Modified Mindfulness-based Stress Reduction Intervention in Chronic Obstructive Pulmonary Disease.

Abstract

Background: People with Chronic Obstructive Pulmonary Disease (COPD) have a high incidence of anxiety. This pilot study established feasibility and examined potential effects of mindfulness based stress reduction, modified for people with COPD. Primary outcomes included; sense of coherence, mindfulness, emotional function, mastery of disease, symptoms of dyspnea, fatigue and breathing patterns.

Methods: Subjects with COPD were recruited from pulmonary rehabilitation programs and randomized to 8 weeks of modified Mindfulness Based Stress Reduction (MBSR) or waitlist control. The following measures were taken before and after the intervention: Anxiety Sensitivity Index (ASI-3), Friedburg Mindfulness Inventory (FMI), Sense of Coherence (SOC), Chronic Respiratory Disease Questionnaire (CRQ) and breathing timing parameters via inductive plethysmography.

Results: Forty-eight subjects were enrolled, 6 were dropped due to low enrollment at their site. Three chose to drop out of the study (N = 36). There were significant interaction effects (time X group) for the FMI (P = 0.02) and respiratory rate (P = 0.05). The treatment group decreased FMI and increased respiratory rate and the control group increased FMI with no change in respiratory rate. CRQ Emotion correlated with the number of classes attended (r = .347, P = 0.05). Those attending <1 meditation class were statistically different at baseline compared to those who attended >1 meditation class: ASI-3 (41.50 vs 17.73, P = 0.00); CRQ Mastery (2.81 vs 4.9, P = 0.00); CRQ Emotion (2.81; mean vs 4.89, P = 0.00); CRQ Fatigue (2.35 vs 4.09, P = 0.01) SOC (51.85 (13.17) vs 66.41 (12.82), P = 0.01); FMI (33.71 (8.16) vs 41.42 (8.05), P = 0.03). .

Discussion: The decline in mindfulness scores and the increase in respiratory rate in the treatment group were unexpected but likely indicate that a longer intervention is needed. The differences between attenders and non-attenders could indicate a need for a longer time spent introducing beginning meditation skills. These results combined with other evidence from this study will aid in designing future meditation programs for persons with COPD.