Cognitive Behavioral Therapy for COPD (CLIMB)

University of Washington

Status: Completed

Conditions: Depression; COPD

Treatments: Behavioral: CLIMB (COPD Lifestyle, Mood, and Behavior)

Study type: Interventional

Funder types: Other

Identifiers

NCT01694628

43252

Details and patient eligibility

About

The purpose of this study in patients with advanced COPD and depression is twofold:

1. Determine the feasibility and acceptability of a 6-session e-counseling intervention
2. Determine the efficacy of the e-counseling intervention on depressive symptoms

We hypothesize that patients who participate in e-counseling will have improved depressive symptoms compared to patients receiving usual care at 8 weeks.

Full description

Chronic obstructive pulmonary disease (COPD) is the third leading cause of the death in the US. Although COPD is mostly preventable, there is no cure. Thus, care of patients with COPD is primarily focused on symptom palliation with the goal of improving quality of life for both patients and their families. These goals are highly consistent with core principles of palliative care. Dyspnea is the most distressing symptom for patients. Even optimal disease-directed treatment provides only partial relief from dyspnea. Depression is consistently associated with worse dyspnea, but the mechanisms underlying this relationship are poorly understood. Since existing treatment for dyspnea has only limited success and there is evidence that treating depression alleviates pain, we propose that by improving mood, we may be more successful in alleviating dyspnea. Psychosocial-behavioral therapy (PBT) which is focused on increasing pleasant events and improving problem solving skills has been shown to have immediate and sustained effects on depressive symptoms in patients with dementia and post-stroke holds tremendous promise for efficacy in advanced COPD. Testing the use of novel technologies to provide efficacious interventions such as PBT to patients with advanced disease is critical for translational palliative care research

Enrollment: 18 patients

Sex: All

Ages: 40+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• COPD (FEV1/FVC < 70% & FEV1 <80%; current or past smoking >10pack-years)
• Depressed (PHQ-9 >=10)
• Ability to speak, read and write English
• Willingness to use computer or study-issued tablet device

Exclusion criteria

• Current non-nicotine substance abuse or dependence
• Psychotic disorder
• Active suicide ideation with intent and plan
• Alzheimer's/dementia
• Currently receiving any psychotherapy

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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18 participants in 2 patient groups

CLIMB (COPD Lifestyle, Mood, and Behavior)

Experimental group

Description:

Counseling sessions for COPD and depression

Treatment:

Behavioral: CLIMB (COPD Lifestyle, Mood, and Behavior)

Control

No Intervention group

Description:

Usual Care