Key result
Cognitive behavioural therapy added to pulmonary rehabilitation significantly improved short-term depression, stress, fatigue, and exercise capacity in patients with chronic obstructive pulmonary disease.
Why the study?
Does the addition of cognitive behavioural therapy to pulmonary rehabilitation improve exercise capacity and psychological outcomes in patients with COPD?
Does the addition of cognitive behavioural therapy to pulmonary rehabilitation improve exercise capacity and psychological outcomes in patients with COPD?
Standardized Mean Difference: -0.33 (95% CI -1.08–0.42)
Absolute Event Rate: -4.3% vs -1.9%
The addition of cognitive behavioural therapy to pulmonary rehabilitation improves exercise capacity and psychological well-being in patients with COPD.
May support CBT integration in COPD pulmonary rehab; leaves open causality and durability pending randomized trials.
OBJECTIVE: To investigate whether the use of cognitive behavioural therapy in pulmonary rehabilitation addresses the depression and anxiety burden and thereby improves rehabilitation outcomes. DESIGN: Prospective controlled clinical trial. PATIENTS: A total of 70 patients with chronic obstructive pulmonary disease who were referred to a community centre for pulmonary rehabilitation. METHODS: Patients were allocated to either the control group, consisting of pulmonary rehabilitation alone, or to the treatment group, receiving pulmonary rehabilitation and an additional 6 sessions of group-based cognitive behavioural therapy. Assessments consisting of questionnaires and walk tests were conducted pre- and post-pulmonary rehabilitation. RESULTS: A total of 28 patients were enrolled. The cognitive behavioural therapy group had significant improvements in exercise capacity following pulmonary rehabilitation (mean change 32.9 m, p = 0.043), which was maintained at 3 months post-pulmonary rehabilitation (mean change 23.4 m, p = 0.045). Patients in the cognitive behavioural therapy group showed significant short-term improvements in fatigue, stress and depression (mean change 2.4, p = 0.016, 3.9, p = 0.024 and 4.3, p = 0.047, respectively) and a 3-month post-pulmonary rehabilitation improvement in anxiety score (mean change 3.1, p = 0.01). No significant changes were seen in the control group. CONCLUSION: The addition of cognitive behavioural therapy improved patients' physical, psychological and quality of life results. Cognitive behavioural therapy should be considered for inclusion in a pulmonary rehabilitation programme to enhance outcomes.
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Luk et al. (2017) studied Chronic obstructive pulmonary disease (n=28). Cognitive behavioural therapy vs. Pulmonary rehabilitation alone was evaluated on Change in Depression Anxiety Stress Scale (DASS) depression score from baseline to end of rehabilitation (Cohen's d -0.33, 95% CI -1.08 to 0.42). Cognitive behavioural therapy added to pulmonary rehabilitation significantly improved short-term depression, stress, fatigue, and exercise capacity in patients with chronic obstructive pulmonary disease.
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