Psychosocial Intervention in Chronic Obstructive Pulmonary Disease: Meta-Analysis of Randomized Controlled Trials. Issue 3 (24th April 2022)

• Record Type: Journal Article
• Authors: Farver-Vestergaard, Ingeborg; Danielsen, Josefine Tingdal Taube; Løkke, Anders; Zachariae, Robert
• Is Part Of: Psychosomatic medicine. Volume 84:Issue 3(2022)
• Page Start: 347
• Page End: 358
• Publication Date: 2022-04-24
• Subjects: 'COPD' -- 'respiratory illness' -- 'systematic review' -- 'psychological' -- 'physical' -- 'meta-analysis' -- 6MWT = 6-Minute Walk Test -- ASI-3 = Anxiety Sensitivity Index-3 -- BAI = Beck Anxiety Inventory -- BDI = Beck Depression Inventory -- BF = Bayes factor -- CAT = COPD Assessment Test -- CBT = cognitive behavioral therapy -- CES-D = Center for Epidemiological Studies Depression scale -- CCQ = Clinical COPD Questionnaire -- CRQ = Chronic Respiratory Questionnaire -- COPD = chronic obstructive pulmonary disease -- d.f. = degrees of freedom -- ES = effect size -- GDS = Geriatric Depression Scale -- HADS = Hospital Anxiety and Depression Scale -- HCP = health care professional -- IF-V = Ingeborg Farver-Vestergaard -- JTTD = Josefine Tingdal Taube Danielsen -- MBSR = Mindfulness Based Stress Reduction -- mMRC = modified Medical Research Council dyspnea scale -- MSAS = Memorial Symptom Assessment Scale -- POMS = Profile of Mood States -- PR = pulmonary rehabilitation -- PRISMA = Preferred Reporting Items for Systematic Reviews and Meta-Analyses -- PSQI = Pittsburgh Sleep Quality Index -- RCT = randomized controlled trial -- SAI = Spielberger Anxiety Inventory -- SCL-90 = Symptom Checklist-90 -- VAS = Visual Analogue Scale; Medicine, Psychosomatic -- Periodicals; 616.0805
• DOI: 10.1097/PSY.0000000000001043
• Languages: English
• ISSNs: 0033-3174

Abstract

ABSTRACT: Objective: Many patients with chronic obstructive pulmonary disease (COPD) experience persistent interrelated psychological and physical symptoms despite optimal treatment. Several studies of psychosocial intervention in COPD have been published in recent years. The present study aimed to conduct a quantitative summary of the efficacy of such interventions on psychological and physical outcomes. Methods: Two independent raters screened PubMed, PsycINFO, Embase, Web of Science, Cochrane Library, and CINAHL for eligible studies. In all, 35 independent, randomized controlled trials with a total of 3, 120 patients with COPD were included, assessed for their methodological quality, and subjected to meta-analytic evaluation. Results: Meta-analyses revealed small, statistically significant effects of psychosocial intervention on combined psychological (Hedges's g = 0.28; 95%CI: 0.16–0.41) and physical outcomes ( g = 0.21; 95%CI: 0.07–0.35) with no indications of publication bias. Supplementary Bayesian meta-analyses provided strong evidence for a non-zero overall effect on psychological outcomes (Bayes factor (BF) = 305) and moderate support for physical outcomes (BF = 6.1). Exploring sources of heterogeneity with meta-regression indicated that older age of patients and longer duration of interventions were associated with smaller effects on psychological outcomes. Conclusions: The results support psychosocial intervention as an additional, useful tool in multidisciplinary respiratory care with the potential to improve both psychological and physical outcomes. Future studies are recommended to monitor adverse effects, apply blinding of active control conditions, and determine sample sizes with a priori power calculations. Registration: Registered with Prospero (www.crd.york.ac.uk/prospero/ ) prior to initiation of the literature search (Reg. ID: CRD42020170083).