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Key messages
What is the key question?
Can a mind-body training programme bring about a lasting improvement in quality of life and lung function in patients with asthma?
What is the bottom line?
Compared with an educational control, a mind-body training programme was found to result in lasting improvements in patients' quality of life.
Why read on?
This is the first report of a controlled trial of a mind-body training programme that used an active control programme, followed patients for 12 months, and included clinically accepted disease outcome markers. It has significant implications for the clinical management of asthma.
Introduction
Asthma places considerable demands on patients, and interventions to facilitate adjustment to the disease may be important in asthma management even when lung function does not improve. 1 Psychosocial factors are also implicated. The elevated perceived stress prevalent in patients with asthma negatively affects their quality of life (QOL) and is strongly associated with reduced medication adherence and worse asthma control, 2 and with over-perceiving dyspnoea and respiratory symptoms unaccompanied by objective measures. 3 To limit exacerbations related to these factors, patients need to be able to discriminate between their asthma symptoms and the associated affect-related sensations and cognitions 4 ; nevertheless, self-management programmes typically focus on education about external triggers and medication usage. While cognitive behavioural therapy appears to have a positive effect on asthma QOL and relaxation therapy reduced 'as needed' medication use, the heterogeneity and low quality of studies of the complementary approaches used by 40% of patients with asthma preclude firm conclusions on their role in asthma. 5 6
Mindfulness training involves learning to recognise and discriminate between components of experience, including thoughts, feelings, and sensations, and developing a non-reactive awareness of these. Mindfulness-based stress reduction (MBSR) is a widely available group-based mindfulness training programme that reduces perceived stress, disease-related distress and reported medical symptoms in a range of chronic diseases, 7 but has not been studied for its effect on asthma QOL and management. We hypothesised that MBSR would result in greater QOL and lung function improvements compared with an education control condition.
Methods
Study sample
Participants were adult patients recruited between October 2006 and December 2007 from primary and pulmonary care clinics at UMass Memorial Health Care (UMMHC) in...