Pulmonary Rehabilitation with and without a Cognitive Behavioral Intervention for Breathlessness in People Living with Chronic Obstructive Pulmonary Disease: Randomized Controlled Trial
(1) Background: Most controlled trials of cognitive behavior therapy (CBT) in people living with chronic obstructive pulmonary disease (COPD) have targeted anxiety and depression. (2) Methods: This pragmatic randomized controlled trial explored whether a comprehensive pulmonary rehabilitation progra...
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-11-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/12/23/7286 |
| _version_ | 1797399990986866688 |
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| author | Marie T. Williams Hayley Lewthwaite Catherine Paquet Paul Cafarella Peter Frith |
| author_facet | Marie T. Williams Hayley Lewthwaite Catherine Paquet Paul Cafarella Peter Frith |
| author_sort | Marie T. Williams |
| collection | DOAJ |
| description | (1) Background: Most controlled trials of cognitive behavior therapy (CBT) in people living with chronic obstructive pulmonary disease (COPD) have targeted anxiety and depression. (2) Methods: This pragmatic randomized controlled trial explored whether a comprehensive pulmonary rehabilitation program (CPRP) with CBT for breathlessness or social group control (CPRP + SC) significantly improved health outcomes. (3) Results: People with moderate-to-severe COPD were block randomized (CPRP + CBT <i>n</i> = 52 or CPRP + SC <i>n</i> = 49). Primary outcomes (Hospital Anxiety and Depression scale (HADs), six-minute walk distance (6MWD)) and secondary outcomes (breathlessness, quality of life and habitual physical activity) were assessed before and 1, 6 and 12 months post intervention. Between-group differences were calculated with mixed models for each time point to baseline (intention to treat (ITT)). Participants (<i>n</i> = 101, mean ± SD age 70 ± 8.5 years, 54 (53%) males, FEV<sub>1</sub>% pred 47.7 ± 16.3) were similar between groups. Post intervention, primary outcomes did not differ significantly between groups at 1 (6MWD mean difference −7.5 [95% CI −34.3 to 19.4], HADs-A −0.3 [−1.4 to 0.9], HADs-D 0.2 [−0.8 to 1.3]), 6 (6MWD −11.5 [−38.1 to 15.1], HADs-A 1.1 [0.0 to 2.2], HADs-D 0.2 [−0.9 to 1.3]), or 12 months (6MWD −3.8 [−27.2 to 19.6], HADS-A −0.4 [−1.5 to 0.6], HADs-D −0.7 [−1.7 to 0.4]). (4) Conclusions: In this cohort, combining CBT with a CPRP did not provide additional health benefits beyond those achieved by a standard CPRP. |
| first_indexed | 2024-03-09T01:49:05Z |
| format | Article |
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| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-09T01:49:05Z |
| publishDate | 2023-11-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-95da63699602405a860f12a7bfe737bc2023-12-08T15:19:09ZengMDPI AGJournal of Clinical Medicine2077-03832023-11-011223728610.3390/jcm12237286Pulmonary Rehabilitation with and without a Cognitive Behavioral Intervention for Breathlessness in People Living with Chronic Obstructive Pulmonary Disease: Randomized Controlled TrialMarie T. Williams0Hayley Lewthwaite1Catherine Paquet2Paul Cafarella3Peter Frith4Allied Health and Human Performance, Innovation, IMPlementation and Clinical Translation in Health (IIMPACT), University of South Australia, Adelaide, SA 5000, AustraliaAllied Health and Human Performance, Innovation, IMPlementation and Clinical Translation in Health (IIMPACT), University of South Australia, Adelaide, SA 5000, AustraliaAllied Health and Human Performance, Innovation, IMPlementation and Clinical Translation in Health (IIMPACT), University of South Australia, Adelaide, SA 5000, AustraliaDepartment of Respiratory Sleep Medicine