Two Interventions for Patients with Major Depression and Severe Chronic Obstructive Pulmonary Disease: Impact on Dyspnea-Related Disability
Open accessAbstract
Objective The Personalized Intervention for Depressed Patients with Chronic Obstructive Pulmonary Disease (PID-C) is an intervention aiming to help patients adhere to their rehabilitation and care. This study tested the hypothesis that the Problem-Solving Adherence (PSA) intervention, which integrates problem-solving into adherence enhancement procedures, reduces dyspnea-related disability more than PID-C. Exploratory analyses sought to identify patients with distinct dyspnea-related disability trajectories and to compare their clinical profiles.Methods In this randomized controlled trial in an acute inpatient rehabilitation and community, 101 participants diagnosed with chronic obstructive pulmonary disease (COPD) and major depression were included after screening 633 consecutive admissions for acute inpatient rehabilitation. Participants underwent 14 sessions of PID-C versus PSA over 26 weeks using the Pulmonary Functional Status and Dyspnea Questionnaire.Results The study hypothesis was not supported. Exploratory latent class growth modeling identified two distinct disability trajectories. Dyspnea-related disability improved in 39% of patients and remained unchanged in the rest. Patients whose dyspnea-related disability improved had more severe disability and less sense of control over their condition at baseline.Conclusion Improvement or no worsening of disability was noted in both treatment groups. This is a favorable course for depressed patients with a severe, deteriorating medical illness. PID-C is compatible with the expertise of clinicians working in community-based rehabilitation programs, and after further testing in the community, it can be integrated in the care of depressed COPD patients.
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Personalized interventions aiming to increase adherence to treatment for major depression and COPD improved both depressive symptoms and disability.
“Personalized interventions aiming to increase adherence to treatment for major depression and COPD improved both depressive symptoms and disability165–167.”
From Mechanisms and treatment of late-life depression (2019) · cites this paper as [166]
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- Authors
- Alexopoulos, G. S., Sirey, J. A., Banerjee, S., Jackson, D. S., Kiosses, D. N., Pollari, C., Novitch, R. S., Artis, A., & Raue, P. J.
- Affiliations
- Weill Cornell Medicine (US)
- Burke Rehabilitation Hospital (US)
- University of Washington (US)
- Corresponding author
- Alexopoulos, George S.
- ORCID
- Venue
- The American Journal of Geriatric Psychiatry
- Publisher
- Elsevier BV
- Published
- 2018-02
- Volume
- 26
- Issue
- 2
- Pages
- 162-171
- ISSN
- 1064-7481 (ISSN-L)
- PMC
- PMC5817020
- OpenAlex
- W2763683444
- Cited by
- 11
- References
- 43
- Citations by year
- 2022: 2 · 2021: 2 · 2020: 1 · 2019: 2 · 2018: 3 · 2017: 1
- FWCI
- 1.58
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- American Journal of Geriatric Psychiatry (acceptedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute of Mental Health (R01 MH076829, P50 MH113838, T32 MH019132)
- Sanchez Foundation
- Will Rogers Institute
- Topics
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Chronic Obstructive Pulmonary Disease (COPD) Research
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Health and Mental Health
- Health Sciences › Medicine › Oncology › Cancer survivorship and care
- Keywords
- major depressive disorder, chronic obstructive pulmonary disease, medication adherence, rehabilitation, disability trajectories, perceived control, community-based rehabilitation, inpatient rehabilitation
- MeSH terms
- Adult, Behavior Therapy, Depressive Disorder, Major, Major Depressive Disorder, Dyspnea, Female, Humans, Male, Outcome and Process Assessment, Health Care, Patient Compliance, Problem Solving, Severity of Illness Index, Comorbidity, Pulmonary Disease, Chronic Obstructive
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