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A randomised controlled feasibility trial of Group Cognitive Behavioural Therapy for people with severe asthma

Yorke, J; Adair, P; Doyle, A; Dubrow-Marshall, LJ; Fleming, S; Holmes, L; Menzies-Gow, A; Niven, R; Pilling, M; Shuldham, C

Authors

J Yorke

P Adair

A Doyle

S Fleming

L Holmes

A Menzies-Gow

R Niven

M Pilling

C Shuldham



Abstract

Objectives: Evidence for the efficacy of Cognitive Behavioural Therapy (CBT) in asthma is developing but it is not known if this translates to benefits in severe asthma or if a group approach is acceptable to this patient group.This study aimed to assess the feasibility and acceptability of Group-CBT in severe asthma. Method: This was a two-centre, randomised controlled parallel group feasibility study. Eligible participants (patients with severe asthma and a clinically significant diagnosis of anxiety and/or depression – Hospital Anxiety and Depression Scale (HAD) score greater than 8 for the anxiety or depression sub-scale) received Group-CBT in weekly sessions for eight consecutive weeks and usual care or usual care only.Follow-up was for 16weeks and endpoints were: Asthma Quality of Life Questionnaire, Asthma Control Questionnaire, HAD, Dyspnoea-12, EuroQual-5D and EuroQuol-VAS.
Results: 51 patients were randomised: 36% (51 out of 140) consent rate and attrition at week 16 was 12.Screening logs indicated that study take-up was influenced by patients living long distances from the treatment centre and inability to commit to the weekly demands of the programme. Drop-out was higher in Group-CBT compared due to inability to commit to the weekly programme because of poor health. Participants who contributed to focus group discussions reported that Group-CBT contributed to a better understanding of their illness and related approaches to anxiety management and acceptance of their asthma condition. Although weekly face-to-face sessions were challenging,this was the preferred method of delivery for these participants.
Conclusions: This feasibility study shows that Group-CBT warrants further investigation as a potentially promising treatment option for patients with severe asthma. It has been possible but not easy t orecruit and retain the sample. Options for a less demanding intervention schedule,such as less frequent face-to-face visits and the use of web-based interventions, require careful consideration.

Citation

Yorke, J., Adair, P., Doyle, A., Dubrow-Marshall, L., Fleming, S., Holmes, L., …Shuldham, C. (2017). A randomised controlled feasibility trial of Group Cognitive Behavioural Therapy for people with severe asthma. Journal of Asthma, 54(5), 543-554. https://doi.org/10.1080/02770903.2016.1229335

Journal Article Type Article
Acceptance Date Aug 22, 2016
Online Publication Date Nov 23, 2016
Publication Date Jan 1, 2017
Deposit Date Dec 12, 2016
Publicly Available Date Nov 23, 2017
Journal Journal of Asthma
Print ISSN 0277-0903
Electronic ISSN 1532-4303
Publisher Taylor and Francis
Volume 54
Issue 5
Pages 543-554
DOI https://doi.org/10.1080/02770903.2016.1229335
Publisher URL http://dx.doi.org/10.1080/02770903.2016.1229335
Related Public URLs http://www.tandfonline.com/toc/ijas20/current

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