Eficácia da intervenção baseada em mindfulness online (eibm) na redução da dispneia, depressão, ansiedade e estresse de pacientes com doença pulmonar intersticial: um ensaio clínico randomizado controlado

Abstract

Background: Dyspnea and cough are frequent symptoms in patients with interstitial lung diseases (ILDs) and are responsible for reducing quality of life with consequent psychological and emotional implications. Management of these symptoms is challenging and evidence-based therapies are lacking. Objectives: To evaluate the effect of an online Mindfulness-Based Intervention (eMBI) in reducing dyspnea in patients affected by different ILDs. Methods: this study was a prospective, open-label, single-center, randomized controlled trial, that included patients diagnosed with different ILDs, over 18 years old, with dyspnea mMRC > 1. The intervention group (IG) underwent the e MBI for 8 weeks (W) via the Google Meet platform and the control group (CG) received information about a healthy lifestyle in the first week and an incentive to record a positive event in a diary for 8W. Dyspnea (mMRC), Leicester cough (QTL), quality of life for ILD (K-BILD) and anxiety/depression/stress (DASS-21) questionnaires were completed before and at the end of the 8W. Outcome variables were analyzed using Generalized Estimating Equations. Comparisons of CI95% were analyzed using Fisher's procedure of multiple least significant difference tests. All analyzes were conducted on an intention-to-treat basis. Results: 45 patients in the eIBM Group and 23 GC completed the main endpoint. The groups were similar in terms of clinical and functional characteristics. After the intervention, there was a reduction in the median of dyspnea according to the mMRC scale (p = 0.003). In the eMBI group, an improvement in the total QTL score was observed after the intervention and in the physical domain (p = 0.006, 95%CI, -0.62 to -0.11). Additionally, a significant reduction was evidenced in the domains of depression (p = 0.029, 95%CI: 0.23 to 4.22); anxiety (p = 0.025, 95%CI: 0.14 to 2.12) and stress (p = 0.026, 95%CI: 0.17 to 2.64) and improvement in quality of life (K-BILD)( (p = 0.036,95%CI, -11.40 to -0.40) in the eMBI group. No adverse events were observed. Conclusion: eMBI is a viable and safe approach in patients with ILDs. Our results suggest an effect in reducing dyspnea and the influence of cough on quality of life, reducing depression, anxiety and stress.