TY - JOUR
T1 - Psychosocial intervention in chronic obstructive pulmonary disease
T2 - meta-analysis of randomized controlled trials
AU - Farver-Vestergaard, Ingeborg
AU - Danielsen, Josefine Tingdal Taube
AU - Løkke, Anders
AU - Zachariae, Robert
N1 - Copyright © 2022 by American Psychosomatic Society.
PY - 2022/4/1
Y1 - 2022/4/1
N2 - Objective: Many patients with chronic obstructive pulmonary disease (COPD) experience persistent interrelated psychological and physical symptoms despite optimal treatment. Several studies of psychosocial intervention in COPD have been published in recent years. The present study aimed to conduct a quantitative summary of the efficacy of such interventions on psychological and physical outcomes. Methods: Two independent raters screened PubMed, PsycINFO, Embase, Web of Science, Cochrane Library, and CINAHL for eligible studies. In all, 35 independent, randomized controlled trials with a total of 3,120 patients with COPD were included, assessed for their methodological quality, and subjected to meta-analytic evaluation. Results: Meta-analyses revealed small, statistically significant effects of psychosocial intervention on combined psychological (Hedges's g = 0.28; 95%CI: 0.16-0.41) and physical outcomes (g = 0.21; 95%CI: 0.07-0.35) with no indications of publication bias. Supplementary Bayesian meta-analyses provided strong evidence for a non-zero overall effect on psychological outcomes (Bayes factor (BF) = 305) and moderate support for physical outcomes (BF = 6.1). Exploring sources of heterogeneity with meta-regression indicated that older age of patients and longer duration of interventions were associated with smaller effects on psychological outcomes. Conclusions: The results support psychosocial intervention as an additional, useful tool in multidisciplinary respiratory care with the potential to improve both psychological and physical outcomes. Future studies are recommended to monitor adverse effects, apply blinding of active control conditions, and determine sample sizes with a priori power calculations.
AB - Objective: Many patients with chronic obstructive pulmonary disease (COPD) experience persistent interrelated psychological and physical symptoms despite optimal treatment. Several studies of psychosocial intervention in COPD have been published in recent years. The present study aimed to conduct a quantitative summary of the efficacy of such interventions on psychological and physical outcomes. Methods: Two independent raters screened PubMed, PsycINFO, Embase, Web of Science, Cochrane Library, and CINAHL for eligible studies. In all, 35 independent, randomized controlled trials with a total of 3,120 patients with COPD were included, assessed for their methodological quality, and subjected to meta-analytic evaluation. Results: Meta-analyses revealed small, statistically significant effects of psychosocial intervention on combined psychological (Hedges's g = 0.28; 95%CI: 0.16-0.41) and physical outcomes (g = 0.21; 95%CI: 0.07-0.35) with no indications of publication bias. Supplementary Bayesian meta-analyses provided strong evidence for a non-zero overall effect on psychological outcomes (Bayes factor (BF) = 305) and moderate support for physical outcomes (BF = 6.1). Exploring sources of heterogeneity with meta-regression indicated that older age of patients and longer duration of interventions were associated with smaller effects on psychological outcomes. Conclusions: The results support psychosocial intervention as an additional, useful tool in multidisciplinary respiratory care with the potential to improve both psychological and physical outcomes. Future studies are recommended to monitor adverse effects, apply blinding of active control conditions, and determine sample sizes with a priori power calculations.
KW - ANXIETY
KW - Bayes Theorem
KW - CLINICAL-TRIALS
KW - COGNITIVE-BEHAVIORAL THERAPY
KW - COPD
KW - COPD PATIENTS
KW - DEPRESSION
KW - DISORDERS
KW - DYSPNEA
KW - Humans
KW - MANAGEMENT
KW - PSYCHOLOGICAL INTERVENTIONS
KW - Psychosocial Intervention
KW - Pulmonary Disease, Chronic Obstructive/psychology
KW - QUALITY-OF-LIFE
KW - Quality of Life
KW - Randomized Controlled Trials as Topic
KW - meta-analysis
KW - physical
KW - psychological
KW - respiratory illness
KW - systematic review
UR - http://www.scopus.com/inward/record.url?scp=85128161345&partnerID=8YFLogxK
U2 - 10.1097/PSY.0000000000001043
DO - 10.1097/PSY.0000000000001043
M3 - Journal article
C2 - 35067652
SN - 0033-3174
VL - 84
SP - 347
EP - 358
JO - Psychosomatic Medicine
JF - Psychosomatic Medicine
IS - 3
ER -