Personalized Exercise Program Improves Survival Rate in Liver Transplant Patients

Principal Investigator: Daniela P. Ladner, MD, MPH, Interim Director, Comprehensive Transplant Center; Professor of Surgery (Organ Transplantation) and Medical Social Sciences, Northwestern University Feinberg School of Medicine Patients with poor physical conditioning who are diagnosed with cirrhosis frequently experience worse outcomes before and after receiving a liver transplant. Exercise helps reduce frailty and leads to better outcomes, but patients face a variety of financial and logistical barriers to the regular physical activity needed to maintain strength. Additionally, transplant teams often expect patients to optimize their physical health on their own with little guidance. The Ladner research team seeks to optimize patient outcomes through a practical and affordable approach to enhance physical conditioning in the pre- and post-liver transplant setting. The researchers are developing a simple and cost-effective intervention called LIFT (Liver FrailTY), which will include a full in-person strength assessment, an exercise program with smart phone guidance, and remote coaching. Regular and frequent check-ins will be essential to encouraging patients to achieve recommended levels of exercise. Dr. Ladner’s study will then measure the impact of LIFT on strength as well as on positive clinical outcomes, such as increased survival and fewer hospitalizations for patients facing liver...

Measuring which aspects of living with IBD, including its treatments, may contribute to a patient developing post-traumatic stress (PTS), a chronic psychological reaction to a traumatic event characterized by flashbacks, nightmares, and hypervigilance

Principal Investigator: Tiffany Taft, PsyD Living with inflammatory bowel disease (IBD) is both physically and psychologically challenging and has the potential to negatively impact patient lives. As many as one-third of individuals with IBD demonstrate significant post-traumatic stress (PTS) symptoms, according to the first study of IBD-related PTS in the United States conducted by Dr. Taft and her team. Negative hospital experiences may play a substantial role. Further advancing this research, Dr. Taft aims to identify targets for early psychosocial counseling to better intervene and prevent the potential impact of undiagnosed PTS on patient outcomes. The novel study will include the use of online patient surveys to better understand PTS prevalence in IBD and to assess differences in illnesses and demographics traits between IBD patients with and without PTS. The next step will involve in-depth interview s with patients recruited from Northwestern’s and Rush University’s gastroenterology clinics. A clinical psychologist who specializes in working with adult IBD patients will conduct these interviews to gather information not easily collected via standardized tests to better evaluate PTS causes and guide...
DHF BioRepository

DHF BioRepository

Introducing a groundbreaking research technology, the The Digestive Health Foundation became a founding supporter in 2017 of a powerful new resource for digestive health medical research: The Digestive Health Foundation BioRepository.  As one of only a few GI biorepositories of its kind in the world, the DHF BioRepository stores, organizes, and makes accessible (digitally, in real time) blood and tissue samples from patients and family members diagnosed with one or more of the digestive disorders treated at the Northwestern Medicine Digestive Health Center.  Digestive disease research using the DHF BioRepository will leverage the latest advances in information technology with cutting-edge biologic and molecular research techniques to better understand gastrointestinal diseases and to help develop better treatment options for patients. Across GI sub-specialties, from liver and pancreatic cancers, esophageal diseases/swallowing disorders, inflammatory bowel disease (Crohn’s Disease and ulcerative colitis), GERD, IBS, bariatric surgery, nutritional issues, and many more, the extensive and growing patient network at Northwestern Medicine provides a diverse and valuable resource of participants.  After a patient chooses to participate, Northwestern Medicine directly links the patient’s anonymized electronic medical record, physiologic diagnostic test results, imaging results, and patient-directed quality of life indicators to a tissue bank that will include: samples obtained during endoscopy (biopsies), blood, urine, and stool.  The DHF BioRepository’s depth of capacity will enable physician scientists around the world to pursue large scale research studies into the mechanisms of digestive diseases.  Discoveries about the natural history and progression of digestive disease is providing the insight necessary to develop new diagnostic tools, better treatments, and eventual cures for digestive disease patients and future generations. — The Digestive Health...

Use of Health Coaches to Improve the Effectiveness of Behavioral Therapies for GI Conditions

Principal Investigator: Sarah Quinton, MD Behavioral and psychological interventions for digestive health conditions are highly effective in reducing symptoms and enhancing patient well-being and adjustment to living with chronic digestive conditions. However, most patients face significant barriers to accessing care from a trained GI health psychologist despite high levels of interest. In recent years, health coaching has been integrated into standard models of behavioral health care, and the benefits of health coaching have been demonstrated with patients with a variety of chronic diseases. In a study conducted by a multidisciplinary team, Kathryn Tomasino, PhD, Assistant Professor in the Division of Gastroenterology & Hepatology, and Sarah Kinsinger, PhD, Adjunct Associate Professor of Medicine at Northwestern University, Feinberg School of Medicine, will evaluate the usefulness of integrating health coaching into standard behavioral interventions for digestive conditions provided by GI health psychologists. The team will recruit participants to the study from patients referred for behavioral medicine services at Northwestern Medicine and will randomize participants into two groups. Half will receive the standard psychological therapy sessions (care as usual) and the other half will receive a reduced number of sessions with a GI psychologist plus support from a trained health coach. The coach connect with patients in between sessions via bi-weekly phone calls or MyChart messages to reinforce behavior change, enhance motivation and skills practice, and problem solve challenges—all with the goal of supporting patients along their journey to better health. The team hopes to determine the benefits and feasibility of this integrated model compared to standard...