Improving the wellbeing of caregivers of patients with COPD using a home-based pulmonary rehabilitation programme

Abstract

ObjectivesTo evaluate the effects of a home-based pulmonary rehabilitation (PR) programme on anxiety and depressive symptoms, general fatigue and burden in informal caregivers of patients with COPD. We also evaluated the baseline characteristics of both patients and caregivers that contributed to the change in caregiver's outcomes after PR.MethodsIn this retrospective study, patients with COPD were referred to an 8-week home-based PR programme consisting of a weekly supervised 90-minute session. Informal caregivers, according to the patient's preference and its availability, were invited to participate in PR. Caregivers received educational supports, behavioral therapies and self-management strategies using the same methods as for patients. Burden, anxiety and depressive symptoms and general fatigue of caregivers were assessed at baseline and at the end of PR.Results241 patients with COPD and 138 (57.3%) caregivers were included. The majority of the caregivers were women (70.5%), spouses (90.3%) and with at least three comorbidities (57.3%). A large proportion of caregivers showed baseline high burden, anxiety symptoms, and abnormal fatigue (40%, 40%, 45%, respectively). Burden, anxiety and depressive symptoms and general fatigue of informal caregivers were all improved after PR (p<0.05). Long-term oxygen therapy and/or non-invasive ventilation, coronaropathy and/or peripheral arterial disease and a higher baseline mMRC score in patients with COPD were associated with a decrease in caregiver's burden after PR.ConclusionA large proportion of caregivers of patients with COPD showed anxiety symptoms, fatigue and a high burden. These outcomes were improved by integrating the caregiver into a home-based PR programme.

ERS International Congress 2022: highlights from the Respiratory Clinical Care and Physiology Assembly

“…The intervention resulted in a significant improvement of all these descriptors. This study highlights the burden in caregivers and family members of patients with chronic respiratory diseases, and the importance of integrating caregivers into PR [23].…”

Integrating palliative care education in pulmonary rehabilitation: a randomized controlled study protocol

“…In daily clinical practice, this impact of the caring role is undervalued and not addressed by healthcare professionals. In fact, there is limited literature on interventions that include family and/or friend caregivers of people with COPD or ILD [ 9 , 13 – 17 ].…”

“…Recognizing family and/or friend caregivers as a cornerstone of the unit of care has been consistently advocated by palliative care in different chronic progressive diseases [ 7 , 21 ] and is clearly stated in the most recent recommendations for serious respiratory illness [ 18 , 22 ]. Less explored has been the role of PR to support family and/or friend caregivers [ 9 , 13 , 15 – 17 ]. To date, only one randomized controlled trial has been performed in this area [ 17 ].…”

Barriers to adherence to home-based pulmonary rehabilitation among patients with chronic obstructive pulmonary disease in Iran: a descriptive qualitative study

“…HBPR is an advanced strategy to reduce disease complications and improve independence and quality of life. It is particularly effective when patients have severe physical dysfunction, poor psychosocial status and limited access to healthcare services 16. A study showed that HBPR can reduce disease management costs, disease exacerbations, and need for hospital care, and improve quality of life 17.…”

“…It is particularly effective when patients have severe physical dysfunction, poor psychosocial status and limited access to healthcare services. 16 A study showed that HBPR can reduce disease management costs, disease exacerbations, and need for hospital care, and improve quality of life. 17 Another study reported that HBPR reduced disease exacerbations and improved patient satisfaction, physical activity and quality of life.…”