A digital programme combining guided movement, breathing exercises and meditation, and coping skills training reduced symptoms of anxiety and depression in adults with chronic diseases, according to a new study published on 20 August in the journal PLOS Medicine by Puneeta Tandon of the University of Alberta, Canada, and colleagues. More than half of adults living with chronic physical diseases experience anxiety, depression or fatigue, which can significantly reduce quality of life.
The researchers conducted a fully remote, three-arm randomised controlled trial across 13 countries with 825 adults with self-reported chronic medical diseases, including primary biliary cholangitis, chronic digestive diseases, cirrhosis and heart failure. Participants were assigned to a waitlist control group, a self-administered digital programme (eMPower) or the same programme supplemented with weekly phone check-ins from trained non-clinical professionals. The programme included movement, breathing and meditation, coping skills and disease education.
At 12 weeks, participants who received the digital programme with phone support showed significantly greater improvement in anxiety and depression symptoms compared with the control group (2.9-point greater improvement; 95% confidence interval, 2.0–3.8). They also reported improvement in quality of life and less fatigue. In exploratory analyses, the self-administered programme alone also significantly improved symptoms compared with the control group (2.6-point greater improvement; 95% confidence interval, 1.8–3.5), and no significant difference was found between the two programme formats, although the trial was not designed or powered to compare them directly.
The study included predominantly women with higher education and only measured outcomes over 12 weeks, so long-term impact and generalisation to other populations remain uncertain. However, the authors noted that the data suggest a way forward for digital mental health interventions. "Overall, the eMPower clinical trial provides robust evidence that a comprehensive, multicomponent digital intervention reduced anxiety and depression symptoms and was associated with improvements in fatigue and quality of life across a variety of populations with chronic diseases," the authors stated.
Tandon noted that as clinicians, they are good at treating specific organ problems, but the burden of chronic disease across the whole person—the anxiety, low mood and exhaustion—is often where patients have the fewest practical options. "What was striking was that, in an exploratory analysis, we found no significant difference between the fully self-administered programme and the programme with brief weekly check-ins from a trained team member. This does not prove that the two approaches are equal, but it suggests that a programme like this could reach many more people without requiring one-to-one support for everyone," he added.
