Effects of a Hybrid, Personalised Mindfulness-optimised Pulmonary Rehabilitation (Mindful-Breath) Programme for Active Living for People With Chronic Obstructive Pulmonary Disease: A Pilot Randomised Controlled Trial
Trial Snapshot
- Phase
- Not Applicable
- Status
- Recruiting
- Sponsor
- The University of Hong Kong
- Enrollment
- 60
- Locations
- 1
- Primary Endpoint
- Feasibility in terms of rates of recruitment, retention and adherence
Study Overview
Brief Summary
Individuals living with chronic obstructive pulmonary disease (COPD) often suffer from stress and behavioral risks such as physical inactivity. In an attempt to promote healthy behaviors and overall wellbeing among this particular population, this study aims to develop and evaluate a personalized Mindful-Breath intervention combining telehealth technology and mindfulness for COPD patients. This is an assessor-blinded, two-arm exploratory randomized controlled trial with a sequential mixed-method design. A total of 60 participants will be recruited and randomly assigned to either intervention or control group using 1:1 ratio. Intervention group will go through 8 weekly 60-min hybrid group sessions, combining mindfulness-based pulmonary rehabilitation and lifestyle modification. Personalized mindfulness-based lifestyle counselling through instant messages with chat-based support throughout the 8-week intervention period will also be provided. Control group will receive a single in-person 60-min group session on general education on pulmonary rehabilitation and lifestyle modification and will only receive reminder messages for follow-ups. Variables such as time spent on physical activity, lung function, perceived stress, symptom burden and health-related quality of life will be collected at three time-points (T0: baseline, prior to randomization; T1: immediate post-intervention; T2: 3-month post-intervention).
Study Design
- Study Type
- Interventional
- Allocation
- Randomized
- Intervention Model
- Parallel
- Primary Purpose
- Supportive Care
- Masking
- Double (Investigator, Outcomes Assessor)
Eligibility Criteria
- Ages
- 50 Years to 80 Years (Adult, Older Adult)
- Sex
- All
- Accepts Healthy Volunteers
- No
Inclusion Criteria
- •Age: 50-80 years
- •Sex: Male or female
- •Education level: Primary or above
- •Diagnosis: COPD (Baseline FEV1 <80% and FEV1/FVC <70% of predicted normal values)
- •Severity of COPD: Stage I to IV
- •Group of COPD: Group B, or E, based on 2024 GOLD guideline (36)
- •Clinical stability: No acute exacerbation in the past 4 weeks. Patients with recent acute exacerbation in the past 4 weeks will be screened again in subsequent follow-up.
- •Moderate stress: PSS score ≥14 (28)
- •Access to a mobile device (e.g., a smartphone, tablet, or laptop) with internet connectivity
- •Ability to read, communicate, and provide written consent in Chinese.
Exclusion Criteria
- •Engaging in >60 minutes/week of moderate PA based on American Lung Association guidelines
- •Recent or ongoing receipt of other pharmacological/behavioral trials within the past 3 months
- •Contraindications or severe comorbidities that may limit full participation (mental diseases, deafness, limb activity disorder, coronary heart disease, arterial aneurysm, uncontrolled hypertension, pregnancy, etc)
- •Co-existing respiratory diseases (Asthma/interstitial lung disease/bronchiectasis) or active malignancies
- •Very severe COPD requiring long-term oxygen therapy or home non-invasive ventilation
Arms & Interventions
Intervention: hybrid mindfulness-based pulmonary rehabilitation and lifestyle modification group
(i) Eight 60-min hybrid group sessions, combining mindfulness-based pulmonary rehabilitation and lifestyle modification. The sessions cover topics such as the eight yoga's ethical guidelines (yamas and niyamas) for positive lifestyle behaviors, breathing mechanisms, dysfunctional breathing styles, voluntary control of breathing (pranayama), relaxation and sense withdrawal (pratyahara), concentration (dharana), meditation (dhyana), and enlightenment (samadhi). Subsequent sessions will be delivered via videoconferencing using Zoom and will include guided breathing-focused practices.
(ii) Ecological Momentary Interventions (EMI):Personalised mindfulness-based lifestyle counselling through instant messages with chat-based support throughout the 8-week intervention period.
(iii) Activity Monitoring: All participants will wear a wristband activity tracker to monitor their physical activity in daily life.
Intervention: Hybrid Mindfulness-Based Group Sessions (Behavioral)
Intervention: hybrid mindfulness-based pulmonary rehabilitation and lifestyle modification group
(i) Eight 60-min hybrid group sessions, combining mindfulness-based pulmonary rehabilitation and lifestyle modification. The sessions cover topics such as the eight yoga's ethical guidelines (yamas and niyamas) for positive lifestyle behaviors, breathing mechanisms, dysfunctional breathing styles, voluntary control of breathing (pranayama), relaxation and sense withdrawal (pratyahara), concentration (dharana), meditation (dhyana), and enlightenment (samadhi). Subsequent sessions will be delivered via videoconferencing using Zoom and will include guided breathing-focused practices.
(ii) Ecological Momentary Interventions (EMI):Personalised mindfulness-based lifestyle counselling through instant messages with chat-based support throughout the 8-week intervention period.
