Brief Mindfulness Intervention vs. Health Enhancement Program for Patients Undergoing Dialysis: A Randomized Controlled Trial

Abstract

Background: Between 20–50% of patients undergoing maintenance dialysis for end-stage kidney disease experience symptoms of depression and/or anxiety, associated with increased mortality, greater health care utilization, and decreased quality of life. It is unknown whether mindfulness-based interventions can improve depression and anxiety symptoms in patients receiving this treatment. Methods: We conducted an 8-week multicenter randomized controlled trial comparing a brief mindfulness intervention (BMI) vs. an active control (Health Enhancement Program [HEP]) in 55 patients receiving dialysis with symptoms of depression and/or anxiety. The primary outcome was change in Patient Health Questionnaire-9 (PHQ-9) depression scores, with a primary analysis in participants with baseline PHQ-9 ≥ 10, and a secondary analysis including all participants. The secondary outcome was change in Generalized Anxiety Disorder-7 (GAD-7) anxiety scores with corresponding primary and secondary analyses. Results: Both BMI and HEP reduced depressive symptoms, with no difference between trial arms (PHQ-9 change = −7.0 vs. −6.1, p = 0.62). BMI was more effective than HEP in reducing anxiety (GAD-7 change = −8.7 vs. −1.4, p = 0.01). Secondary analyses revealed no differences between arms. Conclusions: For patients undergoing dialysis, both BMI and HEP may be helpful interventions for depression symptoms, and BMI may be superior to HEP for anxiety symptoms. Mindfulness-based and other psychosocial interventions may be further evaluated in those undergoing dialysis as treatment options for symptoms of depression and anxiety.

Mindfulness-Based Interventions to Reduce Burnout in Primary Healthcare Professionals: A Systematic Review and Meta-Analysis

“…Mindfulness refers to a process of paying attention, on purpose, in the present moment, and nonjudgmentally [23][24][25]. The ultimate goal of MBIs is to cultivate mindfulness within individuals and incorporate its practice into daily life through contemplation meditation exercises, yoga, and other practices [24,26].…”

Effectiveness of a brief positive skills intervention to improve psychological adjustment in patients with end-stage kidney disease newly initiated on haemodialysis: protocol for a randomised controlled trial (HED-Start)

“…Minor or subclinical depression despite being highly prevalent in general and patient populations remains unrecognised and untreated. 85 Proactive interventions 86 offered to all new patients have the potential to support adjustment by imparting broader positive skills for patients to navigate transition and adaptation to renal replacement therapy but these have not yet evaluated in the context of CKD.…”

Do Brief Mindfulness Interventions (BMI) and Health Enhancement Programs (HEP) Improve Sleep in Patients in Hemodialysis with Depression and Anxiety?

“…Participants provided written consent, and ethics approval was obtained by all sites. Further details can be found in the parent study [18].…”

“…It was structurally equivalent to the mindfulness meditation program (two 15 min sessions per week for 8-weeks, delivered via audio headsets in groups of 4-6 participants, with 3-5 min for questions or discussion), and encouraged the same amount of home practice (implementing health-enhancing habits for 10 min daily). Each session involved educational and activity-based sessions on light exercise, sleep, stress and anxiety, nutrition, journaling, and music enjoyment with drawing [18].…”