Adjusting to Chronic Conditions Using Education, Support, and Skills
| Status: | Completed |
|---|---|
| Conditions: | Anxiety, Chronic Obstructive Pulmonary Disease, Depression, Cardiology, Pulmonary |
| Therapuetic Areas: | Cardiology / Vascular Diseases, Psychiatry / Psychology, Pulmonary / Respiratory Diseases |
| Healthy: | No |
| Age Range: | 18 - Any |
| Updated: | 4/21/2016 |
| Start Date: | February 2011 |
| End Date: | October 2014 |
Cognitive Behavioral Therapy in Primary Care: Treating the Medically Ill
The current study seeks to test the effectiveness of a talk-therapy intervention designed to
better meet the needs of chronically ill Veterans. This project looks to recruit 450
Veterans with either chronic obstructive pulmonary disease (COPD) or heart failure (HF) who
also have symptoms of worry, stress, anxiety, or sadness. Participants will be randomly put
into either the talk-therapy intervention or enhanced usual care.
The talk therapy intervention will be provided by VA clinicians in the primary care setting
and will consist of 6 core meetings (30-45 minutes in duration) and 2 follow-up telephone
meetings. Enhanced usual care participants will receive feedback regarding the assessment
findings and educational materials on COPD and/or HF, depression and anxiety.
better meet the needs of chronically ill Veterans. This project looks to recruit 450
Veterans with either chronic obstructive pulmonary disease (COPD) or heart failure (HF) who
also have symptoms of worry, stress, anxiety, or sadness. Participants will be randomly put
into either the talk-therapy intervention or enhanced usual care.
The talk therapy intervention will be provided by VA clinicians in the primary care setting
and will consist of 6 core meetings (30-45 minutes in duration) and 2 follow-up telephone
meetings. Enhanced usual care participants will receive feedback regarding the assessment
findings and educational materials on COPD and/or HF, depression and anxiety.
Diseases of the heart and circulatory system, namely, Chronic Obstructive Pulmonary Disease
(COPD) and Heart Failure (HF), are two of the most common and disabling chronic diseases.
Both COPD and HF account for significant disability, mortality, and healthcare costs and are
associated with lower health status and more functional and social limitations than other
chronic illnesses, such as hypertension and diabetes. As our population ages and life span
increases, the numbers of patients with these conditions and the subsequent healthcare costs
will increase dramatically.
The symptoms associated with COPD and HF can significantly affect daily functioning.
Physical symptoms are often linked to increased levels of psychological distress, namely,
anxiety and depression, which significantly affect quality of life and functioning above and
beyond the impact of the medical disease. As depression and anxiety are modifiable clinical
factors, there is a potential to significantly alter patient outcomes, as well as use of
healthcare services. However, focused interventions are needed, given the high risk for poor
mental health treatment and underuse of mental health services in persons with COPD and HF.
Unfortunately, few intervention studies have been conducted in medically ill patients with
these conditions. The current project will examine whether existing VA clinicians in the
primary care setting, with training and support, can effectively administer a structured
Cognitive Behavioral Therapy (CBT) intervention for depressed and anxious Veterans with COPD
and HF.
(COPD) and Heart Failure (HF), are two of the most common and disabling chronic diseases.
Both COPD and HF account for significant disability, mortality, and healthcare costs and are
associated with lower health status and more functional and social limitations than other
chronic illnesses, such as hypertension and diabetes. As our population ages and life span
increases, the numbers of patients with these conditions and the subsequent healthcare costs
will increase dramatically.
The symptoms associated with COPD and HF can significantly affect daily functioning.
Physical symptoms are often linked to increased levels of psychological distress, namely,
anxiety and depression, which significantly affect quality of life and functioning above and
beyond the impact of the medical disease. As depression and anxiety are modifiable clinical
factors, there is a potential to significantly alter patient outcomes, as well as use of
healthcare services. However, focused interventions are needed, given the high risk for poor
mental health treatment and underuse of mental health services in persons with COPD and HF.
Unfortunately, few intervention studies have been conducted in medically ill patients with
these conditions. The current project will examine whether existing VA clinicians in the
primary care setting, with training and support, can effectively administer a structured
Cognitive Behavioral Therapy (CBT) intervention for depressed and anxious Veterans with COPD
and HF.
Inclusion Criteria:
- COPD and/or HF diagnosis; confirmation based upon medical chart review.
- clinically significant symptoms for anxiety and/or depression.
Exclusion Criteria:
- cognitive impairment
- presence of bipolar, psychotic or substance abuse disorder.
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