Effect of treatment of depression and anxiety on physiological state of severe COPD patients

Momtaz, Osama; Rabei, Salwa M.; Tawfike, Nezar R.; Hasan, Ali A.

doi:10.1016/j.ejcdt.2014.08.006

Cited by 11 publications

(5 citation statements)

References 28 publications

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“…This is consistent with the observation that patients with COPD who are treated for A/D show improvements in PROs. 34 However, despite numerical improvements in SGRQ total scores in the A/D (+) group, a significant difference with GLY was not observed when compared with placebo; this is likely due to a high placebo response observed in the A/D (+) group. This high placebo response was notably high in the SGRQ symptoms domain, where MCID of –4.57 was observed in the A/D (+) group ( Figure 3D ) not with other domains.…”

Section: Discussionmentioning

confidence: 89%

“… 33 The role of A/D in COPD progression is further supported by the observation that patients with COPD who are treated for A/D disorders show improvements in both lung function and PROs. 34 Comorbid A/D in COPD may also confound pulmonary function tests in a laboratory setting; in patients with lung disease, an association between A/D and respiratory symptoms has been reported. 35 Another possibility that may have confounded the FEV 1 outcomes among patients in the A/D (+) group is that patients with both anxiety and depression may have greater problems performing forced expiratory maneuvers properly, and these suboptimal efforts may have influenced the observed outcomes.…”

Section: Discussionmentioning

confidence: 99%

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Improvement in Lung Function and Patient-Reported Outcomes in Patients with COPD with Comorbid Anxiety and Depression Receiving Nebulized Glycopyrrolate in the GOLDEN 3 and 4 Studies

Hanania

Yohannes

Ozol-Godfrey

et al. 2021

COPD

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Background: Anxiety and depression (A/D) are common in patients with chronic obstructive pulmonary disease (COPD) and are often associated with lower adherence to treatment and worse patient-related outcomes. However, studies on the impact of comorbid A/D on responses to bronchodilators are limited. Methods: This post hoc analysis of pooled data (N=861) from the GOLDEN 3 and 4 studies compared the efficacy and safety of nebulized glycopyrrolate (GLY) 25 µg in patients with moderate-to-very-severe COPD, grouped by self-reported A/D. Changes in forced expiratory volume in 1 second (FEV 1 ) and health-related quality of life determined by St George's Respiratory Questionnaire (SGRQ) scores in patients with or without comorbid A/D (A/D [+] or A/D [-]) were examined following 12 weeks of GLY 25 µg twice-daily (BID) or placebo treatment. Results: A/D (+) patients were predominantly female, younger, included a higher proportion of current smokers, and had higher baseline SGRQ scores compared with the A/D (-) group. At 12 weeks, GLY resulted in placebo-adjusted improvements from baseline in FEV 1 of 46.9 mL (p=0.19; not significant) and 106.7 mL (p<0.0001), in the A/D (+) and A/D (-) groups, respectively. Improvements were observed with GLY compared to placebo in SGRQ scores, regardless of baseline A/D status; the placebo-adjusted least squares mean change from baseline in SGRQ total scores was -3.16 (p>0.05) and -3.34 (p<0.001), for the A/D (+) and A/D (-) groups, respectively. Despite numerical improvements in SGRQ scores with GLY in the A/D (+) group, a higher response to placebo was observed. GLY was generally well tolerated throughout 12 weeks of treatment; incidence of adverse events was higher in the A/D (+) group compared with the A/D (-) group in both treatment arms. Conclusion: GLY 25 µg BID resulted in numerical improvements in FEV 1 , SGRQ total scores and SGRQ responder rates in patients with moderate-to-very-severe COPD, regardless of A/D status at baseline; significant improvements were noted only in the A/D (+) group. The results emphasize the importance of considering underlying comorbidities including A/D when evaluating the efficacy of COPD treatments.

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Section: Discussionmentioning

confidence: 89%

Section: Discussionmentioning

confidence: 99%

Improvement in Lung Function and Patient-Reported Outcomes in Patients with COPD with Comorbid Anxiety and Depression Receiving Nebulized Glycopyrrolate in the GOLDEN 3 and 4 Studies

Hanania

Yohannes

Ozol-Godfrey

et al. 2021

COPD

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“…After the implementation of the screening, the detection of depressive symptoms certainly improved, but it is unclear how the screening affected the patients’ clinical course. Optimally, the detection and treatment of depression would improve quality of life and also reduce the pulmonary disease symptoms . Therefore, screening for depression is recommendable, but the issue to be resolved is how to organise services so that they are both accessible and acceptable from the patients’ point of view.…”

Section: Discussionmentioning

confidence: 99%

Implementation of a depression screening protocol among respiratory insufficiency patients

