Real-world Evaluation of a Novel Technology-enabled Capnometry-assisted Breathing Therapy for Panic Disorder

Abstract

Introduction: Anxiety disorders which include generalized anxiety disorder, panic disorder (PD), post-traumatic stress disorder, and obsessive-compulsive disorder are common psychiatric condition associated with significant social, occupational, physical, and economic costs. Interventions that target the respiratory dysregulation associated with anxiety disorders have demonstrated considerable therapeutic benefit. However, no such intervention has been evaluated in among PD patients receiving care in an employer-sponsored health center.Objective: To evaluate the use of a novel, capnometry-assisted breathing therapy on clinical outcomes, engagement, and satisfaction for patients with PD receiving care in an employer-sponsored health center.Methods: Prospective analysis of participants using the program between 1/1/2018 and 06/30/2020.Results: Twenty-two participants enrolled. Their average weekly usage remained high throughout the 4-week treatment protocol of 17 minutes twice a day for 28 days (11.6 sessions (SD 3.1) in week one and 10.4 sessions (SD 4.0) in week four). Their average Panic Disorder Severity Scale score decreased from 13.3 (SD ± 3.6) to 5.6 (SD ± 1.8), indicating that panic severity decreased from "moderately ill" to "slightly ill." Use of the program was associated with clinically and statistically significant improvements in respiratory markers: average respiratory rate decreased from 14.9 (SD 3.6) to 11.9 (SD 4.7) breaths per minute (p<0.001) and end-tidal pCO 2 increased from 37.2 mmHg (SD 4.2) to 39.1 mmHg (SD 3.6) (p<0.001). Engagement was associated with decline in utilizations of behavioral health services at employer-sponsored primary care center clinic after the intervention. Conclusion:The clinical improvements observed in this pilot suggest that capnometry-assisted breathing therapy is a valuable tool for patients suffering from panic-associated symptoms. Background / IntroductionAnxiety disorders which include generalized anxiety disorder, PD, PTSD, and obsessive-compulsive disorder are common psychiatric conditions associated with significant social, occupational, physical, and economic costs 1,2 . Approximately 27 million US adults experience panic attacks annually with over 6.7 million suffering from PD and 8 million from PTSD 3,4 . Anxiety disorders are associated with poor workplace productivity and short and long term disabilities 5,6 accounting for approximately $45 billion in annual health care spending 7 . While these conditions are commonly treated with pharmacotherapy and/or psychotherapy, not all patients respond or achieve full recovery with these modalities 8 .

Real-world outcomes of an innovative digital therapeutic for treatment of panic disorder and PTSD: A 1,500 patient effectiveness study

“…A real-world study ( 22 ) was conducted in an employer-sponsored health clinic. CGRI was offered to patients seeking treatment for panic-related symptoms, following identification by primary care or behavioral health staff clinicians.…”