title: Study protocol for a randomized controlled trial of telephone-delivered cognitive behavior therapy compared with befriending for treating depression and anxiety in older adults with COPD.
abstract: BACKGROUND
  COPD is an umbrella term to describe chronic lung diseases that cause limitations in lung airflow, including emphysema and chronic bronchitis. The prevalence of depression and anxiety in people with COPD is high, although these comorbidities are often undiagnosed, untreated, or undertreated. There is a need to identify efficacious treatments for depression and anxiety in people with COPD. Cognitive behavior therapy (CBT) for the treatment of anxiety and depression has a strong evidence base. There has been some success delivering this treatment over the telephone in limited studies. The aim of this study is to evaluate the efficacy of both telephone-administered CBT and befriending on outcomes for patients with diagnosed COPD who have at least mild levels of depression and/or anxiety.
  
  
  METHODS
  The protocol described in this paper is of a pragmatic randomized controlled trial comparing eight sessions of telephone CBT to an active social control, referred to as befriending. Primary outcome measures will include depression and anxiety symptoms, and secondary outcome measures will include quality of life, self-efficacy, and COPD symptom severity. Participants' satisfaction with the intervention and therapeutic alliance will also be assessed. Measures will be taken pre- and postdelivery of the intervention and again at 8 weeks following the intervention.
  
  
  CONCLUSIONS
  People with COPD often have limitations to their mobility because of their breathlessness. They are often already attending many medical appointments and could be reluctant to attend for face-to-face psychological treatment. The results of this study should identify the relative efficacy of CBT delivered over the telephone to this population, which, if successful, may be a cost-effective and more palatable alternative to face-to-face treatment of depression or anxiety for this population.
authors.affiliation: Australian Catholic University, Melbourne, VIC, Australia.
authors.forename: Colleen
authors.initials: C
authors.lastname: Doyle
authors.affiliation: Centre for Health Policy, The University of Melbourne, Melbourne, VIC, Australia.
authors.forename: David
authors.initials: D
authors.lastname: Dunt
authors.affiliation: National Ageing Research Institute, Melbourne, VIC, Australia.
authors.forename: David
authors.initials: D
authors.lastname: Ames
authors.affiliation: National Ageing Research Institute, Melbourne, VIC, Australia.
authors.forename: Marcia
authors.initials: M
authors.lastname: Fearn
authors.affiliation: Australian Catholic University, Melbourne, VIC, Australia.
authors.forename: Emily Chuanmei
authors.initials: EC
authors.lastname: You
authors.affiliation: Department of Psychological Sciences, Swinburne University of Technology, Hawthorn, VIC, Australia.
authors.forename: Sunil
authors.initials: S
authors.lastname: Bhar
mesh_terms: D001007:Anxiety / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D015897:Comorbidity; D003863:Depression / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D011569:Psychiatric Status Rating Scales; D029424:Pulmonary Disease, Chronic Obstructive / Q000175:diagnosis / Q000523:psychology; D011788:Quality of Life; D012107:Research Design; D020377:Self Efficacy; D012720:Severity of Illness Index; D017216:Telemedicine / Q000379:methods*; D016896:Treatment Outcome
keywords: anxiety; befriending; chronic obstructive pulmonary disease (COPD); cognitive behavior therapy (CBT); depression; telephone