Chronic Obstructive Pulmonary Disease (COPD) Clinical Trial
Official title:
A Randomised Controlled Trial of Mindfulness-based Cognitive Therapy (MBCT) for Patients With Chronic Obstructive Pulmonary Disease (COPD)
The purpose of the study is to determine the efficacy of mindfulness-based cognitive therapy
(MBCT) as an add-on to pulmonary rehabilitation (treatment as usual, TAU) in chronic
obstructive pulmonary disease (COPD).
The investigators hypothesize that compared to treatment-as-usual, the add-on of MBCT will
result in improved psychological (anxiety, depression) and physical outcomes (physical
health status, activity level, inflammatory markers). Furthermore, the investigators will
explore the possible moderating role of individual differences in sociodemographic and
disease-related characteristics and the perceived quality of the therapeutic alliance, as
well as the mediating role of mindfulness, breathlessness catastrophizing, self-efficacy,
and self-compassion for the hypothesised effect.
Chronic obstructive pulmonary disease (COPD) is a major burden for the affected patients,
who are continuously struggling with the hallmark symptoms breathlessness, cough, and sputum
together with high levels of anxiety and depression and impairment of quality of life (QoL).
The potential value of complementary interventions in COPD has long been recognised, yet so
far, no overall significant effects of psychosocial intervention programs such as cognitive
behavioural therapy or supportive/analytical psychotherapy have been found.
Mindfulness-based interventions have been shown to improve levels of physical symptoms,
stress, anxiety, depression, and QoL in other chronic conditions, and could also be relevant
in COPD. The present randomized controlled trial will test the efficacy of mindfulness-based
cognitive therapy (MBCT) in COPD patients. The investigators hypothesize that compared to
treatment-as-usual, the add-on of MBCT will result in improved psychological (anxiety,
depression) and physical outcomes (physical health status, activity level, inflammatory
markers). Furthermore, the investigators will explore the possible moderating role of
individual differences in sociodemographic and disease-related characteristics and the
perceived quality of the therapeutic alliance, as well as the mediating role of mindfulness,
breathlessness catastrophizing, self-efficacy, and self-compassion for the hypothesised
effect.
Patients recruited from the Department of Respiratory Medicine, Aarhus University Hospital,
will be randomized to participate in either an 8-week MBCT program as an add-on to the
already established pulmonary rehabilitation program (intervention group) or pulmonary
rehabilitation only (treatment-as-usual). Questionnaires assessing outcomes, mediators and
moderators will be completed before, during, and after the intervention as well as at a 3
and 6 mo. follow-up.
This study will be one of the first to test the efficacy of MBCT in COPD, bringing attention
to a patient group that is relatively ignored by the public as well as in the health
psychological empirical literature.
After data collection, but prior to analysis, inaccuracies in the content of the
registration were discovered. Some changes made prior to recruitment of the first
participant had not been registered. The inaccuracies were amended in an update, 15 February
2017: 1) The primary outcome measure of iBODE (objective physical health status) was omitted
(no data were collected). 2) The time frame for primary outcomes was changed from "Baseline,
week 8" to "Baseline, 6 mo. follow-up". 3) Prior to data collection, three variables to be
included in moderator and mediator analyses were added (therapeutic working alliance,
mindfulness, and breathlessness catastrophizing).
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