Anxiety and depression symptoms after pulmonary rehabilitation in people with interstitial lung disease: responders and non-responders

Abstract

Pulmonary rehabilitation (PR) is an effective intervention for people with interstitial lung disease (ILD), as it improves exercise capacity, quality of life and dyspnoea. Less is, however, known about other important and frequent symptoms, such as anxiety and depression. This study explored the response of anxiety and depression symptoms to PR in people with ILD.Participants undertook a 12-week community-based PR programme. Anxiety and depression symptoms were evaluated before and after PR with the hospital anxiety and depression scale (HADS). The sample was stratified into 2 groups according to the HADS score: ≥8 probable anxiety (PA) or depression (PD) and score <8 normal symptoms (NS). Responders were classified using the HADS minimal clinical important difference (≥1.5 points).46 people with ILD (62±13 years; 63%♀; 75±20 FVC% ; 56±18 DLCO% ) participated. Number of responders in anxiety symptoms (73% PA; HADS-A pre: 12±3; mean change: 4±2; p<0.001 vs 25% NS; HADS-A pre: 6±2; mean change: 2±0; p<0.001) was much higher than in depression symptoms (27% PD; HADS-D pre: 11±3; mean change: 3±1; p=0.014 vs 13% NS; HADS-D pre: 5±2; mean change: 2±1; p=0.003).PR seems to improve anxiety symptoms, but it might not be as effective for depression symptoms in people with ILD.Future studies are needed to investigate the role of PR in the psychological health of people with ILD.

ERS International Congress 2022: highlights from the Interstitial Lung Diseases Assembly

“…A few studies evaluated different aspects of pulmonary rehabilitation (PR). Two studies, one in IPF (n=235) and one in a broader group of ILDs (n=46), assessed the impact of pulmonary rehabilitation on anxiety and depression [ 13 , 14 ]. PR significantly reduced anxiety and depression scores in patients with high scores at baseline.…”

“…PR significantly reduced anxiety and depression scores in patients with high scores at baseline. S amuel S antos et al [ 14 ] reported a more pronounced beneficial effect of PR on anxiety than on depressive symptoms. A small pilot RCT (n=40) investigated the effects of a physical activity telecoaching programme in patients with ILD.…”

ERS International Congress 2022: highlights from the Allied Respiratory Professionals Assembly

“…The four clusters that were found according to the achievement of 70% of predicted in these measures were 1) non-achievers, 2) partial achievers, 3) achievers and 4) overachievers. These clusters may guide tailored interventions to improve patients’ functional status [ 31 ]. Finally, Q uadflieg et al [ 32 ] explored the applicability of the 1-minSTS to predict post-operative complications in lung cancer and showed that a cut-off of 22 repetitions and 59% predicted in the 1-minSTS could discriminate between patients with and without post-operative complications.…”