Promoting Acceptance and Adherence to Noninvasive Ventilation in Chronic Obstructive Pulmonary Disease: A Randomized Controlled Trial

Abstract

ObjectivePeople with chronic obstructive pulmonary disease (COPD) may suffer from anxiety, depression, low quality of life, and cognitive deficits that could play a role in their clinical conditions. These situations could be worsened during the adaptation process to a new treatment such as noninvasive ventilation (NIV), which is often rejected or inappropriately used. The study aimed to analyze the impact of a brief psychological support intervention on adherence to NIV among patients with COPD.MethodsA two-branch randomized controlled trial was conducted on 90 patients with COPD who had an indication for NIV. The experimental group received cognitive behavioral therapy support, including counseling, relaxation, and mindfulness-based exercises. Controls received standard care and watched educational videos. The course had been structured for four to eight meetings at the hospital, at home, and/or via telemedicine.ResultsThe psychological intervention was related to improvements in both adherence to NIV (F(304) = 19.054, p < .001) and quality of life (F(156) = 10.264, p = .002) after eight meetings from baseline compared with the control group. Results indicated a significant change in the quality of life also over time (F(71.480) = 8.114, p = .006).ConclusionsThe findings suggest that the psychological intervention is an appropriate treatment for acceptance of and adherence to NIV in COPD in clinical practice and highlight the importance of determining the underlying reasons for NIV use.Trial Registration:ClinicalTrials.gov identifier NCT02499653.

Anxiety and Depression in Chronic Obstructive Pulmonary Disease: Perspectives on the Use of Hypnosis

“…For example, when implemented in respiratory medicine, and particularly in COPD, hypnosis has been mostly used as a form of “relaxation therapy” ( Cafarella et al, 2012 ; Tselebis et al, 2016 ). Certainly, hypnotic inductions often include relaxation exercises ( Batty et al, 2006 ), and of course, the implementation of hypnosis and other forms of guided mental imagery as a form of relaxation is beneficial in and of itself ( Hammond, 2010 ; Volpato et al, 2015 , 2022 ). However, as explained above, hypnotic effects depend primarily on the contents of suggestions ( Figure 1 ), which are fundamentally independent from hypnosis’ relaxation component ( Cardeña et al, 2012 ).…”

Leveraging Mobile Health to Manage Mental Health/Behavioral Health Disorders: Systematic Literature Review

“…A total of 11 themes and 2 individual observations were identified by the reviewers for a total of 48 occurrences in the literature, whereas 11 themes and 7 observations were noted for a total of 95 observations. In the 33 studies analyzed, 26 (79%) showed an improvement in symptoms of depression [25,26,[28][29][30][31][32][33][35][36][37][40][41][42][43][44][46][47][48][49][50][51][52][54][55][56], while 19 (58%) showed an improvement in anxiety [26][27][28][29][30][31][32][33]36,[38][39][40][44][45][46][53][54][55][56]. Only 11/33 (33%) reported that at least one symptom was not statistically significant when compared with results from the control group, but the improvement was still noted [25]…”

“…The following observations only occurred once in the literature: decrease in anger [26], decrease in decision conflict [30], decrease in decision regret [30], decreased digestive disturbance [26], decreased pain [26], increased medication adherence [41], and the intervention had no effect on self-efficacy [34]. [25,26,[28][29][30][31][32][33][35][36][37][40][41][42][43][44][46][47][48][49][50][51][52][54][55][56] 19 Reduced anxiety [26][27][28][29][30][31][32][33]36,[38][39][40][44][45][46][53]…”

“…Following the PRISMA checklist [20] and the Kruse protocol [21], we extracted the following data fields: participants, intervention, comparison with the control or other group, medical outcomes, and study design (PICOS; Table 1) as a way to summarize study characteristics, as required by PRISMA. Of the 33 studies analyzed over the 1-year period, 17 were from 2021 [25][26][27][28][29][30][31][32][33][34][35][36][37][38][39][40][41] and 16 were from 2022 [42][43][44][45][46][47][48][49][50][51][52][53][54][55][56][57]. All studies were RCTs involving adults, and 48% (16/33) involved an average age of 50 years or above.…”

“…The only difference was 1 study [34] reported no effect on depression or anxiety. [36,41,44,49,54,56,57] 5 Increased mental well-being/cognitive flexibility [45][46][47]49,57] 4 Decreased distress [30,36,43,53] 4 Increased sleep [26,45,47,50] 4 Increased self-efficacy [41,42,44,57] 2 Decreased fatigue/increased resilience [45,46] 1 Decreased anger [26] 1 Decreased decision conflict [30] 1 Decreased decision regret [30] 1 Decreased digestive disturbance [26] 1 Decreased pain [26] 1 Increased medication adherence [41] 1 None [34]…”