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Randomised controlled trial of cognitive behavioural therapy in COPD
Karen Heslop-Marshall1,2, Christine Baker3, Debbie Carrick-Sen4,5
1Chest Clinic, Newcastle upon Tyne Hospitals NHS Foundation Trust, RVI Hospital, Newcastle upon Tyne, UK.
ERJ Open Research
|November 28, 2018
Summary
Cognitive behavioural therapy (CBT) delivered by nurses significantly reduced anxiety in chronic obstructive pulmonary disease (COPD) patients. This COPD treatment was also more cost-effective than self-help leaflets over 12 months.
Area of Science:
- Pulmonary Medicine
- Psychiatry
- Health Economics
Background:
- Anxiety is a common and significant comorbidity in patients diagnosed with chronic obstructive pulmonary disease (COPD).
- Effective and cost-efficient interventions are needed to manage anxiety in this patient population.
Purpose of the Study:
- To evaluate the efficacy of cognitive behavioural therapy (CBT) delivered by respiratory nurses in reducing anxiety symptoms among COPD patients.
- To assess the cost-effectiveness of this CBT intervention compared to standard self-help leaflets.
Main Methods:
- A randomized controlled trial involving 279 patients with COPD and anxiety.
- Participants were assigned to either nurse-delivered CBT or self-help leaflets.
- Anxiety, depression, and quality of life were measured at baseline and at 3, 6, and 12 months using the Hospital Anxiety and Depression Scale and EuroQol-5D.
Main Results:
- The CBT group showed a significantly greater reduction in anxiety symptoms at 3 months compared to the self-help leaflet group (mean difference 1.52, p=0.003).
- The CBT intervention demonstrated superior cost-effectiveness at 12 months, associated with reduced hospital admissions and emergency department visits.
- Quality-adjusted life-years were estimated to evaluate the overall health economic benefit.
Conclusions:
- Cognitive behavioural therapy delivered by respiratory nurses is a clinically effective treatment for anxiety in COPD patients.
- This nurse-led CBT intervention offers a cost-effective alternative to self-help leaflets, improving patient outcomes and reducing healthcare utilization.
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