Effectiveness of cognitive behavioural therapy in a community-based pulmonary rehabilitation programme: A controlled clinical trial

Luk, Edwin K.; Gorelik, Alexandra; Irving, Louis; Khan, Fary

doi:10.2340/16501977-2189

Cited by 11 publications

(18 citation statements)

References 13 publications

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“…As demonstrated in previous studies (174,175), our study showed a significant improvement in GDS by the end of rehabilitation for both the Control and Intervention group; however, the Intervention group seemed to have a larger although modest reduction in mean GDS of 3.1 (almost 50% of baseline score) compared to the Control group (1.34) and although there was a trend it did not reach statistical significance (p = 0.053). Interestingly, there was an overall improvement in GDS in almost all patients that attended CBT, while the control group showed that approximately 2/3 of the patients improved (Figure 4).…”

Section: Effects Of Cbt On Depressionsupporting

confidence: 68%

“…However, this was modest in our rehabilitation program -entailing a 1-hour session in problem-solving, and a basic education session regarding the association of anxiety and depression with chronic lung disease (Appendix 1). The dampening effect of pulmonary rehabilitation may have been present in another recent similar study, which used 6 sessions of groupbased CBT given with a similar pulmonary rehabilitation program (175). Our study had an intention-to-treat analysis that may have also had a dampening effect in assessing improvement in GDS, caused by the significant withdrawal rate in the study.…”

Section: Effects Of Cbt On Depressionmentioning

confidence: 92%

“…The use of CBT has gained traction because of its effectiveness in achieving symptomatic relief for patients with chronic illnesses (100,168). In the COPD population, there have been numerous studies of varying quality and sample size that have shown promising results (37,(169)(170)(171)(172)(173)(174)(175)(176) Cost-effectiveness is undoubtedly an important issue, particularly given tightening health budgets, and increasing service imperatives to reduce health care spending. One study has shown that face-to-face CBT is effective and also may be cost-neutral when implemented in COPD patients (168).…”

Section: Relaxation Therapymentioning

confidence: 99%

“…The addition of psychological therapy could increase the benefit of pulmonary rehabilitation (174,189,239). Two studies have shown that the addition of CBT to pulmonary rehabilitation improved 6-minute walk test (6MWT) (175,240).…”

Section: Pulmonary Rehabilitationmentioning

confidence: 99%

“…reasons for the heterogeneity of results are: different methods of anxiety symptoms assessment tools(175), durations of CBT, method of delivery of therapy or if CBT was aimed at panic symptoms or generalized anxiety. There have been mixed results regarding therapy delivery and duration and improvement in anxiety and depression scores.…”

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confidence: 99%

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Cognitive behavioural therapy (CBT) for patients with chronic lung disease and psychological comorbidities undergoing pulmonary rehabilitation

Pumar¹

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Background: Anxiety and depression are psychological conditions that are highly prevalent among patients with chronic lung disease. These conditions are associated with increased morbidity and, in certain groups, increased mortality. Cognitive behaviour therapy (CBT) has shown potential as a treatment of anxiety and depression among patients with COPD, asthma and bronchiectasis. Pulmonary rehabilitation has the strongest evidence regarding its benefit in these patients, mainly through improved physical capacity and education. Consequently, the combination of both treatments (CBT and pulmonary rehabilitation) is promising, with potentially enhanced therapeutic benefits. The primary aim of this thesis was to determine the impact of cognitive behavioural therapy (CBT) as a treatment for patients with chronic lung disease and psychological comorbidities undergoing pulmonary rehabilitation. The study also assessed risk factors for the presence of anxiety and depression in patients attending pulmonary rehabilitation, the effect of CBT on quality of life and, through a subgroup analysis, the impact of mild cognitive impairment on CBT.Methods: A parallel group, randomised controlled trial (RCT) was conducted, with longitudinal follow-up of 12 months. Participants were screened from the pulmonary rehabilitation program at The Prince Charles Hospital and recruited if they had Geriatric Depression Scale (GDS) ≥4/15 or Geriatric Anxiety Inventory (GAI) ≥3/20, suggestive of depression or anxiety, respectively. In addition to pulmonary rehabilitation, the Intervention group received CBT comprised by two face-to-face sessions and 4 phone sessions, while the Control group received usual care. The main outcome measures were GDS and GAI; secondary outcomes were St. Georges Respiratory Questionnaire (SGRQ), pulmonary rehabilitation attendance and 6 minute walk test (6MWT). Results:The majority of patients attending pulmonary rehabilitation had COPD (58.5%), with the remainder having asthma (19.7%), interstitial lung disease (ILD) (9%) and bronchiectasis (12.4%). Of the patients screened, 25 (13%) had only symptoms of anxiety, 33 (17%) of only depression and 62 (32%) had symptoms of both anxiety and depression. Anxiety and depression were strongly correlated with SGRQ (p<0.01) and pulmonary rehabilitation program attendance. GDS scores were also correlated with 6MWT (p<0.01), past smoking (p<0.01), body-mass index (p<0.01), and body-mass index, airflow obstruction, dyspnea, and exercise capacity index (BODE) scores (p<0.01); while GAI was not correlated with other parameters. 65 patients were randomised to the study (24 in the Intervention group, 41 in the Control group). Of the 24 patients in the Intervention group, 10 (42%) failed to attend pulmonary rehabilitation or withdrew from the study. In the Intervention group, GDS significantly improved, compared to baseline, at the end of rehabilitation (mean difference -3.1, 95% CI -4.39 to -1.7; P<0.01), 3 months follow-up (mean difference -1.46, 95% CI -4.17 to -0.75; P<0.01) and 12 m...

