieu, M; Dagenais, P; Roberge, P; Roux, S.
Even when successful, current treat-to-target approaches leave up to 40% of rheumatoid arthritis (RA) patients into non-remission. Non-remission is most frequently due to persistently negative self-reported global impact of RA (translating into high patient assessment of disease activity or PGA), and not to inflammation (elevated SJC or CRP). This pilot study explored the feasibility and acceptability of Mindfulness Based Stress Reduction (MBSR) group sessions in treated RA patients with low (≤ 2) SJC and normal CRP, but still expressing one of high depressive symptoms, high anxiety, or high PGA discordant with the physician’s evaluation of disease activity, While measuring changes in Patient-related outcomes (depression, anxiety, PGA), we also collected bio samples and data on drug adherence at baseline and at 6 months following the MBSR sessions as well as during the wait period before the sessions start. The impact of the sessions was analysed both quantitatively (from questionnaires and clinical evaluation) and qualitatively (from interviews).
Due to lower-than-expected referral rates by rheumatologists and acceptance rates by patients, the recruitment strategies had to be refined over time. A total of 31 patients in 4 groups were included. Once recruited, more than 85% of the patients completed the 8 weekly sessions.
As expected, MBSR major positive impact was on anxiety levels and stress perception, but we observed also a significant improvement in depression scores. Qualitatively, the patients insisted on positive changes in coping strategies and decrease in anxiety symptoms, Analysis of the impact of MBSR on disease activity indices and on adherence is currently being performed.
In conclusion, group MBSR is an inexpensive and effective approach to improve well-being in symptomatic RA patients whose inflammatory disease is controlled. The major difficulty was having these patients adhere to an intervention that involves time, travel to a central site, group participation, and personal implication.
Presented at the 2018 Canadian Rheumatology Association meeting.