Mindfulness-Based Self-Management Program Using a Mobile App for Patients With Pulmonary Hypertension: Single-Arm Feasibility Study

TL;DR

A mobile app-based mindfulness program for pulmonary hypertension patients showed promise in improving quality of life and emotional well-being.

Contribution

Developed and tested a tailored mindfulness program for pulmonary hypertension patients using a mobile app and videoconferencing.

Findings

75% retention rate with participants valuing the online format and Apple Watch integration.

Significant improvements in quality of life and resilience were observed.

Trends toward reduced depression and anxiety were noted, though not statistically significant.

Abstract

Mindfulness-based interventions have been applied across various chronic illnesses, but no tailored program exists for individuals with pulmonary hypertension (PH).

This study aimed to develop and evaluate the feasibility of a mindfulness-based self-management program for patients with PH, delivered online to accommodate their limited mobility.

A single-arm pre-post study was conducted using an 8-session, weekly videoconference program incorporating PH self-management education and elements of mindfulness-based cognitive therapy. A mobile app linked to an Apple Watch was used to support symptom monitoring and mindfulness awareness. Outcomes included PH-related symptoms, quality of life (emPHasis-10), depression (Patient Health Questionnaire-9 [PHQ-9]), anxiety (Generalized Anxiety Disorder 7-item scale [GAD-7]), resilience (Connor-Davidson Resilience Scale [CD-RISC]), and loneliness (UCLA Loneliness Scale–short version). Assessments occurred at baseline, week 4, and program completion. Exit interviews explored perceived changes and experiences.

Twelve participants (mean age 41.8, SD 10.5 years; range 26‐56 years) were enrolled, and 9 completed the program (75% retention). Participants valued the online format and Apple Watch integration, while noting a need for optional on-demand sessions. Qualitative analysis identified themes such as increased self-awareness, use of meditation for pain management, and enhanced self-compassion. Quantitative analysis showed significant changes across 3 time points (baseline, week 4, and week 8) for emPHasis-10 (χ²₂=9.74; P=.008) and CD-RISC (χ²₂=7.27; P=.03). Trends toward change were observed for PHQ-9 (χ²₂=4.75; P=.09) and GAD-7 (χ²₂=5.07; P=.08), but week 12 data were limited (n=5). No significant changes in loneliness were observed.

The program appeared to support patients with PH in managing symptoms and emotions and suggested potential improvements in quality of life. These preliminary findings warrant evaluation in a future randomized controlled trial.

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