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Psychological therapies for the treatment of depression in chronic obstructive pulmonary disease.

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SUBMITTER: Pollok J

PROVIDER: S-EPMC6400788 | biostudies-literature | 2019 Mar

REPOSITORIES: biostudies-literature

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Psychological therapies for the treatment of depression in chronic obstructive pulmonary disease.

Pollok Justyna J van Agteren Joep Em JE Esterman Adrian J AJ Carson-Chahhoud Kristin V KV

The Cochrane database of systematic reviews 20190306

<h4>Background</h4>Chronic obstructive pulmonary disease (COPD) has been recognised as a global health concern, and one of the leading causes of morbidity and mortality worldwide. Projections of the World Health Organization (WHO) indicate that prevalence rates of COPD continue to increase, and by 2030, it will become the world's third leading cause of death. Depression is a major comorbidity amongst patients with COPD, with an estimate prevalence of up to 80% in severe stages of COPD. Prevalenc ...[more]

PMID: 30838649

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Project description:BackgroundHospitalization of patients with chronic obstructive pulmonary disease creates a huge healthcare burden. Positive airway pressure therapy is sometimes used in patients with chronic obstructive pulmonary disease, but the possible impact on hospitalization risk remains controversial. We studied the hospitalization risk of patients with chronic obstructive pulmonary disease before and after initiation of various positive airway pressure therapies in a "real-world" bioinformatics study.MethodsWe performed a retrospective analysis of administrative claims data of hospitalizations in patients with chronic obstructive pulmonary disease who received or did not receive positive airway pressure therapy: continuous positive airway pressure, bilevel positive airway pressure, and noninvasive positive pressure ventilation using a home ventilator.ResultsThe majority of 1,881,652 patients with chronic obstructive pulmonary disease (92.5%) were not receiving any form of positive airway pressure therapy. Prescription of bilevel positive airway pressure (1.5%), continuous positive airway pressure (5.6%), and noninvasive positive pressure ventilation (<1%) in patients with chronic obstructive pulmonary disease demonstrated geographic-, sex-, and age-related variability. After adjusting for confounders and propensity score, noninvasive positive pressure ventilation (odds ratio [OR], 0.19; 95% confidence interval [CI], 0.13-0.27), bilevel positive airway pressure (OR, 0.42; 95% CI, 0.39-0.45), and continuous positive airway pressure (OR, 0.70; 95% CI, 0.67-0.72) were individually associated with lower hospitalization risk in the 6 months post-treatment when compared with the 6 months pretreatment but not when compared with the baseline period between 12 and 6 months before treatment initiation. Stratified analysis suggests that comorbid sleep-disordered breathing, chronic respiratory failure, heart failure, and age less than 65 years were associated with greater benefits from positive airway pressure therapy.ConclusionInitiation of positive airway pressure therapy was associated with reduction in hospitalization among patients with chronic obstructive pulmonary disease, but the causality needs to be determined by randomized controlled trials.

Project description:BackgroundThe Global Initiative for Chronic Obstructive Lung Disease (GOLD) 2023 revised the combined chronic obstructive pulmonary disease (COPD) assessment, merging groups C and D into group E, and revised the initial inhalation therapy recommendation. We aimed to evaluate the treatment responses among different inhalation therapies in GOLD group E patients stratified by the COPD assessment test (CAT) scores and forced expiratory volume in one-second percentage of predicted (FEV1%pred).MethodsIn this retrospective cohort study, we included patients with COPD registered in the Real World Research of Diagnosis and Treatment of COPD (RealDTC) study between January 2017 and June 2023. According to the GOLD 2023 report, we enrolled patients assigned to GOLD group E based on exacerbations in the past year (≥2 exacerbations or ≥1 hospitalisation) in this study. We classified them into the FEV1%pred <50% and FEV1%pred ≥50% groups, or CAT<10 and CAT≥10 groups. Subsequently, we divided all groups into four subgroups: long-acting muscarinic antagonist (LAMA), long-acting β2-agonist (LABA) + inhaled corticosteroid (ICS), LABA + LAMA, and LABA + LAMA + ICS. All patients finished one year of follow-up, during which we collected data on exacerbations, frequent exacerbations, hospitalisations, and all-cause mortality. We defined frequent exacerbations as ≥2 exacerbations per year.ResultsWe enrolled a total of 3173 patients in this study. During one year of follow-up, there were no significant differences in exacerbations, frequent exacerbations, hospitalisations, and all-cause mortality among LAMA, LABA + LAMA, LABA + ICS, and LABA + LAMA + ICS in the FEV1%pred ≥50% and CAT<10 groups. However, the patients treated with LABA + LAMA or LABA + LAMA + ICS had a lower incidence of exacerbations and frequent exacerbations compared with the patients treated with LAMA or LABA + ICS in the FEV1%pred <50% and CAT≥10 groups (P < 0.05).ConclusionsPatients with COPD in GOLD group E should be further stratified to determine the appropriate initial inhalation therapy. This approach may provide more precise treatment for GOLD group E patients.

Dataset Information

Psychological therapies for the treatment of depression in chronic obstructive pulmonary disease.

Publications

Psychological therapies for the treatment of depression in chronic obstructive pulmonary disease.

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