title: The effectiveness of a group cognitive-behavioural breathlessness intervention on health status, mood and hospital admissions in elderly patients with chronic obstructive pulmonary disease.
abstract: Non-pharmacological breathlessness interventions in lung cancer have proven beneficial. Breathlessness is also a major symptom in chronic obstructive pulmonary disease (COPD). This study measured the effectiveness of a non-exercise-based four-week cognitive-behavioural breathlessness intervention, delivered in a group setting for elderly patients with severe COPD. The results of the one-year feasibility study are presented. Patients with COPD were asked to complete the St. George's Respiratory Questionnaire and Hospital Anxiety and Depression Scale six weeks before the intervention, at the start and end of the intervention and at six weeks follow-up. The multidisciplinary intervention used a cognitive-behavioural format to address understanding of COPD and medication, anxiety, panic and depression, activity pacing, relaxation, breathing retraining and goal-setting. Retrospective data on accident & emergency (A&E) attendances and length of hospital stay was collected six months before and six months after the intervention and the data compared to a matched waiting list control group. The results showed significant improvements in depression and health status. There was a non-significant improvement in anxiety. There was a significant reduction in A&E attendance and a non-significant reduction in length of hospital stay in the intervention group, compared to comparative increases in the control group, highlighting the cost-effectiveness of the intervention.
authors.affiliation: Department of Clinical Health Psychology, Central and North West London NHS Foundation Trust, Uxbridge, UK. choward1@nhs.net
authors.forename: Claire
authors.initials: C
authors.lastname: Howard
authors.forename: Simon
authors.initials: S
authors.lastname: Dupont
authors.forename: Brigitte
authors.initials: B
authors.lastname: Haselden
authors.forename: Johanna
authors.initials: J
authors.lastname: Lynch
authors.forename: Peter
authors.initials: P
authors.lastname: Wills
mesh_terms: D000339:Affect; D000368:Aged; D000369:Aged, 80 and over; D001007:Anxiety; D003863:Depression; D004417:Dyspnea; D005260:Female; D006304:Health Status; D006801:Humans; D008131:London; D008297:Male; D008875:Middle Aged; D010343:Patient Admission / Q000639:trends; D015397:Program Evaluation; D011615:Psychotherapy, Group / Q000379:methods*; D029424:Pulmonary Disease, Chronic Obstructive / Q000503:physiopathology / Q000523:psychology*; D012189:Retrospective Studies; D011795:Surveys and Questionnaires