• Study first to
assess predictors of pulmonary rehabilitation completion among men and women
separately; women with depression may drop out of rehab
Researchers from The Miriam Hospital have found that people with Chronic obstructive pulmonary disease (COPD) who are also depressed have difficulty sticking to a pulmonary rehabilitation program. This appears to be particularlytrue for women, and screening and brief treatment of depression should be considered as part of treatment. The study and its findings are published in print in Respiratory Medicine.
obstructive pulmonary disease is a common and often disabling inflammatory lung
disease characterized by a progressive airway obstruction that is not fully
reversible. An important component of non-medication treatment
for COPD is multidisciplinary pulmonary rehabilitation (PR), which improves
exercise tolerance, shortness of breath, depression and anxiety, and quality of
life. However, as many as 30 percent of patients who begin PR programs drop out
prematurely, and depressed mood has been associated with PR non completion.
“Given its prevalence and disease burden,
there has been relatively little research on COPD,” says lead researcher Andrew
Busch, PhD, of The Centers for Behavioral and Preventive Medicine at The Miriam
Hospital. He and his colleagues sought
to uncover how depression interacts with medical care of those with COPD to
help improve COPD treatment programs.
“Depression interferes with COPD treatment, so it
may be particularly important for those with COPD and depression to receive
adequate depression treatment,” Busch says. “Depression is more common in women
than men with COPD, and historically, women with COPD have been understudied.”
led a study of 111 COPD patients who enrolled in the outpatient pulmonary rehabilitation program at The Miriam
Hospital Center for Cardiac Fitness in Providence, Rhode Island. Those
who attended 20 or more sessions were designated “completers.” Depression was
measured using a standard self-report scale. The researchers analyzed whether depressed
mood predicted completion of PR.
analysis found 68 percent of patients completed PR. Across the whole group, lower
depressed mood independently predicted finishing PR. However, when men and
women were looked at separately, lower depressed mood was an independent
predictor of PR completion for women, but not for men.
“Depression predicts earlier mortality in those with
COPD,” Busch concludes. “Our results suggest that non completion of pulmonary
rehabilitation may be one variable that explains this relationship, and we plan
to use these results to help design and implement treatment for depression
among those with COPD.”