Effectiveness of village doctors led cognitive behavioral therapy for COPD patients in a randomized controlled trial

Anxiety and depression are two common symptoms among patients with chronic obstructive pulmonary disease (COPD). The aim of this study was to explore the efficacy of group CBT (GCBT) delivered by village doctors for reducing anxiety and depression symptoms and improving quality of life among community-dwelling COPD patients. This community-based cluster randomized controlled trial was conducted from October to November 2023 in Xuzhou city, China, and involved COPD patients from 18 communities. The participants received either CBT plus usual care (UC) or UC only. Village doctors were trained in CBT before the intervention. A total of 443 participants with COPD and comorbid depression and anxiety were included in the analysis, with 223 patients in the control group receiving UC only and 220 patients in the intervention group receiving CBT plus UC. The depression and anxiety scores of the CBT group were lower than those of the UC group at 6 months [depression: (7.87 ± 3.73) vs. (10.20 ± 3.85); anxiety: (8.23 ± 3.60) vs. (10.71 ± 4.01); t = 12.605, 14.419, both P < 0. 001)]. The SGRQ and mMRC scores in the CBT group were lower than those in the UC group at 6 months [(41.78 ± 21.56) vs. (57.47 ± 24.46), (1.55 ± 0.82) vs. (2.32 ± 1.21); t = 17.518, 8.376, all P < 0.001)]. The FEV₁ (% pred) was not significantly different between the CBT group and the UC group at 6 months (t = 2.136, P = 0.128). CBT delivered by village doctors was shown to be an effective and practical method for relieving anxiety and depression and improving the quality of life of community-dwelling COPD patients.