Effectiveness of combined physical and psychological interventions for anxiety and depression symptoms in adult patients with chronic obstructive pulmonary disease: a systematic review protocol

OBJECTIVE: The objective of this review is to evaluate the effectiveness of combined physical and psychological interventions for anxiety and depression symptoms in adult patients with chronic obstructive pulmonary disease (COPD). INTRODUCTION: By 2030, COPD is expected to be the third-leading cause of death and the seventh-leading cause of health problems in terms of overall health impact, measured in disability-adjusted life years. As with other comorbidities, anxiety and depressive disorders influence the prognosis. Combined physical and psychological interventions may have better results than isolated interventions for symptoms of anxiety and depression in patients with COPD. INCLUSION CRITERIA: Studies of adult patients with COPD and anxiety and depression symptoms who have undergone combined physical and psychological interventions will be considered for inclusion. This review will primarily include randomized controlled trials. METHODS: Articles will be searched in CINAHL (via EBSCOhost), Cochrane Central Register of Controlled Trials, Academic Search Complete, Psychology and Behavioral Sciences Collection (via EBSCOhost), APA PsycINFO, PubMed, Web of Science Core Collection, and Scopus. Two independent reviewers will select the studies and apply the JBI tools for critical appraisal and data extraction. Studies will be pooled in a meta-analysis whenever possible. The χ 2 test and I 2 statistics will be the standard tools for assessing heterogeneity. Statistical analyses will be carried out using the random-effects model. The fixed-effects model will be applied if there is low heterogeneity between included studies ( I 2 < 50, or P ≥ 0.5). The Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach will be used to grade the certainty of the evidence, and a Summary of Findings will be presented. REVIEW REGISTRATION: PROSPERO CRD42024550523.