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Cited by 121Palliative Care and End-of-Life IssuesChronic Obstructive Pulmonary Disease (COPD) ResearchRespiratory Support and Mechanisms

Association of depression and life-sustaining treatment preferences in patients with COPD

Stapleton, Renee D., Nielsen, Elizabeth L., Engelberg, Ruth A., Patrick, Donald L., Curtis, J. Randall·2005·Chest
DOI 10.1378/chest.127.1.328
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Abstract

Study objective Depressive symptoms and reduced health-related quality of life are common in patients with severe COPD. Therefore, understanding the association between preferences for life-sustaining treatment and depression or quality of life is important in providing care. No prior studies have examined the effects of depression and quality of life on treatment preferences in this population.Design and patients Cross-sectional study of 101 patients with oxygen-prescribed COPD.Methods Patients completed the St. George's Respiratory Questionnaire, Center for Epidemiologic Studies-Depression survey, and questions regarding their preferences for mechanical ventilation and cardiopulmonary resuscitation if needed to sustain life.Results Median age was 67.4 years, and median FEV1 was 26.3% predicted. Depression was significantly associated with preferences for resuscitation (50% of depressed patients and 23% of patients without depression refused resuscitation; p = 0.007), but was not associated with preferences for mechanical ventilation. Health-related quality of life was not associated with preferences for either resuscitation or mechanical ventilation.Conclusions Clinicians caring for patients with oxygen-prescribed COPD should understand that health-related quality of life does not predict treatment preferences and should not influence clinicians' views of patients' treatment preferences. However, depression does appear to influence patients' treatment decisions for cardiopulmonary resuscitation, and improvement in depressive symptoms should trigger a reassessment of these preferences.

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  • Depression has a profound impact on end-of-life decisions because depressed patients more often opt for "do not resuscitate" decisions.

    “Furthermore, depression has been found to have a profound impact on end-of-life decisions because depressed patients more often opt for “do not resuscitate” decisions.58”

    From Anxiety and Depression in COPD (2008) · cites this paper as [58]

  • Depression lowers quality of life and decreases adherence to treatment in patients with COPD.

    “In addition, depression lowers quality of life and decreases adherence to treatment.22,58”

    From Anxiety and Depression in COPD (2008) · cites this paper as [58]

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Authors
Stapleton, R. D., Nielsen, E. L., Engelberg, R. A., Patrick, D. L., & Curtis, J. R.
Affiliations
University of Washington (US)
Corresponding author
Stapleton, Renee D.
ORCID
Venue
Chest
Publisher
Elsevier BV
Published
2005-01
Volume
127
Issue
1
Pages
328-334
ISSN
0012-3692 (ISSN-L)
DOI
10.1378/chest.127.1.328
OpenAlex
W2154886013
Cited by
121
References
36
Citations by year
2025: 1 · 2024: 3 · 2023: 2 · 2022: 2 · 2020: 2 · 2019: 6 · 2018: 5 · 2017: 5 · 2016: 6 · 2015: 4 · 2014: 5 · 2013: 4 · 2012: 9
FWCI
13.23
Type
journal article
Language
en
Open access
closed
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • CHEST Journal (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Palliative Care and End-of-Life Issues
  • Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Chronic Obstructive Pulmonary Disease (COPD) Research
  • Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Respiratory Support and Mechanisms
Keywords
depression, chronic obstructive pulmonary disease, life-sustaining treatment preferences, cardiopulmonary resuscitation, mechanical ventilation, health-related quality of life, end-of-life decisions, oxygen therapy
MeSH terms
Aged, Cross-Sectional Studies, Depression, Female, Health Status, Humans, Male, Middle Aged, Quality of Life, Respiration, Artificial, Comorbidity, Logistic Models, Cardiopulmonary Resuscitation, Pulmonary Disease, Chronic Obstructive

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