Psychosocial intervention in chronic obstructive pulmonary disease: meta-analysis of randomized controlled trials

Ingeborg Farver-Vestergaard*, Josefine Tingdal Taube Danielsen, Anders Løkke, Robert Zachariae

*Corresponding author for this work

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaperJournal articleResearchpeer-review

Abstract

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.

Original languageEnglish
JournalPsychosomatic Medicine
Volume84
Issue3
Pages (from-to)347-358
Number of pages12
ISSN0033-3174
DOIs
Publication statusPublished - Apr 2022

Keywords

  • ANXIETY
  • Bayes Theorem
  • CLINICAL-TRIALS
  • COGNITIVE-BEHAVIORAL THERAPY
  • COPD
  • COPD PATIENTS
  • DEPRESSION
  • DISORDERS
  • DYSPNEA
  • Humans
  • MANAGEMENT
  • PSYCHOLOGICAL INTERVENTIONS
  • Psychosocial Intervention
  • Pulmonary Disease, Chronic Obstructive/psychology
  • QUALITY-OF-LIFE
  • Quality of Life
  • Randomized Controlled Trials as Topic
  • meta-analysis
  • physical
  • psychological
  • respiratory illness
  • systematic review

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