Cognitive behavioural therapy could treat anxiety in COPD patients

Treating chronic obstructive pulmonary disease (COPD) patients for anxiety using cognitive behavioural therapy (CBT) may reduce hospital visits, finds a study.

The findings have been published in the journal ERJ Open Research.

COPD is a long-term condition that causes inflammation in the lungs, narrowing of the airways and damaged lung tissue, making breathing difficult. Anxiety often occurs alongside COPD and can mean that patients do less physical activity, leading to loss of fitness, isolation, and deteriorating health overall.

The new study found that brief CBT sessions with respiratory nurses reduced feelings of anxiety for patients with COPD and resulted in less frequent use of hospital services.

Dr Karen Heslop-Marshall, lead researcher of the study, explained: "One of the main symptoms of COPD is breathlessness. This is very frightening and often leads to feelings of anxiety. Many healthcare professionals do not currently screen COPD patients for symptoms of anxiety, even though it can have an impact on their overall health."

"Feeling anxious has a negative impact on patients' quality of life and leads to more frequent use of healthcare resources. We wanted to test whether one-to-one CBT sessions delivered by respiratory nurses could reduce symptoms of anxiety and whether this could be a cost-effective intervention."

The researchers found that CBT was more effective in reducing anxiety symptoms in COPD patients compared to leaflets alone.

After checking the hospital attendance records of patients in the study, the researchers found that for each patient who attended CBT, there was an average saving of £1,089 (approx. Rs. 98,000) for hospital admissions and £63 (approx. Rs. 5,000) for emergency room attendances.

The data also showed no link between a patients' lung function, measured by how much air a person can breathe out in one second, and their anxiety score. The researchers say this suggests that even patients with mild COPD can feel extremely anxious, and so would benefit from this intervention.

Dr Heslop-Marshall said: "We found that one-to-one CBT sessions delivered by respiratory nurses could reduce symptoms of anxiety and that this could be a cost-effective intervention. Although the CBT intervention initially resulted in added costs, as respiratory nurses required training in CBT skills, this was balanced by the savings made thanks to less frequent need of hospital."

"Reducing the levels of anxiety patients experience has a significant impact on their quality of life as well as their ability to keep physically active and may improve survival in the long-term. Our research shows that front-line respiratory staff can deliver this intervention efficiently and effectively.