Two Interventions for PatientsWith Major Depression and Severe Chronic Obstructive Pulmonary Disease: Impact on Quality of Life.

TitleTwo Interventions for PatientsWith Major Depression and Severe Chronic Obstructive Pulmonary Disease: Impact on Quality of Life.
Publication TypeJournal Article
Year of Publication2019
AuthorsJackson DS, Banerjee S, Sirey JAnne, Pollari C, Solomonov N, Novitch R, Chalfin A, Wu Y, Alexopoulos GS
JournalAm J Geriatr Psychiatry
Volume27
Issue5
Pagination502-511
Date Published2019 May
ISSN1545-7214
Abstract

OBJECTIVE: Clinically significant depression occurs in approximately 40% of chronic obstructive pulmonary disease (COPD) patients, and both illnesses severely impair quality of life. This study tests the hypothesis that problem-solving integrated with a treatment adherence intervention, the Problem Solving-Adherence (PSA), is superior to a personalized treatment adherence intervention, the Personalized Intervention for Depressed Patients with COPD (PID-C), alone in improving quality of life in depressed COPD patients.

METHODS: After screening 633 admissions for acute rehabilitation, we studied quality of life in 87 participants with major depression (by Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition) and severe COPD randomly assigned to 14 sessions of PID-C or PSA over 26 weeks. Quality of life was assessed using the Word Health Organization Quality of Life-BREF at baseline and weeks 10, 14, and 26.

RESULTS: The hypothesis was not supported. Exploratory latent class growth modeling identified two quality of life trajectories. In 80.5% of participants, quality of life remained unchanged and improved in the remaining 19.5% during the first 14 weeks. Patients with a stable quality trajectory had higher qualityof life at baseline and a stronger sense of personal agency.

CONCLUSION: Maintaining quality of life is a favorable outcome in depressed patients with COPD whose course is one of deterioration. These findings highlight the usefulness of PID-C, an easy to learn, personalized adherence enhancement intervention that, after further testing, may be integrated into the rehabilitation and care of depressed COPD patients.

DOI10.1016/j.jagp.2018.12.004
Alternate JournalAm J Geriatr Psychiatry
PubMed ID30630702
PubMed Central IDPMC6443466
Grant ListP50 MH113838 / MH / NIMH NIH HHS / United States
R01 MH076829 / MH / NIMH NIH HHS / United States
T32 MH019132 / MH / NIMH NIH HHS / United States
Division: 
Biostatistics and Epidemiology
Category: 
Faculty Publication