Can hypnosis be used to manage breathlessness and anxiety in people with severe COPD?

ISRCTN ISRCTN10029862
DOI https://doi.org/10.1186/ISRCTN10029862
Secondary identifying numbers 2019-A02016-51, NTS 19.07.16.35413.
Submission date
19/12/2019
Registration date
07/01/2020
Last edited
28/02/2023
Recruitment status
No longer recruiting
Overall study status
Completed
Condition category
Respiratory
Prospectively registered
Protocol
Statistical analysis plan
Results
Individual participant data

Plain English summary of protocol

Background and study aims
Patients with chronic obstructive pulmonary disease (COPD) are prone to asthma-like wheezing, breathlessness, chest tightness and other anxiety-inducing symptoms. Drug treatments for the condition focus on improving these symptoms and preventing exacerbations (short periods where the disease becomes much worse). However, as the disease progresses, the drugs stop working as effectively as previously. Patients with advanced COPD and those who are dying often feel less benefit from the treatment in terms of relief from their symptoms and relief from anxiety about their breathing. This lack of relief can worsen their illness over time. Hypnosis is known to induce immediate changes in how a person thinks and experiences their body. These changes can break vicious cycles of anxiety. Hypnosis has already been used successfully people with breathing problems to reduce anxiety and improve breathing. This trial aims to investigate the effect of hypnosis on breathlessness and anxiety in severe and dying COPD patients.

Who can participate?
Patients who suffer from severe COPD, already admitted at the Bligny Hospital Center (CHB)

What does the study involve?
Each participant will receive a 15-min session of hypnosis and a 15-min session of active listening in a random order. Active listening involves the therapist reading aloud and the participant will be encouraged to pay attention and visualize the images that are being described. Participants will have their anxiety level, breathing rate and blood oxygen level measured before and after each session.

What are the possible benefits and risks of participating?
The risks are minimal because hypnosis poses no real threat or adverse effects to a person's mental or physical health. As long as people accept 15 minutes of 'playing the game', it should make them relax and feel good. The same applies to active listening.

Where is the study run from?
Bligny Hospital Center (France)

When is the study starting and how long is it expected to run for?
September 2017 to January 2020

Who is funding the study?
Bligny Hospital Center (France), Fondation pour les Soins Palliatifs (France) and the Japanese Society for the Promotion of Science (JSPS)

Who is the main contact?
Dr François Larue, head of the Palliatve Care Unit at the CHB, flarue@chbligny.fr

Contact information

Dr Hernan Anllo
Scientific

Watanabe Cognitive Science Laboratory
School of Fundamental Science and Engineering
Rm 407-1B, 59th Bldg
Waseda University
3-4-1 Ohkubo
Shinjuku
Tokyo
2110063
Japan

ORCiD logoORCID ID 0000-0002-1663-1881
Phone +81 7018205004
Email subcomarc@gmail.com

Study information

Study designRandomized sham-controlled crossover study
Primary study designInterventional
Secondary study designRandomised cross over trial
Study setting(s)Hospital
Study typeQuality of life
Participant information sheet ISRCTN10029862_PIS_v2_19Jun2019.pdf
Scientific titleHypnosis for management of breathlessness and anxiety in severe and palliative-care COPD patients: a sham-controlled crossover trial
Study acronymHYPNOBPCO_1
Study objectivesHypnosis constitutes a non-drug complementary procedure capable of diminishing subjective feelings of breathlessness and anxiety, while improving patient’s awareness and subjective appreciation of their breathing mechanics. We posit that hypnosis will diminish anxiety in severe and terminal COPD patients, improving their breathing and quality of life (QoL).
Ethics approval(s)Approved 07/11/2019, Comité de Protection des Personnes Ile de France 1 (Hôtel-Dieu-1, Place du Parvis Notre-Dame, 75181, Paris, France; +33 (0)1 42 34 80 52; cpp.iledefrance1@htd.aphp.fr/cppiledefrance1@orange.fr), ref: CPPIDF1-2019-ND75
Health condition(s) or problem(s) studiedDyspnea (breathlessness) in patients with severe chronic obstructive pulmonary disease (COPD)
InterventionTreatment: Hypnosis (15-minute script, available on request)
Sham: Active listening session (15-minute script, available on request)

6-week, randomized, sham-controlled, crossover, non-drug interventional study conducted at the Bligny Hospital Center in Briis-sous-Forges, France. Patients underwent two 15-minute individual interventions, hypnosis (A) and sham (B), in randomly assigned order (AB or BA), with a 24-h washout period between sessions.

