Research: MULARSKI and COLLEAGUES,

Listed in Issue 186

Abstract

MULARSKI and COLLEAGUES,  The Center for Health Research , Kaiser Permanente Northwest, Portland, OR 97227, USA. Richard.A.Mularski@kpchr.org tested the efficacy of a mindfulness-based breathing therapy (MBBT) on improving symptoms and health-related quality of life in those with COPD

Background

Patients with chronic obstructive lung disease (COPD) suffer from significant dyspnoea and may benefit from complementary and alternative medicine (CAM) therapies aimed at mitigating symptoms. The objective of this study was to test the efficacy of a mindfulness-based breathing therapy (MBBT) on improving symptoms and health-related quality of life in those with COPD.

Methodology

The authors conducted a randomized controlled trial of 8-week mindfulness-based breathing therapy (MBBT) compared to support groups to test efficacy on improving symptoms and health-related quality of life in those with COPD. The setting for this study was an academic-affiliated veterans healthcare system. The subjects consisted of 86 patients with COPD. MBBT included weekly meetings practicing mindfulness mediation and relaxation response. Outcome measures: The main outcome measure was a post 6-minute-walk test (6MWT) Borg dyspnea assessment. Other outcome measures included health-related quality of life measures, 6MWT distance, symptom scores, exacerbation rates, and measures of stress and mindfulness. Analysis of covariance compared differences in outcomes between groups; paired t test evaluated changes within groups.

Results

RESULTS: Participants were predominantly elderly men with moderate to severe COPD. We found no improvements in dyspnoea (post 6MWT Borg difference between the MBBT and support group was 0.3 (95% confidence interval [CI]: -1.1, 1.7). We found no differences between groups in almost all other outcome measures by either intention-to-treat analysis or within the subset that completed assigned group sessions. For the physical summary scale of the generic Short Form-36 for Veterans, the difference between outcomes favoured the support group (4.3, 95% CI: 0.4, 8.1). Participant retention was low compared to mind-body trials that randomize from CAM wait lists.

Conclusion

This trial found no measurable improvements in patients with COPD receiving a mindfulness-based breathing CAM therapy compared to a support group, suggesting that this intervention is unlikely to be an important therapeutic option for those with moderate-to-severe COPD.

References

Mularski RA, Munjas BA, Lorenz KA, Sun S, Robertson SJ, Schmelzer W, Kim AC and Shekelle PG. Randomized controlled trial of mindfulness-based therapy for dyspnoea in chronic obstructive lung disease. Journal of Alternative & Complementary Medicine. 15(10):1083-90, 2009 Oct.

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