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Section: Effects Of Cbt On Depressionsupporting

confidence: 68%

Section: Effects Of Cbt On Depressionmentioning

confidence: 92%

Section: Relaxation Therapymentioning

confidence: 99%

Section: Pulmonary Rehabilitationmentioning

confidence: 99%

mentioning

confidence: 99%

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Cognitive behavioural therapy (CBT) for patients with chronic lung disease and psychological comorbidities undergoing pulmonary rehabilitation

Pumar¹

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Psychological therapies for the treatment of depression in chronic obstructive pulmonary disease

Pollok

Agteren

Carson

et al. 2019

Cochrane Database of Systematic Reviews

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Background Chronic obstructive pulmonary disease (COPD) has been recognised as a global health concern, and one of the leading causes of morbidity and mortality worldwide. Projections of the World Health Organization (WHO) indicate that prevalence rates of COPD continue to increase, and by 2030, it will become the world's third leading cause of death. Depression is a major comorbidity amongst patients with COPD, with an estimate prevalence of up to 80% in severe stages of COPD. Prevalence studies show that patients who have COPD are four times as likely to develop depression compared to those without COPD. Regrettably, they rarely receive appropriate treatment for COPD-related depression. Available findings from trials indicate that untreated depression is associated with worse compliance with medical treatment, poor quality of life, increased mortality rates, increased hospital admissions and readmissions, prolonged length of hospital stay, and subsequently, increased costs to the healthcare system. Given the burden and high prevalence of untreated depression, it is important to evaluate and update existing experimental evidence using rigorous methodology, and to identify effective psychological therapies for patients with COPD-related depression. Objectives To assess the effectiveness of psychological therapies for the treatment of depression in patients with chronic obstructive pulmonary disease. Search methods We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (2018, Issue 11), and Ovid MEDLINE, Embase and PsycINFO from June 2016 to 26 November 2018. Previously these databases were searched via the Cochrane Airways and Common Mental Disorders Groups' Specialised Trials Registers (all years to June 2016). We searched ClinicalTrials.gov, the ISRCTN registry, and the World Health Organization International Clinical Trials Registry Platform (ICTRP) to 26 November 2018 to identify unpublished or ongoing trials. Additionally, the grey literature databases and the reference lists of studies initially identified for full-text screening were also searched. Psychological therapies for the treatment of depression in chronic obstructive pulmonary disease (Review)

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Anxiety, Depression, and Using Evidence-Based Techniques and Strategies to Support Engagement and Adherence

McMurray

Sisson

Schiavon

2020

Respiratory Medicine

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Effectiveness of cognitive behavioural therapy in a community-based pulmonary rehabilitation programme: A controlled clinical trial

Abstract: The addition of cognitive behavioural therapy improved patients' physical, psychological and quality of life results. Cognitive behavioural therapy should be considered for inclusion in a pulmonary rehabilitation programme to enhance outcomes.

Cited by 11 publications

References 13 publications

Cognitive behavioural therapy (CBT) for patients with chronic lung disease and psychological comorbidities undergoing pulmonary rehabilitation

Cognitive behavioural therapy (CBT) for patients with chronic lung disease and psychological comorbidities undergoing pulmonary rehabilitation

Psychological therapies for the treatment of depression in chronic obstructive pulmonary disease

Anxiety, Depression, and Using Evidence-Based Techniques and Strategies to Support Engagement and Adherence

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