20 COPD patients (mean FEV1/FVC <0.7) underwent two 15-minute individual sessions, Active Listening and Hypnosis, in the form of a crossover trial with a 24-h washout period. A total of 4 pairs of investigators (medical practitioners specialized in pneumonology and/or palliative care, trained in hypnotherapy) are charged with administering both sessions and obtaining patient data. Session order and assignment of investigator pair (Mp1, Mp2, Mp3 or Mp4) are counterbalanced across patients, so that in a random fashion:
1. Approximately half of the sample goes through Active Listening first and Hypnosis second, and approximately the other half goes through Hypnosis first and Active Listening second.
2. Each pair of experimenters is in charge of testing at least one patient belonging to the first half, and one patient belonging to the second half.
3. No prior clinical relationship shall exist between patients and medical practitioners.
Intervention typeBehavioural
Primary outcome measureAnxiety assessed using the STAI-6 questionnaire at baseline and immediately after intervention
Secondary outcome measures1. Respiratory rate in cycles/min measured manually, following the accepted standard procedure, at baseline and immediately after intervention
2. Oxygen saturation (SpO2) measured with a pulse oximeter at baseline and immediately after intervention
Overall study start date01/09/2017
Completion date20/02/2020

Eligibility

Participant type(s)Patient
Age groupMixed
SexBoth
Target number of participants20
Total final enrolment21
Key inclusion criteria1. Aged 35-80 years
2. Affiliated to a Social Security scheme or beneficiary of such a scheme
3. Absence of neurological disease interfering with the passing of tests
4. Capable of giving free, informed consent.
5. Severe COPD with dyspnea and distension
6. Hospitalized, with or without a tracheotomy
7. Non-obese
8. Predicted FEV1 <60% and FEV/FVC <70%, with distension evidenced by chest x-ray or predicted TLC >120% in pulmonary function tests
9. Severity marked by ongoing hospitalization, with at least one prior instance of decompensation
10. Dyspneic, with resting Borg Scale score ≥3
11. Not having yet participated in the complementary care protocol offered by the hospital, a pulmonary rehabilitation program (PRP) protocol, or any hypnosis protocol
Key exclusion criteria1. Pregnancy
2. Mechanical ventilation during the session
3. Known severe cardiac insufficiency
4. Known severe pulmonary arterial hypertension
5. Cancer diagnosis
6. Significant cognitive impairment, hypercapnic encephalopathy or confusional syndrome
7. Deafness
8. Anemia (hemoglobin ≤8 g/dl)
9. Psychotic pathology
10. Anti-epileptic treatment
Date of first enrolment10/12/2019
Date of final enrolment18/02/2020

Locations

Countries of recruitment

  • France

Study participating centre

Bligny Hospital Center
Rue de Bligny
Briis-sous-Forges
Paris
91640
France

Sponsor information

Bligny Hospital Center
Hospital/treatment centre

Rue de Bligny
Briis-sous-Forges
Paris
91640
France

Phone +33 1 69 26 30 02
Email jb.meric@chbligny.fr
Website http://www.chbligny.fr/

Funders

Funder type

Hospital/treatment centre

Centre Hospitalier de Bligny

No information available

Japanese Society for the Promotion of Science (JSPS)

No information available

Fond pour les Soins Palliatifs

No information available

Results and Publications

Intention to publish date28/02/2020
Individual participant data (IPD) Intention to shareNo
IPD sharing plan summaryData sharing statement to be made available at a later date
Publication and dissemination planWe expect submission to international peer-reviewed publications as soon as the first draft is ready, with local and international press releases if publication is successful.
Additional dissemination strategies will be put in place by the Fondation pour les Soins Palliatifs (France) once the trial is finished.
IPD sharing planThe datasets generated and/or analysed during this study will be made public alongside the results publication.

Study outputs

Output type Details Date created Date added Peer reviewed? Patient-facing?
Participant information sheet version v2 19/06/2019 07/01/2020 No Yes
Results article results 01/10/2020 23/10/2020 Yes No
Protocol article 07/02/2022 28/02/2023 Yes No

Additional files

ISRCTN10029862_PIS_v2_19Jun2019.pdf
Uploaded 07/01/2020

Editorial Notes

28/02/2023: Publication reference added.
23/10/2020: The following changes have been made:
1. Publication reference added.
2. The final enrolment number has been added from the reference.
12/02/2020: The overall trial end date has been changed from 18/02/2020 to 20/02/2020.
11/02/2020: The following changes have been made:
1. The recruitment end date has been changed from 18/01/2020 to 18/02/2020.
2. The overall trial end date has been changed from 31/01/2020 to 18/02/2020.
07/01/2020: The participant information sheet has been uploaded.
23/12/2019: Trial's existence confirmed by Comité de Protection des Personnes Ile de France 1.