Predictors of response to brief CBT in patients with cardiopulmonary conditions.

Hundt, Natalie E.; Renn, Brenna N.; Sansgiry, Shubhada; Petersen, Nancy J.; Stanley, Melinda A.; Kauth, Michael R.; Naik, Aanand D.; Kunik, Mark E.; Cully, Jeffrey A.

doi:10.1037/hea0000595

Cited by 11 publications

(8 citation statements)

References 41 publications

(47 reference statements)

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“…Which patients are most likely respond to CBT? Patients with cardiopulmonary disease who exhibit greater physical disability and lower self-efficacy (unable to manage their symptoms and maintain functioning) are less likely to respond to anxiety and depressive symptoms after brief CBT [23]. Thus, future studies need to examine the efficacy of booster or maintenance CBT.…”

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confidence: 99%

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

Yohannes

2018

ERJ Open Res

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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].

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confidence: 99%

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

Yohannes

2018

ERJ Open Res

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“…57 Eight studies were not included as they reported the sub-analysis of a parent study. [58][59][60][61][62][63][64][65] The majority of studies exclusively recruited people with COPD (78.7%, n=26). With the exception of Blumenthal et al 48 where 42% of participants had COPD, in the remaining seven studies, at least half the sample analyzed were categorized as COPD (Cully et al (75%), 41 Pumar et al (75%), 38 Cully et al (74%), 52 Cully et al (66%), 56 Jonker et al (51%), 45 Malpass et al (50%) 57 ).…”

Section: Resultsmentioning

confidence: 99%

<p>Cognitive Behavioral Therapy for People with Chronic Obstructive Pulmonary Disease: Rapid Review</p>

Williams¹,

Johnston²,

Paquet³

2020

COPD

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Cognitive behavioral therapy (CBT) is increasingly recommended in the management of people living with chronic obstructive pulmonary disease (COPD). This rapid review presents the evidence base for CBT for people with COPD and describes 1) the nature of CBT interventions and comparators in controlled trials (high or low resource intensity); and 2) factors influencing intervention effects on health outcomes (anxiety, depression, breathlessness, quality of life and exercise capacity). Primary studies reporting CBT interventions in adults with COPD were identified with data extracted by a single reviewer (20% of studies checked for data accuracy). Studies were synthesized descriptively with meta-analyses (random effects models) of controlled trials undertaken to report mean standardized effect sizes (95% CI) for health outcomes. Random effects meta-regression models explored whether CBT target, intervention dosage, intensity, facilitator profession, delivery mode, clinically significant anxiety/depression, trial design/quality and sample size predicted effect size. The search identified 33 primary studies published between 1996 and 2019 (controlled trials n=24, single group cohort n=6, case exemplars n=2, phenomenological n=1). Controlled trials frequently compared high-intensity CBT interventions against enhanced/ usual care (n=12) or high-intensity CBT interventions against high-intensity comparators (n=11). When all controlled studies were included, small, significant improvements favoring CBT were evident across all health outcomes (SMD ranged from −0.27 to 0.35, p<0.05). When intensity dyads were considered, significant improvements were evident only when high-intensity CBT interventions were compared to enhanced usual care/usual care (SMDs ranged from −0.45 to 0.54, p <0.05). No other variable consistently predicted intervention effect sizes across all health outcomes. Overall, the evidence base supports the use of CBT for a range of health outcomes in people with COPD. Consistent benefits were evident when high-resource-intensive CBT interventions were compared to usual care. Low-resourceintensity CBT warrants further investigation in settings where cost of comprehensive care is prohibitive.

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“…Theory of Planned Behavior, Transtheoretical Model), and empirical evidence indeed illustrates that improvements in self-efficacy often precede meaningful changes in health behavior (Ajzen and Madden, 1986; Bandura, 1977; Prochaska and Velicer, 1997; Sheeran et al, 2016). Self-efficacy for managing chronic disease was also recently found to predict improvement in depression following engagement in a brief CBT protocol for those with cardiopulmonary conditions (Hundt et al, 2018). Thus, it is possible that increasing patient confidence may have cascading health effects as patients continue management of this long-term disease.…”

Section: Discussionmentioning

confidence: 99%

“…This measure has been used in other brief interventions for patients with cardiopulmonary conditions (e.g. Hundt et al, 2018).…”

Section: Methodsmentioning

confidence: 99%

A randomized trial of a brief behavioral health lifestyle program for outpatient cardiology clinics

et al. 2020

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Research on lifestyle programs for patients with coronary artery disease (CAD) has largely recruited from hospitals and/or recruited following acute coronary syndrome. By contrast, this study evaluated a 3-session behavioral health program for patients with stable CAD treated in an outpatient cardiology clinic. Thirty-three patients were randomized to the behavioral lifestyle intervention or to Treatment as Usual (TAU). A priori feasibility and acceptability criteria were met, and reliable change analyses revealed that at post-treatment and 30-day follow-up, significantly more intervention participants than TAU participants exhibited increased self-efficacy compared with baseline.

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Predictors of response to brief CBT in patients with cardiopulmonary conditions.

Abstract: Patients with greater physical functioning limitations and lower self-efficacy may experience less change in depression and anxiety during brief CBT. Future research should examine how to boost treatment effectiveness for patients with these characteristics. (PsycINFO Database Record

Cited by 11 publications

References 41 publications

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

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

<p>Cognitive Behavioral Therapy for People with Chronic Obstructive Pulmonary Disease: Rapid Review</p>

A randomized trial of a brief behavioral health lifestyle program for outpatient cardiology clinics

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