Home
|
Inbox
|
Search
|
View Abstract
Two Interventions for Patients with Major Depression and Severe COPD: Impact on Dyspnea Related Disability
Description
.abstract img { width:300px !important; height:auto; display:block; text-align:center; margin-top:10px } .abstract { overflow-x:scroll } .abstract table { width:100%; display:block; border:hidden; border-collapse: collapse; margin-top:10px } .abstract td, th { border-top: 1px solid #ddd; padding: 4px 8px; } .abstract tbody tr:nth-child(even) td { background-color: #efefef; } .abstract a { overflow-wrap: break-word; word-wrap: break-word; }
A4884 - Two Interventions for Patients with Major Depression and Severe COPD: Impact on Dyspnea Related Disability
Author Block: R. S. Novitch1, J. Sirey2, G. S. Alexopoulos2, Department of Physical Medicine and Rehabilitation, Albert Einstein College of Medicine, Division of Pulmonary Medicine, Albert Einstein College of Medicine, Department of Geriatric Psychiatry, Weill MedicalCollege of Cornell University; 1Burke Rehabilitation Hospital, White Plains, NY, United States, 2Department of Geriatric Psychiatry, Weill Medical College of Cornell University, White Plains, NY, United States.
Objective:Personalized Intervention for Depressed Patients with COPD (PID-C), an intervention aiming to help patients adhere to their rehabilitation and care. This study tested the hypothesis that Problem Solving-Adherence (PSA) intervention, which integrates problem solving into adherence enhancement procedures, reduces dyspnea related disability more than PID-C. Exploratory analyses sought to identify patients with distinct dyspnea related disability trajectories and to compare their clinical profiles.Design: Randomized controlled trial. Setting: Acute inpatient rehabilitation and community. Participants: 101 diagnosed with COPD and major depression after screening 633 consecutive admissions for acute inpatient rehabilitation. Intervention: 14 sessions of PID-C vs. PSA over 26 weeks. Measurements: Pulmonary Functional Status and Dyspnea Questionnaire (PFSDQ-M). Results: PSA was not more efficacious than PID-C in reducing dyspnea related disability. Exploratory latent class growth modeling identified two distinct disability trajectories. Dyspnea related disability improved in 39% of patients and remained unchanged in the rest. Patients whose dyspnea related disability improved had more severe disability and less sense of control over their condition at baseline. Conclusions: Both PID-C and PSA led to improvement or no worsening of disability. This is a favorable outcome for depressed patients with a severe, deteriorating medical illness. PID-C is compatible with the expertise of clinicians working in community-based rehabilitation programs and can be integrated in the care of depressed COPD patients.
Author Block: R. S. Novitch1, J. Sirey2, G. S. Alexopoulos2, Department of Physical Medicine and Rehabilitation, Albert Einstein College of Medicine, Division of Pulmonary Medicine, Albert Einstein College of Medicine, Department of Geriatric Psychiatry, Weill MedicalCollege of Cornell University; 1Burke Rehabilitation Hospital, White Plains, NY, United States, 2Department of Geriatric Psychiatry, Weill Medical College of Cornell University, White Plains, NY, United States.
Objective:Personalized Intervention for Depressed Patients with COPD (PID-C), an intervention aiming to help patients adhere to their rehabilitation and care. This study tested the hypothesis that Problem Solving-Adherence (PSA) intervention, which integrates problem solving into adherence enhancement procedures, reduces dyspnea related disability more than PID-C. Exploratory analyses sought to identify patients with distinct dyspnea related disability trajectories and to compare their clinical profiles.Design: Randomized controlled trial. Setting: Acute inpatient rehabilitation and community. Participants: 101 diagnosed with COPD and major depression after screening 633 consecutive admissions for acute inpatient rehabilitation. Intervention: 14 sessions of PID-C vs. PSA over 26 weeks. Measurements: Pulmonary Functional Status and Dyspnea Questionnaire (PFSDQ-M). Results: PSA was not more efficacious than PID-C in reducing dyspnea related disability. Exploratory latent class growth modeling identified two distinct disability trajectories. Dyspnea related disability improved in 39% of patients and remained unchanged in the rest. Patients whose dyspnea related disability improved had more severe disability and less sense of control over their condition at baseline. Conclusions: Both PID-C and PSA led to improvement or no worsening of disability. This is a favorable outcome for depressed patients with a severe, deteriorating medical illness. PID-C is compatible with the expertise of clinicians working in community-based rehabilitation programs and can be integrated in the care of depressed COPD patients.
|
Home
|
Inbox
|
Search
|