Mindfulness based cognitive therapy in poorly controlled asthma: Will patients attend and do they benefit?

Abstract

<b>Introduction:</b> Stress, depression and anxiety can affect asthma control and quality of life, but access to clinical psychology is limited. Mindfulness based cognitive therapy (MBCT), a group-based course to reduce stress, has reported benefit in chronic disease. We assessed asthma patients’ attendance at a 10-week MBCT course and its effect on asthma control. <b>Methods:</b> Patients with uncontrolled physician diagnosed asthma (asthma control questionnaire [ACQ-6] score ≥1.5 despite optimised medication) were offered referral to MBCT. ACQ-6, asthma quality of life questionnaire (AQLQ), hospital anxiety and depression scale (HADS-A/HADS-D), perceived stress scale (PSS), spirometry, FeNO and blood eosinophils, were recorded before and after the MBCT course and at 3- and 6-months post completion. <b>Results:</b> Sixty patients were considered for MBCT, 5 successfully completed (figure 1). In those who completed MBCT; median scores for PSS (21 to 13), HADS-A (11 to 6) and HADS-D (12 to 6) reduced by course end, and this was sustained at 6 months. An improvement in median ACQ-6 was seen at 3 months (2.3 from 3.3 [MCID 0.5]) and sustained at 6 months (2.8). An improvement in median AQLQ was seen at 3 months (4.8 from 3.3 [MCID 0.5]) but was not sustained. <b>Conclusion:</b> Successful completion of MBCT was low. In those who did complete, a reduction in stress, anxiety and depression was seen, with improvement in asthma control.