3 ways to help residents with COPD

Coaching residents who have chronic obstructive pulmonary disease (COPD) on three coping techniques—managing stress, practicing relaxation and participating in light exercise—can boost their quality of life and can even improve physical symptoms, new research has found. And technology can make the approach relatively low-cost.

In a study published online today in the journal Psychosomatic Medicine, researchers from Duke University, Ohio State University and University of North Carolina–Chapel Hill examined how telephone-based coaching could help those with the progressive disease, which the Centers for Disease Control and Prevention says is the third leading cause of death in the United States.

"COPD is an increasingly important public health problem. It's a debilitating and distressing illness," says author Scott Palmer, MD, MHS, an associate professor of pulmonary medicine at Duke and medical director of the project. "Our work has established an innovative and important intervention that could improve…quality of life. Although it has not translated into improved survival rates, this approach is worthy of further investigation."

During the five-year study, 147 people with COPD participated in coping skills training. Psychologists provided regularly scheduled phone sessions, offering the individuals and their caregivers general information about COPD, step-by-step instruction in relaxation techniques such as deep breathing and tensing and releasing muscles, and ways to manage their reactions to stressful events. For comparison, psychologists provided a separate group of 151 people phone consultations on topics including medication and nutrition. They did not teach specific coping techniques.

Participants who received coping skills training reported improvements in their overall mental health and lessened depression, anxiety, fatigue and shortness of breath when compared with members of the control group. Although no improvements in COPD-related hospitalizations or deaths were observed, the study suggests that the low-cost approach could enhance quality of life, reduce distress and somatic symptoms and improve physical functioning for those with COPD.

The approach also could be helpful to those with COPD who also could benefit from mental health services but prioritize the COPD, says James Blumenthal, PhD, the J.P. Gibbons Professor of Behavioral Medicine in the Department of Psychiatry and Behavioral Sciences at Duke, noting that the model is private and accessible.