Nurse-led cognitive behavioural therapy for treatment of anxiety in COPD

Abstract

Anxiety disorders are common and debilitating conditions that significantly impair the physical functioning and quality of life (QoL) of patients with chronic obstructive pulmonary disease (COPD). A recent systematic review identified the high prevalence of these disorders in patients with COPD, ranging 6–33% for generalised anxiety, 0–44% for panic disorder, 10–27% for specific phobias, and 5–11% for social phobias [1]. Furthermore, under-recognised or untreated anxiety disorders in COPD patients may reduce the QoL of their caregivers and increase emergency care visits and hospital admissions [1–5]. In 2004, in the European Union, the estimated direct (e.g. hospital admissions and medications) and indirect (e.g. loss of productivity due to absence from work) cost of anxiety disorders exceeded €41 billion per annum [2].

Effectiveness and Efficacy of Therapeutic Interventions Performed by Nurses for Anxiety Disorders: A Systematic Review

“…The results obtained showed that the interventions performed by nurses were effective in the short term and long term in reducing the level of anxiety, and/or remission of symptoms and in clinical improvement of symptoms related to comorbidities. This result corroborates previous studies in which reductions in anxiety levels are commonly evaluated together with the reduction of depressive symptoms in interventions performed by nurses (Berg et al, 2020;Pahlavanzadeh et al, 2017;Yohannes, 2018).…”

“…Richards et al (2003) and Oosterbaan et al (2013) noted in their studies that the CBT can provide cost-related benefits with short-term responses that help reduce public health system expenditures (Izaguirre-Riesgo et al, 2020). In a previous study performed with nurses and chronic respiratory patients, the same economic impact was inferred by reducing emergency visits after individual CBT interventions (Yohannes, 2018).…”

“…This study identified that, through their training, nurses integrated these methods into the clinical practice, impacting on the reduction of anxiety symptoms (Moorey et al, 2009). Other studies also point to the effectiveness of the CBT training for nonspecialized in mental health nurses, leading to effective interventions in reducing anxiety symptoms (Berg et al, 2020; Yohannes, 2018).…”

The role of cognitive behavioural therapy in living well with COPD

“…There is increasing evidence that integrating mental and physical care for people with long-term conditions can improve both physical and mental health and reduce costs [24]. The question of how to incorporate CBT into routine care has been addressed in a real-world study [8]. My colleagues and I have demonstrated that it is feasible to train respiratory nurses to deliver CBT for patients.…”

“…This care model brings significant benefits to patients and cost savings to healthcare services [20]. As Y ohannes [8] has suggested, CBT may be a key step towards improving the care of COPD patients. The challenge facing clinicians, managers and commissioners is to implement this model into routine clinical care and have a clear pathway to refer more complex psychological problems on to mental health teams.…”