8-Week Pilot Study Finds that the Fully Remote Lief Program Significantly Reduced Symptoms of Anxiety and Depression

Lief Team
July 13, 2021 • 1 min read
pilot study

The results of the pilot study have been published in the peer reviewed journal, Applied Psychophysiology and Biofeedback. A brief summary of the study is included below.


The pilot study assessed the feasibility of using a consumer friendly, heart rate variability (HRV) biofeedback wearable device, the Lief Smart Patch, in conjunction with a remote stress management coach to reduce symptoms of anxiety and depression, as well as improve HRV following participation in a 3-minute guided breathing exercise.

Study Design

The study utilized a discreet, continuously wearable electrocardiogram device, the Lief Smart Patch, which measures and records heart rate and HRV in real time, and guides HRV biofeedback exercises using vibrations and visual cues.

During the 8-week study, participants wore the Lief Smart Patch, participated in HRV biofeedback with the device, utilized the mobile app, and communicated with a remote stress management coach.

The study collected self-report survey responses to measure symptoms of anxiety (GAD-2) and depression (PHQ-2) every 2 weeks, as well as HRV data throughout the study.


Participants’ mean GAD-2 score began at 4.6 out of 6. By the trial’s completion, the group’s mean GAD-2 score dropped to 1.7 (t(13) = 11.0, p < .001) with only 14% of subjects remaining over the clinical threshold of high anxiety.

pilot study
Mean GAD-2 scores across 6 time points

Similarly, the group’s mean PHQ-2 score dropped from 2.93 to 1.29 (t(13) = 3.54, p < .01). Finally, participants increased their HRV (RMSSD) by an average of +11.4 ms after participating in a 3-minute biofeedback exercise.


These findings suggest that engaging in HRV biofeedback with the Lief Smart Patch in conjunction with a remote stress management program can effectively help reduce symptoms of anxiety and depression outside a clinical setting.

Remotely delivered HRV biofeedback paired with specialty mental health services has enormous potential, and may be particularly appealing for those interested in non-pharmacological mental health treatment options.

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