Kerminen

Jämsen

Jäntti

et al. 2019

Clinical Respiratory J

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Introduction Unnoticed and untreated depression is prevalent among patients with chronic respiratory insufficiency. Comorbid depression causes suffering and worsens patients’ outcomes. Objectives The objective of this evaluation was to assess preliminary outcomes of a depression screening protocol among chronic respiratory insufficiency patients at a tertiary care pulmonary outpatient clinic. Methods In the depression screening protocol, the patients filled the Depression Scale (DEPS) questionnaire. Patients whose scores suggested depression were offered the opportunity of a further evaluation of mood at a psychiatric outpatient clinic. The outcomes of the protocol were evaluated retrospectively from the patient records. Results During the period of evaluation, 238 patients visited the outpatient clinic. DEPS was administered to 176 patients (74%), of whom 60 (34%) scored ≥9 (out of 30), thus exceeding the cut‐off for referral. However, only 13 patients were referred, as the remainder declined the referral. Finally, seven patients were evaluated at the psychiatric clinic, and they all were deemed depressive. Symptoms of depression were most prevalent among patients with a long smoking history, refractory dyspnoea and a history of depression. Conclusion Depression screening was positive in a third of the patients. The depression screening protocol improved the detection of depression symptoms, but the effects on the patients’ treatment and clinical course were small. Rather than referring patients to a psychiatric unit, the evaluation and management of depression should be undertaken at the pulmonary unit.

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“…It is also possible that as PD is designed to improve psychological outcomes, patients in this group were more motivated to perform better in these tests. Interestingly, there is a known relationship between depression and reduced lung function measurements, 40 and while we were unable to find comparable studies in patients with IPF, in patients with COPD who were treated for depression there were improvements in spirometry measurements 41 …”

Section: Discussionmentioning

confidence: 67%

Pulmonary Daoyin as a traditional Chinese medicine rehabilitation programme for patients with IPF: A randomized controlled trial

Zhou

Zhang

et al. 2020

Respirology

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Background and objective IPF is a chronic progressive lung disease in which PR provides benefit for patients. PD, a TCM PR programme, has known effectiveness in COPD, but its utility in IPF is unknown. We investigated its effectiveness and safety in patients with IPF. Methods A 6‐month randomized controlled trial (RCT) was conducted in three Chinese clinics. Ninety‐six participants diagnosed with IPF were randomly assigned to one of the three groups: the PD group received a PD programme two times a day, 5 days/week for 2 months, and the exercise group exercised via a stationary cycle ergometer, 30 min/day, 5 days/week for 2 months. Volunteers in the control group were advised to maintain their usual activities. Primary outcomes were changes from baseline in the 6MWD and HRQoL score on the SGRQ‐I at 1 and 2 months (at the end of the intervention) and at 6 months (4 months after the intervention). Secondary outcomes measures included FVC, DLCO (% predicted) and the changes in mMRC. Results The 6MWD was increased in the PD group compared to exercise and control groups. 6MWD increased by 60.44 m in the PD group, 32.16 m in the exercise group and 12.42 m in controls after the 2 months of rehabilitation programme. The between‐group differences in the change from baseline were 28.78 m (95% CI: 0.54 to 56.01; P = 0.044) and 48.02 m (95% CI: 23.04 to 73.00; P < 0.001) at 2 months, and 25.61 m (95% CI: −0.67 to 51.89; P = 0.058) and 50.93 m (95% CI: 25.47 to 76.40; P < 0.001) at 6 months, respectively, including a difference exceeding the MCID. There was no significant change in the SGRQ‐I score, the mMRC dyspnoea score, FVC and DLCO (% predicted) in either the PD or exercise groups. Conclusion Two months after the intervention, a clinically meaningful difference in 6MWD was observed favouring the PD programme. The PD programme is safe and effective as a rehabilitation intervention designed to increase exercise tolerance and is an appropriate substitute for PR.

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Effect of treatment of depression and anxiety on physiological state of severe COPD patients

Cited by 11 publications

References 28 publications

Improvement in Lung Function and Patient-Reported Outcomes in Patients with COPD with Comorbid Anxiety and Depression Receiving Nebulized Glycopyrrolate in the GOLDEN 3 and 4 Studies

Improvement in Lung Function and Patient-Reported Outcomes in Patients with COPD with Comorbid Anxiety and Depression Receiving Nebulized Glycopyrrolate in the GOLDEN 3 and 4 Studies

Implementation of a depression screening protocol among respiratory insufficiency patients

Pulmonary Daoyin as a traditional Chinese medicine rehabilitation programme for patients with IPF: A randomized controlled trial

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