Pathways study

Pulmonary Arterial Hypertension: Working on Anxiety and Stress (PATHWAYS)   

A study looking at a stress reduction programme in patients with Pulmonary Arterial Hypertension.

The PATHWAYS project is funded by the National Institute for Health Research (NIHR) under its Research for Patient Benefit (RfPB) Programme.

What is the purpose of the study?

This study is looking at whether patients with Pulmonary Arterial Hypertension (PAH) might benefit from taking part in a stress reduction course. 

Who can take part?

Participants need to be over the age of 16, have a diagnosis of PAH and live in the South West of England. There will be a total of 42 adults with PAH taking part in the study. We will be sending out information to patients, which will be discussed at clinic appointments at the Bristol Heart Institute with Dr Robert Tulloh (consultant cardiologist). 

What will participation involve?

Participants will be asked to fill in some questionnaires about quality of life and how PAH makes them feel. We will also take standard physical measures in the clinic. We also want to see if there is any change in the stress hormone, cortisol, so it is optional to take saliva samples at home. Collecting saliva is very easy and very safe and does not take more than a few minutes. These measures will be taken at baseline, and at three follow-up time points. 

Patients will be randomly allocated to continue treatment as usual or to attend a mindfulness-based stress reduction (MBSR) programme for two hours a week for eight weeks at a local venue. There is a 50/50 chance of being randomised to the MBSR programme.   

What is a mindfulness-based stress reduction (MBSR) programme?

The programme being offered has been specifically developed for patients with PAH. The intervention will involve learning about stress and anxiety, the effect that they can have on the body, and some techniques to manage them. It is based on something called mindfulness, which uses a variety of ways to help participants become more aware of their thoughts, emotions, and body sensations at the moment, and to identify the choices that are available. The programme will also help participants to learn about stress and the effect that it can have on their body so that they can identify times when they are feeling stressed before it overwhelms them. Although eight weeks may seem like a long time to run a course, the skills that it teaches should stay with participants and help them for the rest of their life. For the programme, participants will be in a small group of about eight people and the group will be led by qualified clinical psychologist, Dr Vanessa Garratt.