A randomised controlled trial of cognitive behavioural therapy (CBT) delivered by respiratory nurses to reduce anxiety in chronic obstructive pulmonary disease (COPD). (Trial registration-ISCRCTN55206395)

Background- Anxiety and depression are common co-morbidities in COPD but the effectiveness of CBT in treating these in COPD is unknown. We studied the impact of CBT on anxiety, depression and quality of life in anxious COPD patients. Methods- 1518 secondary care patients were screened for symptoms of anxiety. 900 (59%) of patients had symptoms of anxiety with a Hospital Anxiety and Depression Scale (HADS-A) score >8. 279 were recruited. Patients were randomised to 2-6 sessions of CBT with a respiratory nurse plus self-help leaflets or self-help leaflets alone. Data included HADS-A scores at 3, 6 and 12 months. Results- Data was available on 236 patients (115 from CBT group; 121 leaflet group). The groups were well matched at baseline. The CBT group had a significantly greater improvement in HADS-A scores at 3 months with a mean difference of 1.52; CI 0.50-2.55; p=0.004). The reduction in anxiety symptoms was (Figure Presented) Conclusion- Anxiety is a significant problem in COPD. This is the largest study to date of CBT in COPD demonstrating that a brief CBT intervention delivered by respiratory nurses is an effective intervention.