Abstract
Asthma outcomes remain suboptimal, despite effective pharmacotherapy. Psychological dysfunction (such as anxiety) is common, and associated with poorer outcomes. We evaluated a digital mindfulness programme as an intervention to improve asthma-related quality of life for primary care patients, in a prospectively registered randomized-controlled feasibility study. We offered ‘Headspace’, a widely-used digital mindfulness intervention, to adults with asthma through 16 UK GP practices. Participants were randomized on a 2:1 basis to the mindfulness intervention, or waitlist control. Participants completed questionnaires (including asthma symptom control, asthma-related quality of life, anxiety, depression) at baseline, 6-week and 3-month follow-up. 116 participants completed primary outcomes at 3-month follow-up: intervention 73 (79%), control 43 (84%). Compared to baseline, the intervention group but not the control group reported significantly improved asthma-related quality of life, with a between-group difference favoring the intervention group that was not significant (Mean difference = 0.15, 95%CI − 0.13 to 0.42). Intervention use varied (ranging from 0 to 192 times) but was generally high. Digital mindfulness interventions are feasible and acceptable adjunct treatments for mild and moderate asthma to target quality of life. Further research should adapt ‘generic’ mindfulness-based stress-reduction to maximize effectiveness for asthma, and validate our findings in a fully-powered randomized controlled trial.Trial registration Prospectively registered: ISRCTN52212323.
Highlights
Asthma is a multifaceted chronic disease, with recent estimates that it affects 339 million people of all ages worldwide and 6.5% of the UK population (Bloom et al, 2019)
Evidence suggests that modern pharmacotherapy can achieve good asthma control in clinical trials (Bateman et al, 2004), in reality the heterogenous clinical and behavioral phenotypes mean that asthma outcomes remain suboptimal, and many patients continue to experience persistent symptoms and impaired quality of life (Demoly et al, 2010)
This study aimed to explore the feasibility of using ‘Headspace’, a market-leading digital mindfulness intervention that is commercially available (Mani et al, 2015) for improving patient-reported outcomes for people with mild and moderate asthma treated in primary care, and to estimate effect size for a subsequent fully powered trial
Summary
Asthma is a multifaceted chronic disease, with recent estimates that it affects 339 million people of all ages worldwide and 6.5% of the UK population (Bloom et al, 2019). Evidence suggests that modern pharmacotherapy can achieve good asthma control in clinical trials (Bateman et al, 2004), in reality the heterogenous clinical and behavioral phenotypes mean that asthma outcomes remain suboptimal, and many patients continue to experience persistent symptoms and impaired quality of life (Demoly et al, 2010). The causes of these suboptimal therapeutic outcomes are complex and wide-ranging, including poor self-management (i.e. corticosteroid inhaler adherence and technique; see Thomas, 2015 for a review). Recent reviews have highlighted the need for appropriate treatment that considers these psychological aspects that will improve patient well-being and asthma control (Baiardini et al, 2015)
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