Acceptability of Capnography Assisted Respiratory Therapy (CART): a new mind-body intervention for chronic obstructive pulmonary disease

Abstract

Dyspnea self-management is often suboptimal for patients with chronic obstructive pulmonary disease (COPD). Many patients with COPD experience chronic dyspnea as distressing and disabling, especially during physical activities. Breathing therapy is a behavioral intervention that targets reducing the distress and impact of dyspnea on exertion in daily living.

Using a qualitative design, we conducted interviews with 14 patients after they participated in a novel mind-body breathing therapy intervention adjunct, capnography-assisted respiratory therapy (CART), combined with outpatient pulmonary rehabilitation. Comprehensive CART consisted of patient-centered biofeedback, tailored breathing exercises, home exercise program, and motivational interviewing counseling. We assessed participants’ perceptions and reported experiences to gauge the acceptability of CART and refine CART based on feedback. Constant comparative analysis was used to identify commonalities and themes.

We identified three main themes relating to the acceptability and reported benefits of CART: (1) Self-regulating breathing; (2) Impact on health; and (3) Patient satisfaction. Our findings were used to refine and optimise CART (i.e., its intensity, timing, and format) for COPD. By addressing dysfunctional breathing behaviors and dysregulated interoception, CART offers a promising new paradigm for relieving dyspnea and related anxiety in patients with COPD.