Evidence map›Paper›PMID 38957856›Full record

ArticleCHEST critical care2024

Mobile App-Based Mindfulness Intervention for Addressing Psychological Distress Among Survivors of Hospitalization for COVID-19 Infection.

Christopher E Cox, John A Gallis, Maren K Olsen, Laura S Porter, Tina M Gremore, Theodore J Iwashyna, Ellen S Caldwell, Jeffrey M Greeson, Marc Moss, Catherine L Hough

Registry-linked trialAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in CHEST critical care, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04581200 (Addressing Psychological Distress Symptoms Among Serious Illness Survivors of a Viral Pandemic With a Completely Self-directed, Symptom-responsive Mobile Mindfulness Intervention), which is not on this map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT04581200 nacompletednot on this map

Addressing Psychological Distress Symptoms Among Serious Illness Survivors of a Viral Pandemic With a Completely Self-directed, Symptom-responsive Mobile Mindfulness Intervention: a Randomized Controlled Trial

TypeinterventionalSponsorDuke UniversityRan2021 to 2022Enrolled56ConditionsCOVID-19, Cardiorespiratory FailureArmsLift
3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Christopher E CoxDivision of Pulmonary and Critical Care Medicine (C. E. C.), the Program to Support People and Enhance Recovery (ProSPER) (C. E. C.), and the Department of Biostatistics and Bioinformatics (J. A. G. and M. K. O.), Duke University, Durham, NC; the Center of Innovation (M. K. O.), Durham Veterans Affairs Medical Center, Veterans Administration, Durham, NC; the Department of Psychology (L. S. P. and T. M. G.), Duke University, Durham, NC; the Department of Medicine (T. J. I.), Johns Hopkins University, Baltimore, MD; the Department of Medicine (E. S. C. and C. L. H.), Oregon Health & Science University, Portland, OR; the Department of Psychology (J. M. G.), Rowan University, Glassboro, NJ; and the Department of Medicine (M. M.), University of Colorado, Denver, CO.
John A GallisDivision of Pulmonary and Critical Care Medicine (C. E. C.), the Program to Support People and Enhance Recovery (ProSPER) (C. E. C.), and the Department of Biostatistics and Bioinformatics (J. A. G. and M. K. O.), Duke University, Durham, NC; the Center of Innovation (M. K. O.), Durham Veterans Affairs Medical Center, Veterans Administration, Durham, NC; the Department of Psychology (L. S. P. and T. M. G.), Duke University, Durham, NC; the Department of Medicine (T. J. I.), Johns Hopkins University, Baltimore, MD; the Department of Medicine (E. S. C. and C. L. H.), Oregon Health & Science University, Portland, OR; the Department of Psychology (J. M. G.), Rowan University, Glassboro, NJ; and the Department of Medicine (M. M.), University of Colorado, Denver, CO.
Maren K OlsenDivision of Pulmonary and Critical Care Medicine (C. E. C.), the Program to Support People and Enhance Recovery (ProSPER) (C. E. C.), and the Department of Biostatistics and Bioinformatics (J. A. G. and M. K. O.), Duke University, Durham, NC; the Center of Innovation (M. K. O.), Durham Veterans Affairs Medical Center, Veterans Administration, Durham, NC; the Department of Psychology (L. S. P. and T. M. G.), Duke University, Durham, NC; the Department of Medicine (T. J. I.), Johns Hopkins University, Baltimore, MD; the Department of Medicine (E. S. C. and C. L. H.), Oregon Health & Science University, Portland, OR; the Department of Psychology (J. M. G.), Rowan University, Glassboro, NJ; and the Department of Medicine (M. M.), University of Colorado, Denver, CO.
Laura S PorterDivision of Pulmonary and Critical Care Medicine (C. E. C.), the Program to Support People and Enhance Recovery (ProSPER) (C. E. C.), and the Department of Biostatistics and Bioinformatics (J. A. G. and M. K. O.), Duke University, Durham, NC; the Center of Innovation (M. K. O.), Durham Veterans Affairs Medical Center, Veterans Administration, Durham, NC; the Department of Psychology (L. S. P. and T. M. G.), Duke University, Durham, NC; the Department of Medicine (T. J. I.), Johns Hopkins University, Baltimore, MD; the Department of Medicine (E. S. C. and C. L. H.), Oregon Health & Science University, Portland, OR; the Department of Psychology (J. M. G.), Rowan University, Glassboro, NJ; and the Department of Medicine (M. M.), University of Colorado, Denver, CO.
