Randomized controlled trial of mindfulness-based therapy for dyspnea in chronic obstructive lung disease.
OBJECTIVE
Patients with chronic obstructive lung disease (COPD) suffer from significant dyspnea 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.


METHODS
We 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.


METHODS
The setting for this study was an academic-affiliated veterans healthcare system.


METHODS
The subjects consisted of 86 patients with COPD.


METHODS
MBBT included weekly meetings practicing mindfulness mediation and relaxation response.


METHODS
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
Participants were predominantly elderly men with moderate to severe COPD. We found no improvements in dyspnea (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 favored 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.


CONCLUSIONS
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.
The Center for Health Research , Kaiser Permanente Northwest, Portland, OR 97227, USA. Richard.A.Mularski@kpchr.org
Richard A
RA
Mularski
Brett A
BA
Munjas
Karl A
KA
Lorenz
Su
S
Sun
Sandra J
SJ
Robertson
Wendy
W
Schmelzer
Adina C
AC
Kim
Paul G
PG
Shekelle
D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D001945:Breathing Exercises; D004417:Dyspnea / Q000209:etiology / Q000628:therapy*; D005260:Female; D006801:Humans; D057194:Intention to Treat Analysis; D008297:Male; D019122:Meditation; D008875:Middle Aged; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications / Q000628:therapy*; D011788:Quality of Life; D012064:Relaxation Therapy; D012720:Severity of Illness Index; D013315:Stress, Psychological; D016138:Walking