Mindfulness-based stress reduction in patients with interstitial lung diseases: a pilot, single-centre observational study on safety and efficacy

Sgalla, Giacomo; Cerri, Stefania; Ferrari, Roberto; Ricchieri, Maria Pia; Poletti, Stefano; Ori, Margherita; Garuti, Martina; Montanari, Gloria; Luppi, Fabrizio; Petropulacos, Kyriakoula; Richeldi, Luca

doi:10.1136/bmjresp-2014-000065

Cited by 26 publications

(22 citation statements)

References 22 publications

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“…For example, there is evidence that perceived sense of control acts as a buffer against the effect of socioeconomic disadvantage (42). Several studies have reported success in increasing adherence by using positive affect/self-affirmation (43), mindfulness-based stress reduction (44), and financial literacy interventions to reduce financial stress (45).…”

Section: Discussionmentioning

confidence: 99%

Social Determinants of Adherence to Pulmonary Rehabilitation for Chronic Obstructive Pulmonary Disease

Oates

Hamby

Štěpáníková

et al. 2017

COPD: Journal of Chronic Obstructive Pulmonary Disease

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Adherence to pulmonary rehabilitation (PR) is low. Previous studies have focused on clinical predictors of PR completion. We aimed to identify social determinants of adherence to PR. A cross-sectional analysis of a database of COPD patients (N = 455) in an outpatient PR program was performed. Adherence, a ratio of attended-to-prescribed sessions, was coded as low (<35%), moderate (35-85%), and high (>85%). Individual-level measures included age, sex, race, BMI, smoking status, pack-years, baseline 6-minute walk distance (6MWD: <150, 150-249, ≥250), co-morbidities, depression, and prescribed PR sessions (≤20, 21-30, >30). Fifteen area-level measures aggregated to Census tracts were obtained from the U.S. Census after geocoding patients' addresses. Using exploratory factor analysis, a neighborhood socioeconomic disadvantage index was constructed, which included variables with factor loading >0.5: poverty, public assistance, households without vehicles, cost burden, unemployment, and minority population. Multivariate regression models were adjusted for clustering on Census tracts. Twenty-six percent of patients had low adherence, 23% were moderately adherent, 51% were highly adherent. In the best fitted full model, each decile increase in neighborhood socioeconomic disadvantage increased the risk of moderate vs high adherence by 14% (p < 0.01). Smoking tripled the relative risk of low adherence (p < 0.01), while each increase in 6MWD category decreased that risk by 72% (p < 0.01) and 84% (p < 0.001), respectively. These findings show that, relative to high adherence, low adherence is associated with limited functional capacity and current smoking, while moderate adherence is associated with socioeconomic disadvantage. The distinction highlights different pathways to suboptimal adherence and calls for tailored intervention approaches.

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Section: Discussionmentioning

confidence: 99%

Social Determinants of Adherence to Pulmonary Rehabilitation for Chronic Obstructive Pulmonary Disease

Oates

Hamby

Štěpáníková

et al. 2017

COPD: Journal of Chronic Obstructive Pulmonary Disease

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“…In asthmatic patients, this programs showed to improve quality of life by promoting coping strategies and reducing reactivity to dyspnoea, irrespectively to impairment of lung function [ 126 ]. Recently, a single-center pilot study suggested that Mindfulness-based programs are feasible in patients with ILD and might have a positive effect on mood [ 127 ].…”

Section: Pirfenidone and Nintedanibmentioning

confidence: 99%

Idiopathic pulmonary fibrosis: pathogenesis and management

et al. 2018

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BackgroundIdiopathic pulmonary fibrosis (IPF) is a chronic, progressive disease characterized by the aberrant accumulation of fibrotic tissue in the lungs parenchyma, associated with significant morbidity and poor prognosis. This review will present the substantial advances achieved in the understanding of IPF pathogenesis and in the therapeutic options that can be offered to patients, and will address the issues regarding diagnosis and management that are still open.Main bodyOver the last two decades much has been clarified about the pathogenic pathways underlying the development and progression of the lung scarring in IPF. Sustained alveolar epithelial micro-injury and activation has been recognised as the trigger of several biological events of disordered repair occurring in genetically susceptible ageing individuals. Despite multidisciplinary team discussion has demonstrated to increase diagnostic accuracy, patients can still remain unclassified when the current diagnostic criteria are strictly applied, requiring the identification of a Usual Interstitial Pattern either on high-resolution computed tomography scan or lung biopsy.Outstanding achievements have been made in the management of these patients, as nintedanib and pirfenidone consistently proved to reduce the rate of progression of the fibrotic process. However, many uncertainties still lie in the correct use of these drugs, ranging from the initial choice of the drug, the appropriate timing for treatment and the benefit-risk ratio of a combined treatment regimen. Several novel compounds are being developed in the perspective of a more targeted therapeutic approach; in the meantime, the supportive care of these patients and their carers should be appropriately prioritized, and greater efforts should be made toward the prompt identification and management of relevant comorbidities.ConclusionsBuilding on the advances in the understanding of IPF pathobiology, the further investigation of the role of gene variants, epigenetic alterations and other molecular biomarkers reflecting disease activity and behaviour will hopefully enable earlier and more confident diagnosis, improve disease phenotyping and support the development of novel agents for personalized treatment of IPF.

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“…Sgalla et al . () reported that because IPF symptoms are difficult to manage, effective care for psychological aspects is required.…”

Section: Discussionmentioning

confidence: 99%

End‐of‐life trajectory of coping and self‐care of patients with idiopathic pulmonary fibrosis: A meta‐synthesis using meta‐ethnography

Igai

2018

Japan Journal Nursing Sci

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Mindfulness-based stress reduction in patients with interstitial lung diseases: a pilot, single-centre observational study on safety and efficacy

Cited by 26 publications

References 22 publications

Social Determinants of Adherence to Pulmonary Rehabilitation for Chronic Obstructive Pulmonary Disease

Social Determinants of Adherence to Pulmonary Rehabilitation for Chronic Obstructive Pulmonary Disease

Idiopathic pulmonary fibrosis: pathogenesis and management

End‐of‐life trajectory of coping and self‐care of patients with idiopathic pulmonary fibrosis: A meta‐synthesis using meta‐ethnography

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