Abstract

Patients with chronic obstructive pulmonary disease (COPD) who experience comorbid depression have significantly greater risks for premature death, increased healthcare utilization, and lower quality of life. Depression affects between 26-40% of COPD patients. This reanalysis of a large RCT that tested the efficacy of a 12-week home-based Pulmonary Rehabilitation program that included remote patient monitoring of lifestyle (steps and symptoms), a mindfulness-based movement practice, and health coaching in stable patients with moderate to severe COPD. We aimed to determine the effects of the program on depression symptoms and quality of life in this patient population.

Methods: This repurposed analysis derived from an NIH-funded RCT included stable COPD patients >40 y/o and symptoms of depression (defined by the Patient Health Questionnaire (PHQ-9) >5 points).Chronic Respiratory Questionnaire (CRQ) and PHQ-9 were measured at baseline and 3 months.

Results: A total of 168 patients were included in this analysis. Results are shown in table 1. Depression symptoms and quality of life statistically improved in the intervention group compared to the control group.

Conclusion: We found that COPD patients with at least mild depression at baseline experienced a reduction in depressive symptoms and improvement in all domains of quality of life, dyspnea, fatigue, emotions, and mastery following this intervention. This home-based PR with health coaching may represent a valid alternative to address depression symptoms in patients suffering from COPD. This intervention may also fill a knowledge gap in the treatment of depression in this chronic condition.