Home-based transcutaneous electrical acupuncture-point stimulation for depressive symptoms in inflammatory bowel disease: a randomized feasibility study.

Abstract

Background: Depressive symptoms are common in individuals with inflammatory bowel disease (IBD) and are associated with poor disease outcomes. Transcutaneous electrical acupuncture point stimulation (TEAS) is a noninvasive intervention with potential benefits for inflammation but remains untested in IBD. We developed a smartphone application for home-based TEAS self-administration and evaluated its feasibility, acceptability, and preliminary effects.

Methods: In a randomized feasibility study, IBD patients with Patient Health Questionnaire-9 (PHQ-9) scores ≥ 8 were recruited through Crohn's and Colitis UK. Participants were remotely trained to use the TEAS device, locate acupoints, and self-administer the treatment via the app. Group A completed 30-min daily sessions for 21 days from week 1, while Group B started in week 6. Outcomes [recruitment, retention, acceptability, depression, fatigue, pain, and quality of life (QoL)] were assessed at baseline, week 4, and week 9.

Results: Of the 109 individuals of interest, 57 were assessed, 37 were eligible, and 36 were randomized. In Group A, 83% (15/18) completed ≥ 18 sessions, compared to 50% (9/18) in Group B. The questionnaire completion rates were 92% ( n  = 33) at baseline, 83% ( n  = 30) at 4 weeks, and 67% ( n  = 24) at 9 weeks. Most participants (81%) recommended TEAS. Preliminary analysis showed reduced depressive symptoms and improved QoL postintervention and at the follow-up. Postintervention, the mean PHQ-9 score decreased from 13.9 to 7.7 in Group A and from 14.2 to 6.5 in Group B.

Conclusions: Home-based TEAS is feasible, acceptable, and has a clinical potential. A full-scale randomized controlled trial is needed to confirm its efficacy in the treatment of IBD-related depression.