Royal College of Surgeons in Ireland
Chronic Urticaria paper May 2021 Ridge Conlon Hennessey and Dunne.pdf (602.02 kB)

Feasibility assessment of an 8-week attention-based training programme in the management of chronic spontaneous urticaria

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posted on 2021-05-21, 16:04 authored by Katie Ridge, Niall Conlon, Martina Hennessy, Padraic DunnePadraic Dunne

Background: Chronic spontaneous urticaria is a common disorder that is poorly understood and frequently misdiagnosed. Psychological difficulties are a significant factor in dermatological diseases and may also aggravate symptom burden. Mind-body interventions are used as a complementary approach to alleviate symptoms in chronic diseases and may represent a valuable non-pharmacological approach in CSU.

Methods: We sought to develop and evaluate the feasibility of an 8-week attention-based training (ABT) programme, coupled to biofeedback technology for CSU. Through convergent interviews, we gathered information from individuals with urticaria about possible links between stress, mood and skin symptoms. Using these data, we recruited 12 participants to engage in an amended ABT programme for patients with CSU, comprising eight 90-min sessions held weekly. Participants completed psychometric measures and measures of urticaria symptomatology as assessed by the urticaria control test, prior to and after the intervention. Adherence to ABT practice was measured using individual inner balance devices which tracked heart rate variability. We completed qualitative interviews after the intervention to obtain feedback on participant experience of the programme.

Results: Participants with CSU described how their psychological wellbeing can be linked to skin symptoms, poor sleep and difficulty concentrating. An amended ABT programme was found to be an acceptable component of care in the management of CSU. Retention of participants in the programme was challenging with 33% participants dropping out of the programme. For those who did complete the programme, three participants exceeded weekly practice at week 8. A decrease in severity of urticaria symptomatology as measured by the urticaria control test was observed upon completion of the intervention. The most commonly cited barrier to implementation of the programme was the time commitment required.

Conclusions: Integrating an ABT programme into routine clinical care for CSU patients is feasible and was deemed acceptable and valuable by individuals who took part. Further formal evaluation of ABT for CSU including the analysis of biochemical parameters is required to determine its role in the management of this distressing condition.

Trial registration: This trial is registered with ISRCTN with study ID ISRCTN13672947 . Registration took place on 22/09/2020 (retrospectively registered).



The original article is available at

Published Citation

Ridge K, Conlon N, Hennessy M, Dunne PJ. Feasibility assessment of an 8-week attention-based training programme in the management of chronic spontaneous urticaria. Pilot Feasibility Stud. 2021;7(1):103.

Publication Date

3 May 2021

PubMed ID



  • Centre for Positive Psychology and Health

Research Area

  • Neurological and Psychiatric Disorders
  • Population Health and Health Services
  • Health Professions Education
  • Immunity, Infection and Inflammation


BioMed Central


  • Published Version (Version of Record)

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