Feasibility and acceptability of a group mindfulness intervention in a difficult asthma clinic

Objectives: Psychological dysfunction (such as anxiety) is common in people with difficult asthma and is associated with poor outcomes. Asthma guidelines increasingly emphasise the need to recognise and address co-morbidities, and it is plausible that appropriately targeted psychological interventions may be clinically and cost-effective. We hypothesised that mindfulness – facilitating adaptive responses to mental and emotional stress – would be acceptable and feasible for people with difficult asthma, and undertook a pilot uncontrolled observational study.
Methods: We offered a 4-week mindfulness intervention (four group sessions with 10-20 minutes of daily home practice) to adult patients attending difficult asthma clinics. Seventeen patients provided informed consent. Before and 3 months after the intervention, self-report questionnaires assessed asthma control, asthma-related quality of life, anxiety, depression, medication adherence and dysfunctional breathing symptoms. We conducted a focus group and follow-up telephone interviews with patients, and collected routine clinic data including lung function.
Results: Three-month follow-up patients had lower self-reported anxiety scores, but there were no significant changes in other self-report measures including asthma control and asthma quality of life – though numerical trends generally indicated improvement. Intervention adherence and study retention varied. Thematic analysis exploring qualitative data found overarching themes highlighting the acceptability of mindfulness treatments, and identified some practical challenges to attending the course.
Conclusions: Patients consenting to the mindfulness intervention found it acceptable. Self-report measures suggest potential for positive impact on their wellbeing. Patients successfully integrated mindfulness with their existing treatment, although practical barriers prevented some from attending the face-to-face group course.
Keywords: asthma, anxiety, mindfulness, feasibility, quality of life.