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Pulmonary rehabilitation
P52 Is a pulmonary rehabilitation (PR) programme effective in reducing severe symptoms of anxiety and depression in patients with COPD?
  1. S Harrison,
  2. N Greening,
  3. J Williams,
  4. S Singh
  1. Pulmonary Rehabilitation Research Group, Glenfield Hospital, University Hospitals Leicester NHS Trust, Leicester, England

Abstract

Introduction Patients with COPD have a high prevalence of anxiety and depression which has been associated with poorer health outcomes. PR has been found to be successful in reducing anxiety and depression. Previous studies have not differentiated between mild, moderate and severe symptoms of anxiety and depression and therefore the efficacy of PR are unproven in treating those across a spectrum of anxious and depressed symptoms. Our study aimed to explore the effectiveness of a PR programme in reducing mild, moderate and severe symptoms of anxiety and depression in patients with COPD.

Methods Patients with a clinical and spirometric (GOLD stage ≥2) diagnosis of COPD were identified from the PR database in Leicester, UK. Patients were categorised into three groups based on their Hospital Anxiety and Depression Scale (HADS) scores pre PR (‘none’ 0–7, ‘probable’ 8–10 and ‘presence’ 11–14). These patients undertook an outpatient PR programme between 2000 and January 2009 at a single centre. Changes in HADS scores were retrospectively compared. The two subscales were analysed separately.

Results 518 patients were identified (mean (SD) age 69.2 (8.80) years FEV1 39.9% (15.10) predicted 310 male). Patients with a ‘probable’ and a ‘presence’ of anxiety and depression had a reduction in HADS scores pre- to post- PR (p<0.001). Patients who had ‘none’ did not have a reduction (p>0.05) (Abstract P52 Figure 1). An ANOVA with post hoc analysis showed a difference in the amount of change pre to post PR between the three groups. Patients with a ‘presence’ had the greatest reductions in their scores (p<0.05).

Abstract P52 Figure 1

Results from a paired t-test. Levels of anxiety pre and post PR as measured by the HADS.

Conclusions PR is effective in reducing moderate and severe symptoms of anxiety and depression in patients with COPD. However, PR is not effective in reducing severe symptoms to a level which represents no presence of anxiety and depression.

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