Obstructive Lung Diseases |

The Relationship Between the Adherence to Treatment and the Psychological Profile of Patients With Chronic Obstructive Pulmonary Disease FREE TO VIEW

Epameinondas Kosmas, MD; Athanassios Tselebis, PhD; Dionissios Bratis, PhD; Silvia Dumitru, MD; Elpida Theodorakopoulou, MD; Maria Harikiopoulou, MD; Konstantinos Velentzas, MD; Petros Bakakos, MD; Nachman Alchanatis, MD; Nikolaos Koulouris, MD
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Metropolitan Hospital, Neo Faliro, Greece

Chest. 2014;145(3_MeetingAbstracts):377A. doi:10.1378/chest.1829814
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SESSION TYPE: Poster Presentations

PRESENTED ON: Saturday, March 22, 2014 at 01:15 PM - 02:15 PM

PURPOSE: Adherence to treatment is an important and critical issue in patients with COPD. The purpose of this study is to examine psychological dimensions and to describe the psychological profile of stable COPD patients who comply and of those who do not comply with treatment strategies.

METHODS: In a previous study of 100 stable COPD patients (79 males; age 62±9 years; FEV1 46±11 %pred), we attempted to prognosticate the individual patient's motivation and compliance to our 25-session 3-month pulmonary rehabilitation (PR) program, based on smoking history and addiction to nicotine for every single patient (Kosmas E et al. Am J Respir Crit Care Med 2013; 187: A5131). We found that, among the general group of COPD patients, there are 2 distinct subgroups of patients: 1) Highly motivated patients [HM group; 26 patients, heavy ex-smokers (>40 pack-years) who succeeded to quit smoking despite their severe addiction to nicotine (Fagerstrom scale FS 7-10) and who participated in 23±2 PR sessions], and 2) Less motivated patients [LM group; 29 patients, current smokers despite their non-severe addiction to nicotine (FS 0-6), who participated in only 13±3 PR sessions]. Using as an instrument the Symptom Checklist-90-R (SCL-90-R), a 90-item self-reported psychometric questionnaire, we attempted to desribe possibly different psychological profiles between HM group with high level of adherence and LM group with low level of adherence to PR program.

RESULTS: We found that HM patients had significantly higher scoring, as compared to LM patients, in the following scales of SCL-90-R: somatization (0.92±0.11 vs 0.68±0.13 respectively; p<0.01), obsessive-compulsive (0.88±0.14 vs 0.71±0.12; p<0.01), anxiety (0.73±0.09 vs 0.43±0.10; p<0.001) and phobic anxiety (0.27±0.05 vs 0.20±0.04; p=0.04). On the other hand, the LM patients presented significantly higher scoring in depression (0.99±0.17 vs 0.55±0.11; p<0.001) and hostility (0.53±0.08 vs 0.31±0.07; p<0.001). There was not any difference regarding interpersonal sensitivity, paranoid ideation and psychoticism scale.

CONCLUSIONS: The level of patients' motivation to battle against COPD and to comply or not to difficult therapeutic tasks, such as smoking cessation and pulmonary rehabilitation, is closely related to the psychological profile of patients.

CLINICAL IMPLICATIONS: Psychometry and psychological evaluation of COPD patients is necessary in order to tailor our approach towards every individual patient's needs more effectively.

DISCLOSURE: The following authors have nothing to disclose: Epameinondas Kosmas, Athanassios Tselebis, Dionissios Bratis, Silvia Dumitru, Elpida Theodorakopoulou, Maria Harikiopoulou, Konstantinos Velentzas, Petros Bakakos, Nachman Alchanatis, Nikolaos Koulouris

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