Virtual Patient Groups for Sarcoidosis Associated Fatigue

Fatigue is a common and debilitating symptom of sarcoidosis. There are currently no approved treatments for sarcoidosis associated fatigue. We are testing an MBSR intervention based on previous work showing improvement of sarcoidosis associated fatigue with mindfulness interventions.

Participants will be adults diagnosed with sarcoidosis per self report and experiencing significant fatigue (Fatigue Assessment Scale [FAS] score ≥22). Participants will be recruited through Cleveland Clinic and partnering sarcoidosis clinics. Recruitment includes both in-person and virtual strategies using electronic health record (EHR) screening, MyChart messages, clinician referrals, and self-referral through a recruitment letter. Interested patients will complete eligibility screening, including a virtual or in-person consent process and FAS assessment.

Following enrollment, participants will be randomized 1:1 to either the MBSR intervention or control group (support group). The MBSR intervention consists of 8 weekly, virtual group sessions led by trained facilitators and includes guided mindfulness practices, group discussions, and home practice assignments. The control group will participate in an existing monthly virtual sarcoidosis support group, which includes a brief educational presentation and group discussion.

Study outcomes will be collected using online surveys at three timepoints: baseline (prior to intervention), 8 weeks (immediately post-MBSR), and 5 months (3-month follow-up). Outcomes include fatigue (primary), quality of life, depression, and anxiety. Qualitative interviews will be conducted after the intervention to explore participant experiences with the intervention.

The investigators will conduct an interim analysis to determine feasibility of study for study participants. If there is greater than 30% drop out and drop out assessed by primary investigator, blinded to study results, is determined to be due to intervention components, the study will be paused, the intervention tailored prior to continued recruitment.

Inclusion criteria

• Self reported diagnosis of sarcoidosis
• Fatigue defined as FAS score ≥ 22
• Age ≥ 18 years old
• Ability to speak and read English
• Access to internet
• Capacity to consent

Exclusion criteria

• Current daily meditation practice
• Prior history of engaging in formal mindfulness-based interventions including: MBSR, MBCT, Acceptance and Commitment therapy, Dialectical Behavior Therapy
• Any condition that would prevent being a suitable candidate for the group intervention (as determined by screening interview) including suicidal ideation.
• Lack of access to any form of online video access