TY - JOUR
T1 - Effects of mindfulness training programmes delivered by a self-directed mobile app and by telephone compared with an education programme for survivors of critical illness
T2 - A pilot randomised clinical trial
AU - Cox, Christopher E.
AU - Hough, Catherine L.
AU - Jones, Derek M.
AU - Ungar, Anna
AU - Reagan, Wen
AU - Key, Mary D.
AU - Gremore, Tina
AU - Olsen, Maren K.
AU - Sanders, Linda
AU - Greeson, Jeffrey M.
AU - Porter, Laura S.
N1 - Publisher Copyright:
© Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2019. All rights reserved.
PY - 2019/1/1
Y1 - 2019/1/1
N2 - Background Patients who are sick enough to be admitted to an intensive care unit (ICU) commonly experience symptoms of psychological distress after discharge, yet few effective therapies have been applied to meet their needs. Methods Pilot randomised clinical trial with 3-month follow-up conducted at two academic medical centres. Adult (≥18 years) ICU patients treated for cardiorespiratory failure were randomised after discharge home to 1 of 3 month-long interventions: A self-directed mobile app-based mindfulness programme; a therapist-led telephone-based mindfulness programme; or a web-based critical illness education programme. Results Among 80 patients allocated to mobile mindfulness (n=31), telephone mindfulness (n=31) or education (n=18), 66 (83%) completed the study. For the primary outcomes, target benchmarks were exceeded by observed rates for all participants for feasibility (consent 74%, randomisation 91%, retention 83%), acceptability (mean Client Satisfaction Questionnaire 27.6 (SD 3.8)) and usability (mean Systems Usability Score 89.1 (SD 11.5)). For secondary outcomes, mean values (and 95% CIs) reflected clinically significant group-based changes on the Patient Health Questionnaire depression scale (mobile (â '4.8 (â 6.6, â 2.9)), telephone (â 3.9 (â 5.6, â 2.2)), education (â 3.0 (â 5.3, 0.8)); the Generalized Anxiety Disorder scale (mobile â 2.1 (â 3.7, â 0.5), telephone â '1.6 (â '3.0, â '0.1), education â '0.6 (â '2.5, 1.3)); the Post-Traumatic Stress Scale (mobile â '2.6 (â '6.3, 1.2), telephone â '2.2 (â '5.6, 1.2), education â '3.5 (â '8.0, 1.0)); and the Patient Health Questionnaire physical symptom scale (mobile â '5.3 (â '7.0, â '3.7), telephone â '3.7 (â '5.2, 2.2), education â '4.8 (â '6.8, 2.7)). Conclusions Among ICU patients, a mobile mindfulness app initiated after hospital discharge demonstrated evidence of feasibility, acceptability and usability and had a similar impact on psychological distress and physical symptoms as a therapist-led programme. A larger trial is warranted to formally test the efficacy of this approach. Trial registration number Results, NCT02701361.
AB - Background Patients who are sick enough to be admitted to an intensive care unit (ICU) commonly experience symptoms of psychological distress after discharge, yet few effective therapies have been applied to meet their needs. Methods Pilot randomised clinical trial with 3-month follow-up conducted at two academic medical centres. Adult (≥18 years) ICU patients treated for cardiorespiratory failure were randomised after discharge home to 1 of 3 month-long interventions: A self-directed mobile app-based mindfulness programme; a therapist-led telephone-based mindfulness programme; or a web-based critical illness education programme. Results Among 80 patients allocated to mobile mindfulness (n=31), telephone mindfulness (n=31) or education (n=18), 66 (83%) completed the study. For the primary outcomes, target benchmarks were exceeded by observed rates for all participants for feasibility (consent 74%, randomisation 91%, retention 83%), acceptability (mean Client Satisfaction Questionnaire 27.6 (SD 3.8)) and usability (mean Systems Usability Score 89.1 (SD 11.5)). For secondary outcomes, mean values (and 95% CIs) reflected clinically significant group-based changes on the Patient Health Questionnaire depression scale (mobile (â '4.8 (â 6.6, â 2.9)), telephone (â 3.9 (â 5.6, â 2.2)), education (â 3.0 (â 5.3, 0.8)); the Generalized Anxiety Disorder scale (mobile â 2.1 (â 3.7, â 0.5), telephone â '1.6 (â '3.0, â '0.1), education â '0.6 (â '2.5, 1.3)); the Post-Traumatic Stress Scale (mobile â '2.6 (â '6.3, 1.2), telephone â '2.2 (â '5.6, 1.2), education â '3.5 (â '8.0, 1.0)); and the Patient Health Questionnaire physical symptom scale (mobile â '5.3 (â '7.0, â '3.7), telephone â '3.7 (â '5.2, 2.2), education â '4.8 (â '6.8, 2.7)). Conclusions Among ICU patients, a mobile mindfulness app initiated after hospital discharge demonstrated evidence of feasibility, acceptability and usability and had a similar impact on psychological distress and physical symptoms as a therapist-led programme. A larger trial is warranted to formally test the efficacy of this approach. Trial registration number Results, NCT02701361.
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U2 - 10.1136/thoraxjnl-2017-211264
DO - 10.1136/thoraxjnl-2017-211264
M3 - Article
C2 - 29793970
AN - SCOPUS:85048078168
SN - 0040-6376
VL - 74
SP - 33
EP - 42
JO - Thorax
JF - Thorax
IS - 1
ER -