None listed
Conditions
Brief summary
Chronic obstructive pulmonary disease (COPD) is an irreversible lung disease characterised by airflow obstruction. Symptoms of COPD include breathlessness, a chronic cough and sputum production. COPD is complicated by the number of other diseases experienced by patients, particularly anxiety disorders and depression. Psychological distress is experienced by a large number of people with COPD, with international evidence estimating 37% of COPD patients suffer from anxiety and 40% from depression. Furthermore, COPD patients with anxiety disorders have a poorer quality of life, higher death rates, more hospitalisations and emergency visits, and are a greater economic burden. An effective approach to reduce anxiety disorders is cognitive behavioural therapy (CBT). There are currently no data in Australia on the effect of CBT for COPD patients for anxiety disorders and depression. Furthermore, with the recent advances in technology, there is potential for electronic communication to become a complementary self-management tool with CBT or as a stand-alone resource which can provide COPD patients with coping skills for anxiety and depression. Therefore, a randomised control trial will be conducted to determine the efficacy of CBT and/or simulation-based learning resources on COPD patients on anxiety disorders, depression, health outcomes and healthcare costs. The aims of the project are: Aim 1: To determine the impact on healthcare utilisation of treating anxiety disorders in COPD patients. It is expected that treating anxiety disorders amongst COPD patients will reduce WA hospital bed days and emergency department visits in COPD patients. Aim 2: To demonstrate the use of CBT and/or a simulation-based learning resource improves health outcomes amongst COPD patients It is expected that individually CBT and simulation-based learning resources will reduce anxiety disorders and depression among COPD patients. However, compared to CBT or simulation-based learning resources, combining both methods will reduce anxiety disorders to a greater extent amongst COPD patients.
Interventions
1) Group cognitive behavioural therapy (CBT)
CBT was conducted by a clinical psychologist in groups of 3–7 people. CBT involves a structured program that recognises the way people think affects the way they feel. It teaches people to think rationally about common difficulties, helping to change their thought patterns and the way they react to certain situations. CBT can be as effective as medication to treat depression and anxiety. Our CBT program consisted of two half-day sessions (totalling 9
1) Group cognitive behavioural therapy (CBT) CBT was conducted by a clinical psychologist in groups of 3–7 people. CBT involves a structured program that recognises the way people think affects the way they feel. It teaches people to think rationally about common difficulties, helping to change their thought patterns and the way they react to certain situations. CBT can be as effective as medication to treat depression and anxiety. Our CBT program consisted of two half-day sessions (totalling 9 hours) a fortnight apart and a one-hour telephone booster session four weeks later. The sessions were semi-structured in nature and included both CBT global concepts and those that were specific to people with COPD. A manual was provided to participants for referral to CBT concepts. The topics covered during the sessions and provided in the manual included: 1. Background information - how to recognise anxiety and panic attacks, depression and the link between mental health and COPD. 2. Automatic thoughts 3. Cognitive distortions 4. Relaxation 5. Reclaiming your confidence (catastrophising and self-talk) 6. The influence activities have on your mood (e.g. increase the 'beautifuls') 7. Assertiveness training. 2) ‘Breathing New Life’ self-management cognitive behavioural therapy resource (DVD) The ‘Breathing New Life’ self-management simulation-based CBT learning resource (DVD) contained the same concepts covered by the CBT group. The DVD included 7 chapters (including an introduction) which involved 6 vignettes presenting various scenarios likely to be encountered by the participants. The same clinical psychologist who conducted the group sessions was part of the DVD and provided CBT concepts on how individuals could change their behaviour and thoughts to improve their mental health. There was also an accompanying manual provided to the participants which reinforced concepts within the DVD. The DVD/manual covered the same topics as outlined in the group CBT intervention. Participants were asked to watch one DVD chapter per week (approximately 10 mins) and complete the accompanying section of the manual (approximately 10-20 mins). In total, participants were given 6 weeks for the DVD to be completed. A researcher telephoned each participant once a week to monitor compliance. Each call lasted <5 minutes on average and telephone coaching was deliberately avoided. If any queries arose, participants were referred to a clinical psychologist.
Sponsors
Edith Cowan University
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Treatment
Masking
Open (masking not used)
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
1) A confirmed diagnosis of COPD by respiratory physicians 2) A positive screen for anxiety and/or depression on the BAI and BDI-II, respectively.
Exclusion criteria
1) Life expectancy of less than six months 2) Currently involved in another research study 3) An illness exacerbation resulting in hospitalisation within the previous month 4) Diagnosis of dementia 5) Known difficulty with either their eye-sight, fluency in English or filling out self-report measures.
Outcome results
None listed