Danielle S Jackson1, Samprit Banerjee2, Jo Anne Sirey1, Cristina Pollari1, Nili Solomonov1, Richard Novitch3, Alexandra Chalfin1, Yiyuan Wu4, George S Alexopoulos5. 1. Weill Cornell Institute of Geriatric Psychiatry (DSJ, SB, JAS, CP, NS, AC, GSA), White Plains, NY. 2. Weill Cornell Institute of Geriatric Psychiatry (DSJ, SB, JAS, CP, NS, AC, GSA), White Plains, NY; and the Weill Cornell Department of Healthcare Policy and Research (SB, YW), White Plains, NY. 3. Burke Rehabilitation Hospital (RN), White Plains, NY. 4. and the Weill Cornell Department of Healthcare Policy and Research (SB, YW), White Plains, NY. 5. Weill Cornell Institute of Geriatric Psychiatry (DSJ, SB, JAS, CP, NS, AC, GSA), White Plains, NY. Electronic address: gsalexop@med.cornell.edu.
Abstract
OBJECTIVE: Clinically significant depression occurs in approximately 40% of chronic obstructive pulmonary disease (COPD) patients, and both illnesses severely impair quality of life. This study tests the hypothesis that problem-solving integrated with a treatment adherence intervention, the Problem Solving-Adherence (PSA), is superior to a personalized treatment adherence intervention, the Personalized Intervention for Depressed Patients with COPD (PID-C), alone in improving quality of life in depressed COPD patients. METHODS: After screening 633 admissions for acute rehabilitation, we studied quality of life in 87 participants with major depression (by Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition) and severe COPD randomly assigned to 14 sessions of PID-C or PSA over 26 weeks. Quality of life was assessed using the Word Health Organization Quality of Life-BREF at baseline and weeks 10, 14, and 26. RESULTS: The hypothesis was not supported. Exploratory latent class growth modeling identified two quality of life trajectories. In 80.5% of participants, quality of life remained unchanged and improved in the remaining 19.5% during the first 14 weeks. Patients with a stable quality trajectory had higher qualityof life at baseline and a stronger sense of personal agency. CONCLUSION:Maintaining quality of life is a favorable outcome in depressed patients with COPD whose course is one of deterioration. These findings highlight the usefulness of PID-C, an easy to learn, personalized adherence enhancement intervention that, after further testing, may be integrated into the rehabilitation and care of depressed COPD patients.
RCT Entities:
OBJECTIVE: Clinically significant depression occurs in approximately 40% of chronic obstructive pulmonary disease (COPD) patients, and both illnesses severely impair quality of life. This study tests the hypothesis that problem-solving integrated with a treatment adherence intervention, the Problem Solving-Adherence (PSA), is superior to a personalized treatment adherence intervention, the Personalized Intervention for DepressedPatients with COPD (PID-C), alone in improving quality of life in depressed COPDpatients. METHODS: After screening 633 admissions for acute rehabilitation, we studied quality of life in 87 participants with major depression (by Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition) and severe COPD randomly assigned to 14 sessions of PID-C or PSA over 26 weeks. Quality of life was assessed using the Word Health Organization Quality of Life-BREF at baseline and weeks 10, 14, and 26. RESULTS: The hypothesis was not supported. Exploratory latent class growth modeling identified two quality of life trajectories. In 80.5% of participants, quality of life remained unchanged and improved in the remaining 19.5% during the first 14 weeks. Patients with a stable quality trajectory had higher qualityof life at baseline and a stronger sense of personal agency. CONCLUSION: Maintaining quality of life is a favorable outcome in depressedpatients with COPD whose course is one of deterioration. These findings highlight the usefulness of PID-C, an easy to learn, personalized adherence enhancement intervention that, after further testing, may be integrated into the rehabilitation and care of depressed COPDpatients.
Authors: George S Alexopoulos; Patrick J Raue; Dimitris N Kiosses; R Scott Mackin; Dora Kanellopoulos; Charles McCulloch; Patricia A Areán Journal: Arch Gen Psychiatry Date: 2011-01
Authors: George S Alexopoulos; Jo Anne Sirey; Samprit Banerjee; Danielle S Jackson; Dimitris N Kiosses; Cristina Pollari; Richard S Novitch; Amanda Artis; Patrick J Raue Journal: Am J Geriatr Psychiatry Date: 2017-10-10 Impact factor: 4.105