Long term effects of a standard Mindfulness Based Stress Reduction program in COPD patients

Volume 6, Issue 6, December 2021     |     PP. 400-420      |     PDF (693 K)    |     Pub. Date: October 7, 2021
DOI: 10.54647/cm32615    73 Downloads     4496 Views  

Author(s)

Saïda Bensliman, Department of Respiratory Medicine, Hôpitaux Iris Sud – Site Molière-Longchamps, Belgium
Vincent Ninane, Department of Respiratory Medicine, Centre Hospitalier Universitaire Saint-Pierre, Belgium
Naila Bradstreet, Department of Respiratory Medicine, Hôpitaux Iris Sud – Site Molière-Longchamps, Belgium
Christian Mélot, Department of Emergency, Erasme University Hospital, Université Libre de Bruxelles Brussels, Belgium

Abstract
The management of mental health in addition to physical health in patient with chronic obstructive pulmonary disease (COPD) is often overlooked. Many COPD patients report anxiety and depression due to their respiratory condition. Mindfulness-based approaches has accrued robust evidence base in improving mental health outcomes in patients with chronic diseases. We conducted a study to evaluate the effects of the Mindfulness-Based Stress Reduction (MBSR) program in COPD patients who additionally participate to a pulmonary rehabilitation program versus a control group.Twenty eight COPD outpatients were enrolled,18 attended the standardized protocol 8-weeks MBSR program and the remaining 10 patients constituted the control group. The primary outcomes of psychological distress were measured with the Hospital Anxiety and Depression Scale (HADS), the State-Trait Anxiety Inventory (STAI-Y2) and the Perceived Stress Scale (PSS) at baseline (T0), 10 weeks (T1), 6 month (T2) and 12 months (T3) follow-up.A significantly improvement at 12 months were found in the MBSR group compared with the controls for the HADS (1.91 decrease versus 0.7 increase; respectively; 2.61 differential change; p=0.0463) and for the STAI-Y2 with a differential change of - 6.48 between the two groups (p=0.011). There was no statistically significant effect of the intervention versus control in stress level throughout the 1-year follow-up.MBSR showed a statistically significant long term effect on the mental health of COPD patients. These results suggest that mindfulness based intervention can be proposed, as a non-pharmacological treatment, with recommended treatment.

Keywords
Mindfulness, MBSR, COPD , mental health

Cite this paper
Saïda Bensliman, Vincent Ninane, Naila Bradstreet, Christian Mélot, Long term effects of a standard Mindfulness Based Stress Reduction program in COPD patients , SCIREA Journal of Clinical Medicine. Volume 6, Issue 6, December 2021 | PP. 400-420. 10.54647/cm32615