and Ventilation, Southern Adelaide Local Health Network & College of Nursing and Health Sciences, Flinders University of South Australia, Adelaide, SA 5042, AustraliaCollege of Medicine and Public Health, Flinders University, Adelaide, SA 5042, Australia(1) Background: Most controlled trials of cognitive behavior therapy (CBT) in people living with chronic obstructive pulmonary disease (COPD) have targeted anxiety and depression. (2) Methods: This pragmatic randomized controlled trial explored whether a comprehensive pulmonary rehabilitation program (CPRP) with CBT for breathlessness or social group control (CPRP + SC) significantly improved health outcomes. (3) Results: People with moderate-to-severe COPD were block randomized (CPRP + CBT <i>n</i> = 52 or CPRP + SC <i>n</i> = 49). Primary outcomes (Hospital Anxiety and Depression scale (HADs), six-minute walk distance (6MWD)) and secondary outcomes (breathlessness, quality of life and habitual physical activity) were assessed before and 1, 6 and 12 months post intervention. Between-group differences were calculated with mixed models for each time point to baseline (intention to treat (ITT)). Participants (<i>n</i> = 101, mean ± SD age 70 ± 8.5 years, 54 (53%) males, FEV<sub>1</sub>% pred 47.7 ± 16.3) were similar between groups. Post intervention, primary outcomes did not differ significantly between groups at 1 (6MWD mean difference −7.5 [95% CI −34.3 to 19.4], HADs-A −0.3 [−1.4 to 0.9], HADs-D 0.2 [−0.8 to 1.3]), 6 (6MWD −11.5 [−38.1 to 15.1], HADs-A 1.1 [0.0 to 2.2], HADs-D 0.2 [−0.9 to 1.3]), or 12 months (6MWD −3.8 [−27.2 to 19.6], HADS-A −0.4 [−1.5 to 0.6], HADs-D −0.7 [−1.7 to 0.4]). (4) Conclusions: In this cohort, combining CBT with a CPRP did not provide additional health benefits beyond those achieved by a standard CPRP.https://www.mdpi.com/2077-0383/12/23/7286cognitive behavior therapypulmonary rehabilitationbreathlessnessdyspnea |
| spellingShingle | Marie T. Williams Hayley Lewthwaite Catherine Paquet Paul Cafarella Peter Frith Pulmonary Rehabilitation with and without a Cognitive Behavioral Intervention for Breathlessness in People Living with Chronic Obstructive Pulmonary Disease: Randomized Controlled Trial Journal of Clinical Medicine cognitive behavior therapy pulmonary rehabilitation breathlessness dyspnea |
| title | Pulmonary Rehabilitation with and without a Cognitive Behavioral Intervention for Breathlessness in People Living with Chronic Obstructive Pulmonary Disease: Randomized Controlled Trial |
| title_full | Pulmonary Rehabilitation with and without a Cognitive Behavioral Intervention for Breathlessness in People Living with Chronic Obstructive Pulmonary Disease: Randomized Controlled Trial |
| title_fullStr | Pulmonary Rehabilitation with and without a Cognitive Behavioral Intervention for Breathlessness in People Living with Chronic Obstructive Pulmonary Disease: Randomized Controlled Trial |
| title_full_unstemmed | Pulmonary Rehabilitation with and without a Cognitive Behavioral Intervention for Breathlessness in People Living with Chronic Obstructive Pulmonary Disease: Randomized Controlled Trial |
| title_short | Pulmonary Rehabilitation with and without a Cognitive Behavioral Intervention for Breathlessness in People Living with Chronic Obstructive Pulmonary Disease: Randomized Controlled Trial |
| title_sort | pulmonary rehabilitation with and without a cognitive behavioral intervention for breathlessness in people living with chronic obstructive pulmonary disease randomized controlled trial |
| topic | cognitive behavior therapy pulmonary rehabilitation breathlessness dyspnea |
| url | https://www.mdpi.com/2077-0383/12/23/7286 |
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