Tina M GremoreDivision of Pulmonary and Critical Care Medicine (C. E. C.), the Program to Support People and Enhance Recovery (ProSPER) (C. E. C.), and the Department of Biostatistics and Bioinformatics (J. A. G. and M. K. O.), Duke University, Durham, NC; the Center of Innovation (M. K. O.), Durham Veterans Affairs Medical Center, Veterans Administration, Durham, NC; the Department of Psychology (L. S. P. and T. M. G.), Duke University, Durham, NC; the Department of Medicine (T. J. I.), Johns Hopkins University, Baltimore, MD; the Department of Medicine (E. S. C. and C. L. H.), Oregon Health & Science University, Portland, OR; the Department of Psychology (J. M. G.), Rowan University, Glassboro, NJ; and the Department of Medicine (M. M.), University of Colorado, Denver, CO.
Theodore J IwashynaDivision of Pulmonary and Critical Care Medicine (C. E. C.), the Program to Support People and Enhance Recovery (ProSPER) (C. E. C.), and the Department of Biostatistics and Bioinformatics (J. A. G. and M. K. O.), Duke University, Durham, NC; the Center of Innovation (M. K. O.), Durham Veterans Affairs Medical Center, Veterans Administration, Durham, NC; the Department of Psychology (L. S. P. and T. M. G.), Duke University, Durham, NC; the Department of Medicine (T. J. I.), Johns Hopkins University, Baltimore, MD; the Department of Medicine (E. S. C. and C. L. H.), Oregon Health & Science University, Portland, OR; the Department of Psychology (J. M. G.), Rowan University, Glassboro, NJ; and the Department of Medicine (M. M.), University of Colorado, Denver, CO.
Ellen S CaldwellDivision of Pulmonary and Critical Care Medicine (C. E. C.), the Program to Support People and Enhance Recovery (ProSPER) (C. E. C.), and the Department of Biostatistics and Bioinformatics (J. A. G. and M. K. O.), Duke University, Durham, NC; the Center of Innovation (M. K. O.), Durham Veterans Affairs Medical Center, Veterans Administration, Durham, NC; the Department of Psychology (L. S. P. and T. M. G.), Duke University, Durham, NC; the Department of Medicine (T. J. I.), Johns Hopkins University, Baltimore, MD; the Department of Medicine (E. S. C. and C. L. H.), Oregon Health & Science University, Portland, OR; the Department of Psychology (J. M. G.), Rowan University, Glassboro, NJ; and the Department of Medicine (M. M.), University of Colorado, Denver, CO.
Jeffrey M GreesonDivision of Pulmonary and Critical Care Medicine (C. E. C.), the Program to Support People and Enhance Recovery (ProSPER) (C. E. C.), and the Department of Biostatistics and Bioinformatics (J. A. G. and M. K. O.), Duke University, Durham, NC; the Center of Innovation (M. K. O.), Durham Veterans Affairs Medical Center, Veterans Administration, Durham, NC; the Department of Psychology (L. S. P. and T. M. G.), Duke University, Durham, NC; the Department of Medicine (T. J. I.), Johns Hopkins University, Baltimore, MD; the Department of Medicine (E. S. C. and C. L. H.), Oregon Health & Science University, Portland, OR; the Department of Psychology (J. M. G.), Rowan University, Glassboro, NJ; and the Department of Medicine (M. M.), University of Colorado, Denver, CO.
Marc MossDivision of Pulmonary and Critical Care Medicine (C. E. C.), the Program to Support People and Enhance Recovery (ProSPER) (C. E. C.), and the Department of Biostatistics and Bioinformatics (J. A. G. and M. K. O.), Duke University, Durham, NC; the Center of Innovation (M. K. O.), Durham Veterans Affairs Medical Center, Veterans Administration, Durham, NC; the Department of Psychology (L. S. P. and T. M. G.), Duke University, Durham, NC; the Department of Medicine (T. J. I.), Johns Hopkins University, Baltimore, MD; the Department of Medicine (E. S. C. and C. L. H.), Oregon Health & Science University, Portland, OR; the Department of Psychology (J. M. G.), Rowan University, Glassboro, NJ; and the Department of Medicine (M. M.), University of Colorado, Denver, CO.
Catherine L HoughDivision of Pulmonary and Critical Care Medicine (C. E. C.), the Program to Support People and Enhance Recovery (ProSPER) (C. E. C.), and the Department of Biostatistics and Bioinformatics (J. A. G. and M. K. O.), Duke University, Durham, NC; the Center of Innovation (M. K. O.), Durham Veterans Affairs Medical Center, Veterans Administration, Durham, NC; the Department of Psychology (L. S. P. and T. M. G.), Duke University, Durham, NC; the Department of Medicine (T. J. I.), Johns Hopkins University, Baltimore, MD; the Department of Medicine (E. S. C. and C. L. H.), Oregon Health & Science University, Portland, OR; the Department of Psychology (J. M. G.), Rowan University, Glassboro, NJ; and the Department of Medicine (M. M.), University of Colorado, Denver, CO.

