Managing mood disorders in patients attending pulmonary rehabilitation clinics
Colleen Doyle,1–3 David Dunt,2 David Ames,1 Suganya Selvarajah1
1National Ageing Research Institute, Royal Melbourne Hospital Royal Park Campus, Parkville, Victoria, Australia; 2Centre for Health Policy, Programs and Economics, University of Melbourne, Parkville, Victoria, Australia; 3Australian Catholic University, Fitzroy, Victoria, Australia
Background: There is good evidence for the positive benefits of pulmonary rehabilitation (PR) in the prevention of hospital admissions, lower mortality, and improved health-related quality of life. There is also increasing evidence about the impact of PR on mental health and, in particular, mood disorders. We aimed to identify how depression in chronic obstructive pulmonary disease (COPD) patients in Victoria, Australia, is being managed in PR, to identify the prevalence of depressive symptoms among COPD patients who attend PR, and to determine whether patients with depressive symptoms or anxiety symptoms dropped out of PR early.
Method: Of 61 PR clinics, 44 were invited and 22 agreed to participate. Telephone interviews were conducted to see how depression and anxiety in COPD patients were being recognized and managed in these clinics. A total of 294 questionnaires were distributed to patients by clinic coordinators to determine the prevalence of anxiety/depression, as measured by the Hospital Anxiety and Depression Scale. Coordinators were contacted to provide information on whether respondents dropped out of rehabilitation early or continued with their treatment at 2–4 months post program.
Results: Seven clinics were not aware of local guidelines on assessment/treatment/management of mood. Four clinics did not use any screening tools or other aids in the recognition and management of depression and/or anxiety. Overall, eight clinics participating in this study requested advice on suitable screening tools. The patient survey indicated that the mean depression score on the Hospital Anxiety and Depression Scale was 5.0 (standard deviation 3.0, range 1–13). The mean anxiety score was 5.5 (standard deviation 3.4, range 0–18). There was no evidence of a link between failure to complete rehabilitation and depression or anxiety scores, as only three of 105 patients failed to complete their rehabilitation.
Discussion: Awareness of management guidelines for depression and anxiety in COPD patients was variable across the clinics recruited into our study. We found no link between compliance with rehabilitation and depression, but our sample had limitations.
Conclusion: Future research needs to investigate how best to encourage more use of available guidelines regarding integrating psychological and psychosocial support to supplement the exercise and education that are currently offered routinely by all PR clinics studied in Victoria, Australia.
Keywords: chronic obstructive pulmonary disease, depression, anxiety, pulmonary rehabilitation
This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution - Non Commercial (unported, v3.0) License. By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms.Download Article [PDF] View Full Text [HTML][Machine readable]
Readers of this article also read:
Effectiveness of pulmonary rehabilitation in COPD with mild symptoms: a systematic review with meta-analyses
Rugbjerg M, Iepsen UW, Jørgensen KJ, Lange P
Published Date: 17 April 2015
Home-based pulmonary rehabilitation in patients with chronic obstructive pulmonary disease: a randomized clinical trial
Dias FD, Sampaio LMM, da Silva GA, Dantas Gomes ELF, Nascimento ESP, Santos Alves VL, Stirbulov R, Costa D
Published Date: 5 November 2013
Impact of active and passive smoking as risk factors for asthma and COPD in women presenting to primary care in Syria: first report by the WHO-GARD survey group
Mohammad Y, Shaaban R, Abou Al-Zahab B, Khaltaev N, Bousquet J, Dubaybo B
Published Date: 2 October 2013
Rossi A, Polese G
Published Date: 25 July 2013
Almagro P, Castro A
Published Date: 24 July 2013
The 6-minute pegboard and ring test is correlated with upper extremity activity of daily living in chronic obstructive pulmonary disease
Takeda K, Kawasaki Y, Yoshida K, Nishida Y, Harada T, Yamaguchi K, Ito S, Hashimoto K, Matsumoto S, Yamasaki A, Igishi T, Shimizu E
Published Date: 23 July 2013
Bjerk SM, Edgington BD, Rector TS, Kunisaki KM
Published Date: 15 February 2013
Improving the quality of life in patients with chronic obstructive pulmonary disease: focus on indacaterol
Published Date: 14 February 2013
Why are some evidence-based care recommendations in chronic obstructive pulmonary disease better implemented than others? Perspectives of medical practitioners
Johnston KN, Young M, Grimmer-Somers KA, Antic R, Frith PA
Published Date: 6 December 2011
Implementing chronic care for COPD: planned visits, care coordination, and patient empowerment for improved outcomes
Published Date: 21 November 2011