Effects of a Web-based Multiple Component Mindfulness Meditation for Pulmonary Hypertension (MMPH Program on Symptoms and Health-related Quality of Life: A Pilot Randomized Controlled Trial

Patients with pulmonary hypertension (PH) experience distressing symptoms and poor quality of life (QOL), possibly leading to poor medical treatment adherence and less optimal clinical outcomes. Many integrative health approaches have shown benefits in symptom reduction for chronic conditions such as cancer and heart disease. An in‐person complementary health intervention, such as Urban Zen Integrative Therapy (UZIT), has shown therapeutic benefits in PH. Adapted from the UZIT program, the MMPH content includes mindfulness concepts, application to the PH experience, and mindful practices (breathing, movement, positioning, and meditation) designed for the virtual delivery method. This pilot randomized waitlist study aimed to explore the impact of the web‐based MMPH Program for managing pain, anxiety, fatigue, and dyspnea and improved health‐related QOL in adults with PH. Method: This report presents preliminary data from the first cohort of MMPH participants (n=9) who received the 8‐ week MMPH intervention from 8/8/22 to 9/30/22. Nine adults with PH living across the US received eight weekly 60‐minute MMPH intervention sessions that included three delivery methods: Zoom (Week 1 4), Videos, and the MMPH App daily use. The content had mindful breathing, gentle‐body‐movement, restorative pose, and body awareness practices. Participants rated Mindfulness level (CAMS‐R), symptom severity (Pulmonary Arterial Hypertension Symptom Scale ‐ PAHSS), depressive symptom (PHQ‐9), and QOL (EmPhasis‐10) at baseline, mid‐intervention, and post‐intervention. Linear mixed‐effects modeling and proportional odds regression model with a generalized estimating equation (GEE) approach with repeated measures were used to estimate the trajectory over the pre‐, mid‐, and post‐MMPH programs. Results: Participants completed all intervention components. There was a statistically significant increase in CAMS‐R scores (F(1, 15) =8.09, p = .0123), indicating an increase in Mindfulness level over time (Table 1). We did not detect statistically significant changes in depressive symptoms or QOL. However, these cumulative changes approached significance. There were statistically significant improvements in three of seventeen PH‐related symptoms: chest pain, heart palpitation, and nausea (Table 1). Web‐based MMPH program is associated with clinical improvements, as shown in mindfulness improvement and some PH‐related symptom alleviation. Our inability to detect statistically significant differences in other clinical outcomes is most likely due to the small sample size, low floor effect (PHQ‐9), and too short of a timeframe to detect (EmPHasis‐10). As preliminary data from a larger sample population of this ongoing pilot RCT, these sub‐set analytical results confirm the direction of our hypothesis testing that the MMPH program has potential use in PH management.