Funding

CCC for NHLBI Prevention and Early Treatment of Acute Lung Injury PETAL NetworkU01HL123009 · NHLBI · MASSACHUSETTS GENERAL HOSPITAL · PI FOULKES, ANDREA S, THOMPSON, BOYD TAYLOR · 2014 to 2021
$67.2M
Optimizing a self-directed mobile mindfulness intervention for improvingU01AT009974 · NCCIH · DUKE UNIVERSITY · PI COX, CHRISTOPHER ETHAN, HOUGH, CATHERINE LEE · 2018 to 2020
$3.0M
Optimizing a self-directed mobile mindfulness intervention for improvingR01AT009974 · NCCIH · DUKE UNIVERSITY · PI COX, CHRISTOPHER ETHAN, HOUGH, CATHERINE LEE · 2021 to 2022
$1.4M
NCCIH NIH HHS R01 AT009974NCCIH NIH HHS U01 AT009974NHLBI NIH HHS U01 HL123009
6 · The paper itself

Abstract

backgroundPsychological distress symptoms are present and persistent among many patients who survive a critical illness like COVID-19. RESEARCH QUESTION: Could a self-directed mobile app-delivered mindfulness intervention be feasibly and rapidly implemented within a clinical trials network to reduce distress symptoms? STUDY DESIGN AND

methodsA randomized clinical trial was conducted between January 2021 and May 2022 at 29 US sites and included survivors of hospitalization due to COVID-19-related illness with elevated symptoms of depression at discharge. Participants were randomized to intervention or usual care control. The intervention consisted of four themed weeks of daily audio, video, and text content. All study procedures were virtual. The primary outcome was depression symptoms assessed with the Patient Health Questionnaire 9 at 3 months. Secondary outcomes included anxiety (Generalized Anxiety Disorder 7-item scale), quality of life (EQ-5D), and adherence. We used general linear models to estimate treatment arm differences in outcomes over time.

resultsAmong 56 randomized participants (mean age ± SD, 51.0 ± 13.2 years; 38 female [67.9%]; 14 Black participants [25%]), 45 (intervention: n = 23 [79%]; control: n = 22 [81%]) were retained at 6 months. There was no difference in mean improvement between intervention and control participants at 3 months in Patient Health Questionnaire 9 (-0.5 vs 0.1), Generalized Anxiety Disorder 7-item scale (-0.3 vs 0.1), or EQ-5D (-0.03 vs 0.02) scores, respectively; 6-month results were similar. Only 15 participants (51.7%) initiated the intervention, whereas the mean number ± SD of the 56 prescribed intervention activities completed was 12.0 ± 15.2. Regulatory approvals delayed trial initiation by nearly a year.

interpretationAmong survivors of COVID-19 hospitalization with elevated psychological distress symptoms, a self-directed mobile app-based mindfulness intervention had poor adherence. Future psychological distress interventions mobilized at broad scale should focus efforts on patient engagement and regulatory simplification to enhance success.

trial registrationClinicalTrials.gov; No.: NCT04581200; URL: www.clinicaltrials.gov.

Indexed as

COVID-19critical illnessmobile apppost-intensive care unit syndromepsychological distress

Identifiers

PMID38957856
PMCPMC11218743

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.