C35-11 Patient Perspectives on a Cognitive Behavioral Therapy-informed Intervention to Manage Comorbid Chronic Pain in COPD

Rationale The prevalence of chronic pain is 56% higher in those with COPD compared with the general population. Chronic pain in COPD is associated with reduced physical activity, impaired self-management, greater dyspnea, and dropout from pulmonary rehabilitation. Living Healthy, a peer-coach delivered CBT-informed pain management intervention previously tested in a diabetes population improved pain, physical activity, and functional status. Our aim is to adapt this intervention to an older COPD population, which faces different challenges than the younger diabetes population. Little is known about the qualitative experience of living with pain and COPD, and the acceptability of a CBT-based, peer coached delivered pain management intervention in COPD. We conducted a qualitative study to describe the experience of chronic pain management in COPD and determine patient-perceived barriers and facilitators to engage in a Living Healthy with COPD intervention. Methods Patients with COPD were recruited from the Weill Cornell Pulmonary Clinic and COPD Foundation patient networks. Semi-structured interviews were conducted, audio-recorded, and transcribed. Transcripts were coded by two independent coders using Nvivo software and reconciled. Themes describing the patient experience of living with COPD and pain were generated using the biopsychosocial (BPS) model, an approach to understanding health through the interaction between biological, physiological, and social factors. Thematic analysis was used to generate patient-perceived barriers and facilitators. Results Twenty patients (mean age 729.48) completed interviews and all questionnaires. Participants were predominantly female (n = 15, 75%), White (n = 15, 75%), retired (n = 12, 60%), and former smokers (n = 15, 75%). Analysis identified four interrelated themes and subthemes. Patients described the challenges living with COPD and pain, including frustration with lost function and variable pain management strategies driven by fear of medication overuse and social withdrawal. Participants discussed barriers and facilitators to the proposed intervention (time-consuming, reframing negative thinking is beneficial) and peer support (unfamiliarity with role, potential to build confidence and knowledge). Table 1 details selected themes and representative quotes. Conclusions Patients with COPD and chronic pain face interconnected biological, psychological, and social barriers that limit physical activity, worsen isolation, and highlight unmet needs for effective pain management. Peer coaching and CBT strategies were perceived as motivating, supportive, and capable of addressing key fears around breathlessness and physical limitations. The feasibility of peer-delivered, CBT-informed behavioral interventions should be studied in pilot intervention studies to understand their impact on physical activity engagement and pain reduction among patients with COPD and chronic pain. This abstract is funded by: American Lung Association