Long-term effects of a brief mindfulness intervention versus a health enhancement program for treating depression and anxiety in patients undergoing hemodialysis: a randomized controlled trial

Christina Rigas *, Haley Park, Marouane Nassim, Chien-Lin Su, Kyle Greenway, Mark Lipman, Clare McVeigh, Marta Novak, Emilie Trinh, Ahsan Alam, Rita Suri, Istvan Mucsi, Susana Torres-Platas, Helen Noble, Harmehr Sekhon, Soham Rej, Michael Lifshitz

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

2 Citations (Scopus)
61 Downloads (Pure)

Abstract

Background: Depression and anxiety affect approximately 50% of patients with kidney failure receiving hemodialysis and are
associated with decreased quality of life and increased risk of hospitalization and mortality. A Brief Mindfulness Intervention
(BMI) may be promising in treating depressive and anxiety symptoms in this population, but the long-term sustainability of
the intervention’s effects is unknown.
Objective: We previously conducted a randomized controlled trial (RCT; n = 55) comparing an 8-week BMI with an active
control (Health Enhancement Program [HEP]) for patients receiving dialysis, with depression and/or anxiety. Here, we
examine the 6-month follow-up data to determine the long-term sustainability of BMI versus HEP in reducing (1) depressive
symptoms, (2) anxiety symptoms, and (3) the efficacy of BMI versus HEP in reducing the likelihood of hospitalization.
Design: In this study, we analyzed 6-month follow-up data from an 8-week assessor-blinded parallel RCT, which evaluated
the efficacy of a BMI against an active control, HEP, in patients receiving hemodialysis with symptoms of depression and/or
anxiety.
Setting: The study took place at hemodialysis centers in 4 tertiary-care hospitals in Montreal, Canada.
Participants: Participants included adults aged ≥18 years who were receiving in-center hemodialysis 3 times per week and
had symptoms of depression and/or anxiety as indicated by a score ≥6 on the Patient Health Questionnaire–9 (PHQ-9) and/
or the General Anxiety Disorder–7 (GAD-7).
Methods: Participants were randomized to the treatment arm (BMI) or the active control arm (HEP) and completed
assessments at baseline, 8 weeks, and 6-month follow-up. Depression was assessed using the PHQ-9, and anxiety was
assessed by the GAD-7. Hospitalization rates were assessed using medical chart information.
Results: We observed significant decrease in depression scores over 6 months in both BMI and HEP groups, with no
significant difference between groups. Anxiety scores significantly decreased over 6 months, but only in the BMI group. Brief
Mindfulness Intervention and Health Enhancement Program were comparable in terms of hospitalization rates.
Limitations: The limitations of our study include the modest sample size and lack of a third arm such as a waitlist control.
Conclusions: Our results suggest that the beneficial effects of BMI and HEP for improving mood disorder symptoms in
patients receiving dialysis persist at 6-month follow-up. Both interventions showed sustained effects for depressive symptoms,
but BMI may be more useful in this population given its efficacy in reducing anxiety symptoms as well.
Original languageEnglish
JournalCanadian Journal of Kidney Health and Disease
Volume9
DOIs
Publication statusPublished - 04 Mar 2022

Fingerprint

Dive into the research topics of 'Long-term effects of a brief mindfulness intervention versus a health enhancement program for treating depression and anxiety in patients undergoing hemodialysis: a randomized controlled trial'. Together they form a unique fingerprint.

Cite this