The implementation of a psychological support during the adaptation to Non Invasive Ventilation (NIV) in Chronic Obstructive Pulmonary Disease (COPD): a Randomized Controlled Trial

Background: People with 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’s process to a new treatment such as NIV, which is often rejected or inappropriately used. Aims and objectives: This study aims to investigate the impact of a brief psychological support on acceptance and adherence to NIV in COPD patients. Methods: Eighty-four COPD patients with an indication for NIV were recruited and involved in a two-branch randomised controlled trial, single-blind. The experimental group underwent a psychological support including counselling, relaxation and mindfulness-based exercises and neuropsychological rehabilitation exercises. Controls received standard care and watched educational videos related to the disease’s management. The interventions were delivered at the HD Respiratory Rehabilitation Unit of Fondazione Don Carlo Gnocchi in Milan (Italy), at home or via telemedicine. Results: The psychological intervention had an impact on the objected utility and quality of life rather than the subjective one as assessed by the EuroQoL-5D and contributed to improve the weekly NIV hours practiced (F(65.42)=14.63, p=.000). Moreover, illness perception as assessed with the Brief Illness Perception Questionnaire predicted changes in respiratory function (FEV1%; F(48, 18)=3.047, p<.05). Conclusions: These findings suggested that a brief psychological intervention is appropriate in order to promote acceptance and adherence to NIV in COPD in clinical practice.