Effectiveness of cognitive behavioural therapy in a community-based pulmonary rehabilitation programme: A controlled clinical trial.
OBJECTIVE
To investigate whether the use of cognitive behavioural therapy in pulmonary rehabilitation addresses the depression and anxiety burden and thereby improves rehabilitation outcomes.


METHODS
Prospective controlled clinical trial.


METHODS
A total of 70 patients with chronic obstructive pulmonary disease who were referred to a community centre for pulmonary rehabilitation.


METHODS
Patients were allocated to either the control group, consisting of pulmonary rehabilitation alone, or to the treatment group, receiving pulmonary rehabilitation and an additional 6 sessions of group-based cognitive behavioural therapy. Assessments consisting of questionnaires and walk tests were conducted pre- and post-pulmonary rehabilitation.


RESULTS
A total of 28 patients were enrolled. The cognitive behavioural therapy group had significant improvements in exercise capacity following pulmonary rehabilitation (mean change 32.9 m, p = 0.043), which was maintained at 3 months post-pulmonary rehabilitation (mean change 23.4 m, p = 0.045). Patients in the cognitive behavioural therapy group showed significant short-term improvements in fatigue, stress and depression (mean change 2.4, p = 0.016, 3.9, p = 0.024 and 4.3, p = 0.047, respectively) and a 3-month post-pulmonary rehabilitation improvement in anxiety score (mean change 3.1, p = 0.01). No significant changes were seen in the control group.


CONCLUSIONS
The addition of cognitive behavioural therapy improved patients' physical, psychological and quality of life results. Cognitive behavioural therapy should be considered for inclusion in a pulmonary rehabilitation programme to enhance outcomes.
Rehabilitation, Royal Melbourne Hospital, 3052 Melbourne, Australia. edwin.luk@mh.org.au.
Edwin K
EK
Luk
Alexandra
A
Gorelik
Louis
L
Irving
Fary
F
Khan
D000368:Aged; D001007:Anxiety / Q000209:etiology / Q000628:therapy*; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D003131:Combined Modality Therapy; D003863:Depression / Q000209:etiology / Q000628:therapy*; D005221:Fatigue / Q000209:etiology / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D011446:Prospective Studies; D029424:Pulmonary Disease, Chronic Obstructive / Q000523:psychology / Q000534:rehabilitation*; D011788:Quality of Life; D011795:Surveys and Questionnaires; D016896:Treatment Outcome