(iii) Activity Monitoring: All participants will wear a wristband activity tracker to monitor their physical activity in daily life.
Intervention: Ecological Momentary Interventions (EMI) (Behavioral)
Intervention: hybrid mindfulness-based pulmonary rehabilitation and lifestyle modification group
(i) Eight 60-min hybrid group sessions, combining mindfulness-based pulmonary rehabilitation and lifestyle modification. The sessions cover topics such as the eight yoga's ethical guidelines (yamas and niyamas) for positive lifestyle behaviors, breathing mechanisms, dysfunctional breathing styles, voluntary control of breathing (pranayama), relaxation and sense withdrawal (pratyahara), concentration (dharana), meditation (dhyana), and enlightenment (samadhi). Subsequent sessions will be delivered via videoconferencing using Zoom and will include guided breathing-focused practices.
(ii) Ecological Momentary Interventions (EMI):Personalised mindfulness-based lifestyle counselling through instant messages with chat-based support throughout the 8-week intervention period.
(iii) Activity Monitoring: All participants will wear a wristband activity tracker to monitor their physical activity in daily life.
Intervention: Activity Monitoring (Device)
Control: Single General Education on Pulmonary Rehabilitation and Lifestyle Modification Group
(i) The control group participants will receive a single in-person 60-min group session on general education on pulmonary rehabilitation and lifestyle modification based on the GOLD 2024 teaching set and HEARTS technical package for NCD prevention as recommended by the WHO, and will only receive reminder messages for follow-ups. (ii) Activity Monitoring: All participants will wear a wristband activity tracker to monitor their physical activity in daily life.
Intervention: Single General Education on Pulmonary Rehabilitation and Lifestyle Modification Group (Behavioral)
Control: Single General Education on Pulmonary Rehabilitation and Lifestyle Modification Group
(i) The control group participants will receive a single in-person 60-min group session on general education on pulmonary rehabilitation and lifestyle modification based on the GOLD 2024 teaching set and HEARTS technical package for NCD prevention as recommended by the WHO, and will only receive reminder messages for follow-ups. (ii) Activity Monitoring: All participants will wear a wristband activity tracker to monitor their physical activity in daily life.
Intervention: Activity Monitoring (Device)
Outcomes
Primary Outcomes
Feasibility in terms of rates of recruitment, retention and adherence
Time Frame: Repeated outcome measures will be collected at three time-points (T0:baseline, prior to randomisation; T1: immediate post-intervention; T2: 3-month post-intervention)
The feasibility of interventions will be evaluated in terms of rates of recruitment, retention, and adherence. Reasons for these rates will be recorded.
Acceptability in terms of instances of adverse events
Time Frame: Repeated outcome measures will be collected at three time-points (T0:baseline, prior to randomisation; T1: immediate post-intervention; T2: 3-month post-intervention)
Instances of adverse events (information regarding physical and psychological problems will be kept)
Acceptability in terms of satisfaction with intervention
Time Frame: T1 (immediate post-intervention)
Satisfaction with intervention will be measured by a questionnaire rating on four key domains: usefulness of treatment, opinion of the therapist, perceived improvement and likelihood to recommend the treatment to others
Secondary Outcomes
- Spiritual well-being(Repeated outcome measures will be collected at three time-points (T0:baseline, prior to randomisation; T1: immediate post-intervention; T2: 3-month post-intervention).)
- Time spent on moderate-vigorous PA in the past week (min)(Repeated outcome measures will be collected at three time-points (T0:baseline, prior to randomisation; T1: immediate post-intervention; T2: 3-month post-intervention))
- Self-reported PA in the past week(Repeated outcome measures will be collected at three time-points (T0:baseline, prior to randomisation; T1: immediate post-intervention; T2: 3-month post-intervention).)
- Pulmonary function(Repeated outcome measures will be collected at three time-points (T0:baseline, prior to randomisation; T1: immediate post-intervention; T2: 3-month post-intervention).)
- Perceived stress(Repeated outcome measures will be collected at three time-points (T0:baseline, prior to randomisation; T1: immediate post-intervention; T2: 3-month post-intervention).)
- Symptom burden and HRQOL(Repeated outcome measures will be collected at three time-points (T0:baseline, prior to randomisation; T1: immediate post-intervention; T2: 3-month post-intervention).)
- Impact of COPD on daily life(Repeated outcome measures will be collected at three time-points (T0:baseline, prior to randomisation; T1: immediate post-intervention; T2: 3-month post-intervention).)
- Breathlessness(Repeated outcome measures will be collected at three time-points (T0:baseline, prior to randomisation; T1: immediate post-intervention; T2: 3-month post-intervention).)
- Cardiopulmonary functions(Repeated outcome measures will be collected at three time-points (T0:baseline, prior to randomisation; T1: immediate post-intervention; T2: 3-month post-intervention).)
- Exacerbation in the follow-up period(Repeated outcome measures will be collected at three time-points (T0:baseline, prior to randomisation; T1: immediate post-intervention; T2: 3-month post-intervention).)
Investigators
Kwok Yan Yan
Assistant Professor
The University of Hong Kong