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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: a pilot randomised clinical trial.

Publication ,  Journal Article
Cox, CE; Hough, CL; Jones, DM; Ungar, A; Reagan, W; Key, MD; Gremore, T; Olsen, MK; Sanders, L; Greeson, JM; Porter, LS
Published in: Thorax
January 2019

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 (-4.8 (-6.6, -2.9)), telephone (-3.9 (-5.6, -2.2)), education (-3.0 (-5.3, 0.8)); the Generalized Anxiety Disorder scale (mobile -2.1 (-3.7, -0.5), telephone -1.6 (-3.0, -0.1), education -0.6 (-2.5, 1.3)); the Post-Traumatic Stress Scale (mobile -2.6 (-6.3, 1.2), telephone -2.2 (-5.6, 1.2), education -3.5 (-8.0, 1.0)); and the Patient Health Questionnaire physical symptom scale (mobile -5.3 (-7.0, -3.7), telephone -3.7 (-5.2, 2.2), education -4.8 (-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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Published In

Thorax

DOI

EISSN

1468-3296

Publication Date

January 2019

Volume

74

Issue

1

Start / End Page

33 / 42

Location

England

Related Subject Headings

  • Telephone
  • Survivors
  • Stress Disorders, Post-Traumatic
  • Respiratory System
  • Respiratory Insufficiency
  • Psychiatric Status Rating Scales
  • Pilot Projects
  • Patient Satisfaction
  • Patient Education as Topic
  • Patient Acceptance of Health Care
 

Citation

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Cox, C. E., Hough, C. L., Jones, D. M., Ungar, A., Reagan, W., Key, M. D., … Porter, L. S. (2019). 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: a pilot randomised clinical trial. Thorax, 74(1), 33–42. https://doi.org/10.1136/thoraxjnl-2017-211264
Cox, Christopher E., Catherine L. Hough, Derek M. Jones, Anna Ungar, Wen Reagan, Mary D. Key, Tina Gremore, et al. “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: a pilot randomised clinical trial.Thorax 74, no. 1 (January 2019): 33–42. https://doi.org/10.1136/thoraxjnl-2017-211264.
Cox CE, Hough CL, Jones DM, Ungar A, Reagan W, Key MD, Gremore T, Olsen MK, Sanders L, Greeson JM, Porter LS. 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: a pilot randomised clinical trial. Thorax. 2019 Jan;74(1):33–42.

Published In

Thorax

DOI

EISSN

1468-3296

Publication Date

January 2019

Volume

74

Issue

1

Start / End Page

33 / 42

Location

England

Related Subject Headings

  • Telephone
  • Survivors
  • Stress Disorders, Post-Traumatic
  • Respiratory System
  • Respiratory Insufficiency
  • Psychiatric Status Rating Scales
  • Pilot Projects
  • Patient Satisfaction
  • Patient Education as Topic
  • Patient Acceptance of Health Care