The purpose of this study in patients with advanced COPD and depression is twofold: 1. Determine the feasibility and acceptability of a 6-session e-counseling intervention 2. Determine the efficacy of the e-counseling intervention on depressive symptoms We hypothesize that patients who participate in e-counseling will have improved depressive symptoms compared to patients receiving usual care at 8 weeks.
Chronic obstructive pulmonary disease (COPD) is the third leading cause of the death in the US. Although COPD is mostly preventable, there is no cure. Thus, care of patients with COPD is primarily focused on symptom palliation with the goal of improving quality of life for both patients and their families. These goals are highly consistent with core principles of palliative care. Dyspnea is the most distressing symptom for patients. Even optimal disease-directed treatment provides only partial relief from dyspnea. Depression is consistently associated with worse dyspnea, but the mechanisms underlying this relationship are poorly understood. Since existing treatment for dyspnea has only limited success and there is evidence that treating depression alleviates pain, we propose that by improving mood, we may be more successful in alleviating dyspnea. Psychosocial-behavioral therapy (PBT) which is focused on increasing pleasant events and improving problem solving skills has been shown to have immediate and sustained effects on depressive symptoms in patients with dementia and post-stroke holds tremendous promise for efficacy in advanced COPD. Testing the use of novel technologies to provide efficacious interventions such as PBT to patients with advanced disease is critical for translational palliative care research
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
18
Cognitive Behavioral Therapy delivered to patients via telephone aimed to improve mood and decrease depressive symptoms.
University of Washington
Seattle, Washington, United States
Depressive Symptoms
Personal Health Questionnaire-9
Time frame: 8 weeks
Dyspnea Intensity and Distress
Chronic Respiratory Questionnaire, Shortness of Breath Questionnaire, Dyspnea Management Questionnaire
Time frame: 8 weeks
Fatigue
Chronic Respiratory Questionnaire
Time frame: 8 weeks
Anxiety
Hospital Anxiety and Depression Scale
Time frame: 8 weeks
Physical Activity
Accelerometry (Stepwatch)
Time frame: 8 weeks
Quality of Life
Chronic Respiratory Questionnaire and Medical Outcomes Short Form-36
Time frame: 8 weeks
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