AB1530 AN INTEGRATIVE APPROACH TO SYSTEMIC IMMUNE-MEDIATED DISEASES: A HOSPITAL-BASED INTERVENTION STUDY
Authors: S. Salvucci, F. Gazzoli, R. Santangeli, E. Filippini, M. Leo, L. Lucarelli, A. Festa, L. Manfredi, G. Moroncini
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> Systemic immune-mediated diseases (IMDs) pose an increasing challenge in modern medicine, profoundly affecting daily life due to persistent chronic pain and fatigue, despite effective pharmacological disease control. <h3>Objectives:</h3> This study aims to evaluate whether supplementing standard-of-care pharmacological therapy with an integrated approach involving yoga, mindfulness, Chinese medicine, and shiatsu can enhance the overall quality of life for patients with IMDs. <h3>Methods:</h3> Outpatients with IMDs, experiencing distress despite standard treatment, were enrolled in an uncontrolled observational study. Our integrative approach, provided free of charge within the hospital, comprised weekly group sessions of yoga or mindfulness and eight individual sessions of Tuina, Shiatsu, or counseling. We assessed the quality of life (QoL) using the SF-36 questionnaire. Subgroup analyses, categorized by disease, and a six-month post-treatment follow-up were conducted. Data analysis involved the Wilcoxon signed-rank test, Friedman test, and p-value correction using the Benjamini-Hochberg method. <h3>Results:</h3> Between May 2019 and September 2023, 105 patients were enrolled, and 47 (17 with systemic sclerosis, 12 with systemic lupus erythematosus, 3 with undifferentiated connective tissue disease, 1 with rheumatoid arthritis, 12 with psoriatic arthritis, 1 with Sjögren's syndrome, and 1 with granulomatosis with polyangiitis) successfully completed the study. The median age was 56 years (IQR 42.5-61.5). Notably, 7 out of 47 patients (17%) met the diagnostic criteria for fibromyalgia. Data analysis revealed significant differences (p-values &lt; 0.05) between pre- and post-treatment values across all SF-36 scales, including the physical and mental component summary scales (PCS and MCS). In the 6-month follow-up post-treatment analysis, statistically significant differences were observed only in the domains related to the mental component of SF-36. Meanwhile, the benefits on the physical health component seem to diminish over time. The subgroup analysis (conducted only for the SSc, SLE, and PsA groups) did not reveal statistically significant differences in pre-post-treatment scores, likely due to the small sample size. It's worth noting that all patients expressed interest in the novel approach, with logistical issues and distance from the hospital being the primary reasons for declining participation in the study. <h3>Conclusion:</h3> This study highlights the effectiveness of a multidisciplinary and integrative approach to systemic immune-mediated diseases, addressing both physical and mental aspects. The transformation of the hospital's image, traditionally linked to suffering and therapies, into a space fostering meaningful human connections is a qualitative achievement. This shift suggests new possibilities, positioning the hospital as a hub for interaction, friendship, and well-being, marking a significant advancement in enhancing the overall quality of life for patients with systemic immune-mediated diseases. REFERENCES: NIL. <h3>Acknowledgements:</h3> <b>NIL.</b> <h3>Disclosure of Interests:</h3> <b>None declared.</b>