EFFORTS to address the pressing issue of psychological distress among survivors of critical illnesses were explored in a study that optimized a mobile mindfulness intervention app. This app is designed to aid in alleviating symptoms of depression, anxiety, and PTSD in individuals recovering from severe cardiorespiratory failure. The findings were presented as a late-breaking abstract at ATS International Conference 2024 in San Diego, California, USA.
Critical illness survivors often face significant psychological distress post-discharge. Despite the prevalence of these symptoms, tailored therapeutic interventions are scarce. Healthcare professionals may recommend the use of apps that offer a self-directed mindfulness approach, making it a potentially valuable tool for these patients.
The study employed a 2x2x2 factorial design under the multiphase optimization strategy (MOST) framework. Conducted across three sites from August 2019 to July 2023, the trial involved 247 participants (mean age 50.2 years, 42.1% female) with elevated post-discharge depression symptoms. Participants were randomized into eight groups based on three intervention components: intervention introduction method (mobile app vs. therapist call), mindfulness meditation dose (standard vs. high), and management of increasing symptoms (mobile app vs. therapist call).
The primary outcome measured was depression symptoms using the Patient Health Questionnaire 9-item (PHQ-9) at one month. Secondary outcomes included anxiety, PTSD symptoms, adherence, and feasibility assessed at 1 and 3 months.
The study revealed that a high dose of mindfulness meditation significantly reduced depression symptoms, with a 1.2 unit decrease at one month and a 1.5 unit decrease at three months on the PHQ-9 scale. Interestingly, the introduction method and symptom management approach did not significantly impact outcomes, leading researchers to prefer the app-only version for its simplicity and feasibility.
Adherence to the intervention was robust, with 87.9% of participants actively using the app by the end of the study. The retention rates stood at 77% and 74% at 1 and 3 months, respectively. Overall, participants across all groups reported substantial improvements in psychological distress and quality of life.
This study’s optimized version of the app, which does not necessitate a trained therapist, showed promise as a scalable and effective intervention for critical illness survivors. However, a definitive clinical trial is needed to confirm these findings and solidify the app’s role in post-critical care therapy.
Reference:
Cox et al. Optimizing a Self-directed Mobile Mindfulness Intervention for Improving Cardiorespiratory Failure Survivors’ Psychological Distress: A Randomized Factorial Trial. B14. American Thoracic Society Annual Meeting 2024.