References

[ 1 ] Mannino DM, Kiriz VA. Changing the burden of COPD mortality. Int J Chron Obstruct Pulmon Dis. 2006;1(3):219–33.
[ 2 ] Rosenberg SR, Kalhan R, Mannino DM. Epidemiology of chronic obstructive pulmonary disease: prevalence, morbidity, mortality, and risk factors. Semin Respir Crit Care Med. 2015;36(4):457–69.
[ 3 ] Vestbo J, Hurd SS, Agustí AG, Jones PW, Vogelmeier C, Anzueto A, et al. Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease: GOLD executive summary. Am J Respir Crit Care Med. 2013;187(4): 347–65.
[ 4 ] Benzo RP, Abascal-Bolado B, Dulohery MM. Self-management and quality of life in chronic obstructive pulmonary disease (COPD): the mediating effects of positive affect. Patient Educ Couns. 2016;99(4):617–23.
[ 5 ] Dalal AA, Shah M, Lunacsek O, Hanania NA. Clinical and economic burden of depression/anxiety in chronic obstructive pulmonary disease patients within a managed care population. COPD. 2011;8(4):293–9.
[ 6 ] Laurin C, Moullec G, Bacon SL, Lavoie KL. Impact of anxiety and depression on chronic obstructive pulmonary disease exacerbation risk. Am J Respir Crit Care Med. 2012;185:918–23.
[ 7 ] Coventry PA, Bower P, Keyworth C, Kenning C, Knopp J, Garrett C, et al. The effect of complex interventions on depression and anxiety in chronic obstructive pulmonary disease: systematic review and meta-analysis. PloS One. 2013; Apr 5;8(4):e60532.
[ 8 ] Kabat-Zinn J. An outpatient program in behavioral medicine for chronic pain patients based on the practice of mindfulness meditation: theoretical considerations and preliminary results. Gen Hosp Psychiatry. 1982;4:33–47.
[ 9 ] Bohlmeijer E, Prenger R, Taal E, Cuijpers P. Meta-analysis on the effectiveness of mindfulness-based stress reduction therapy on mental health of adults with a chronic disease: what should the reader not make of it? J Psychosom Res. 2010;69 614–15.
[ 10 ] Parswani MJ, Sharma MP, Iyengar S. Mindfulness-based stress reduction program in coronary heart disease: a randomized control trial. Int. J. Yoga. 2013;6:111–7.
[ 11 ] Pbert L, Madison JM, Druker S, Olendzki N, Magner R, Reed G, et al. Effect of mindfulness training on asthma quality of life and lung function: a randomized controlled trial. Thorax. 2012;67:769–76.
[ 12 ] Zangi HA, Mowinckel P, Finset A,  Eriksson LR, Hoystad TO, Lunde AK, et al. A mindfulness-based group intervention to reduce psychological distress and fatigue in patients with inflammatory rheumatic joint diseases: a randomized controlled trial. Ann Rheum Dis. 2012;71:911–7.
[ 13 ] Grossman P, Niemann L, Schmidt S, Walach H. Mindfulness-based stress reduction and health benefits: a meta-analysis. J Psychosom Res. 2004; 57: 35–43.
[ 14 ] Chiesa A, Serretti A. Mindfulness-based stress reduction for stress management in healthy people: a review and meta-analysis. J Altern Complement Med. 2009;15: 593- 600.
[ 15 ] Fjorback LO, Arendt M, Ornbol E, Fink P, Walach H. Mindfulness-based stress reduction and mindfulness-based cognitive therapy: a systematic review of randomized controlled trials. Acta Psychiatr Scand. 2011;124:102–19.
[ 16 ] Mularski RA, Munjas BA, Lorenz KA, Sun S, Robertson SJ, Schmelzer W, et al. Randomized controlled trial of mindfulness-based therapy for dyspnea in chronic obstructive lung disease. J Altern Complement Med. 2009;15:1083–90.
[ 17 ] Chan RR, Giardino N, Larson JL. A pilot study: mindfulness meditation intervention in COPD. Int J Chronic Obstr Pulm Dis. 2015;10:445–54.
[ 18 ] Farver-Vestergaard I, O’Toole MS, O’Connor M,  Lokke A, Bendstrup E, Basdeo SA, et al. Mindfulness-based cognitive therapy in COPD: a cluster randomised controlled trial. Eur Respir J. 2018;51:1702082.
[ 19 ] Kabat-Zinn J. Full Catastrophe Living. Using the Wisdom of Your Body and Mind to Face Stress, Pain and Illness. New York: Hachette books. 2013.
[ 20 ] Bishop SR. What do we really know about mindfulness-based stress reduction? Psychosom Med. 2002;64:71–83.
[ 21 ] Kabat-Zinn J. Mindfulness-based interventions in context: past, present, and future. Clin Psychol Sci Practice. 2003;10:144–56.
[ 22 ] Zigmond AS, Snaith RP. The Hospital Anxiety and Depression Scale. Acta Psychiatr Scand. 1983;67:361–70.
