PROMOTING ACCEPTANCE AND ADHERENCE TO NON-INVASIVE VENTILATION IN COPD. A RANDOMIZED CONTROLLED TRIAL

Objective: People with Chronic Obstructive Pulmonary Disease (COPD) may suffer from anxiety, depression, low quality of life, and cognitive deficits that could play a role in their clinical conditions. These situations could be worsened during the adaptation process to a new treatment such as non-invasive ventilation (NIV), which is often rejected or inappropriately used. The study aimed to analyse the impact of a brief psychological support intervention on adherence to NIV among patients with COPD. Methods: A two-branch randomized controlled trial was conducted with 90 patients with COPD who had an indication for NIV. The experimental group received cognitive behavioural therapy (CBT) support, including counselling, relaxation and mindfulness-based exercises. Controls received standard care and watched educational videos. The course had been structured over 4 to 8 meetings at the hospital, at home and/or via telemedicine. Results: The psychological intervention was related to improvements in both adherence to NIV (F(304) = 19.054, p < .001) and quality of life (F(156) = 10.264, p = .002) after 8 meetings from baseline compared to the control group. Results indicated a significant change in the quality of life also over time (F(71.480) = 8.114, p = .006). Conclusions: The findings suggest that the psychological intervention is an appropriate treatment for acceptance of and adherence to NIV in COPD in clinical practice and highlight the importance of determining the underlying reasons for NIV use.Trial registration:ClinicalTrials.govidentifier NCT02499653.