[ 23 ] Puhan MA, Frey M, Buchi S, Schünemann HJ. The minimal important difference of the hospital anxiety and depression scale in patients with chronic obstructive pulmonary disease. Health Qual Life Outcomes. 2008;6:46.
[ 24 ] Spielberger CD, Gorsuch RL, Lushene R, Vagg PR, Jacobs GA. Manual for the State-Trait Anxiety Inventory (form Y). Palo Alto, CA: Consulting Psychologists Press. 1983.
[ 25 ] Bruchon-Scweitzer M, Paulhan I. Manuel du STAI forme Y, adaptation française. Paris : Editions du Centre de Psychologie Appliquée (ECPA). 1993.
[ 26 ] Cohen S, Kamarck T, Mermelstein R. A global measure of perceived stress. J Health Soc Behav. 1983;24:385-96.
[ 27 ] Williams JE, Singh SJ, Sewell L, Guyatt GH, Morgan MD. Development of a self-reported chronic respiratory questionnaire (CRQ-SR). Thorax. 2001;56:954-9.
[ 28 ] Singh SJ, Sodergren SC, Hyland ME, Williams J, Morgan MD. A comparison of three disease-specific and two generic health-status measures to evaluate the outcome of pulmonary rehabilitation in COPD. Respir Med. 2001;95:71-7.
[ 29 ] Harper R, Brazier JE, Waterhouse JC, Walters SJ, Jones NM, Howard P. Comparison of outcome measures for patients with chronic obstructive pulmonary disease (COPD) in an outpatient setting. Thorax. 1997;52:879-87
[ 30 ] Jones PW. Interpreting thresholds for a clinically significant change in health status in asthma and COPD. Eur Respir J. 2002;19:398–404.
[ 31 ] Medical Section of the American Lung Association. Standardization of spirometry: 1994 update. Am J Respir Crit Care Med. 1995;152:1107–36.
[ 32 ] American Thoracic Society. ATS statement: guidelines for six-minute walk test. Am J Respir Crit Care Med. 2002;166:111–7.
[ 33 ] Morisky DE, Green LW, Levine DM. Concurrent and predictive validity of a self-reported measure of medication adherence. Med Care. 1986;24:67–74.
[ 34 ] Parsons CE, Crane C, Parsons LJ, Fjorback LO, Kuyken W. Home practice in mindfulness-based cognitive therapy and mindfulness-based stress reduction: a systematic review and meta-analysis of participants’ mindfulness practice and its association with outcomes. Behav Res Ther. 2017;1:29–41.
[ 35 ] Segal ZV, Williams JMG, Teasdale JD. Mindfulness-based cognitive therapy for depression: A new approach to preventing relapse. New York: Guilford. 2002.
[ 36 ] Segal ZV, Williams JMG, Teasdale JD, Gemar M. A cognitive science perspective on kindling and episode sensitization in recurrent affective disorder. Psychol Med. 1996;26:371–80.
[ 37 ] Alsubaie M, Abbott R, Dunn B, Dickens C, Keil TF, Henley W, Kuyken W. Mechanisms of action in mindfulness-based cognitive therapy (MBCT) and mindfulness-based stress reduction (MBSR) in people with physical and /or psychological conditions: A systematic review. Clin Psychol Rev. 2017; 55:74-91.
[ 38 ] Holzel B, Lazar S, Gard T, Schuman-Olivier Z, Vago D, Ott U. How does Mindfulness Meditation work? Proposing mechanisms of action from a conceptual and neural perspective. Perspect Psychol Sci. 2011;6:537-59.
[ 39 ] Redelmeier DA, Bayoumi AM, Goldstein RS, Guyatt GH. Interpreting small differences in functional status: the six-minute walk test in chronic lung disease patients. Am J Respir Crit Care Med. 1997;155:1278-82.
[ 40 ] Troosters T, Gosselink R, Decramer M. Short- and long-term effects of outpatient rehabilitation in patients with chronic obstructive pulmonary disease: a randomized trial. Am J Med. 2000;109:207-12.
[ 41 ] Guthrie SJ, Hill KM, Muers, ME. Living with severe COPD. A qualitative exploration of the experience of patients in Leeds. Respir Med. 2001;95:196– 204.
[ 42 ] Seamark DA, Blake SD, Seamark CJ, Halpin DM. Living with severe chronic obstructive pulmonary disease (COPD): perceptions of patients and their careers: an interpretative phenomenological analysis, Palliat Med. 2004;18:619–25.
[ 43 ] Bourbeau J, Bartlett SJ. Patient adherence in COPD. Thorax. 2008;63:831-8.
[ 44 ] Vestbo J, Anderson JA, Calverley PM, Celli B, Ferguson GT, Jenkins C, Knobil K, Willits LR, Yates JC, Joneset PW. Adherence to inhaled therapy, mortality and hospital admission in COPD. Thorax. 2009;64:939-43.