The Relationship Between Anxiety, Depression and Treatment Adherence in Chronic Obstructive Pulmonary Disease: A Systematic Review

Figures & data

Figure 1 Flow chart diagram of the identification and selection of studies.

Notes: Adapted from: Moher D, Liberati A, Tetzlaff J, Altman DG, The PRISMA Group. Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA Statement. PLoS Med. 2009;6(7): e1000097. 10.1371/journal.pmed1000097.²⁸ For more information, visit www.prisma-statement.org.

Table 1 Characteristics of the Quantitative Studies Included

References	Country	Kind of Study	Sample Size	Gender/Mean Age	Primary Outcomes	Follow Up	Drop Out	Analysis	Intruments and Measurements
Albrecht et al, 2017^Citation37	USA	Retrospective cohort study	16,075	F = 76.5% Mean Age = 67.6 (±12.8); range from under 65 to over 84	All-cause emergency department (ED) visits and hospitalizations	Minimum 12-month follow-up period	MISSING	Generalized linear models with a binomial distribution and a complementary log-log link	PDC, ICD-9-CM codes 296.2x, 296.3x and 311.xx
Heerema-Poelman et al, 2013^Citation39	The Netherlands	Longitudinal Cohort study	70	M = 45.5% in nonadherent group and 47.3% in adherent group. Mean Age = 62.8(±10,5) in the nonadherent group; 60.4(±10,2) in the adherent group	Adherence to the maintenance exercise program	After 6 and 12 months	10 patients	Logistic regression analysis, Pearson correlations, The Hosmer and Lemeshow Test	ISWT, self-reported questionnaire on adherence, Illness Perception Questionnaire–Revised, St George’s Respiratory Questionnaire, HADS
Zucchelli et al, 2020^Citation40	Italy	Longitudinal cohort study	3177	M = 69.1% F = 30.9% Mean age = MISING; range from 40 to over 80	Adherence to the triple inhaled therapy	1 year from the first day of triple therapy prescription	MISSING	logistic regression model with backward stepwise procedure, sensitivity analysis	PDC, ICD-9-CM
Kokturk et al, 2018^Citation45	UAE	Observationalcross-sectional study	405	M = 81.5% F = 18.5% Mean age = MISSING; range from 40 to over 60	Adherence, disease impact	No	No	Univariate and multivariate analysis, χ2-test, Fisher’s exact test, Kruskal–Wallis test, multiple logistic regression analysis	CAT, MRC dyspnea scale, EQ-5D-3L, HADS, MMAS-8
Gauthier et al, 2018^Citation51	Canada	Retrospective observational study	115	M = 45% F = 55% Mean Age = 74(±9)	Compliance (daily duration of oxygen)	No	No	Fisher exact test, univariate analyses and multivariate logistic regression model	CCI, concentrator
Albrecht et al, 2016^Citation43	USA	Retrospective longitudinal cohort study	31,033	F = 64.8% Mean Age = 68.4(±12.2); range from under 65 to over 84	Adherence to inhaled COPD maintenance medications, depression	24 months	MISSING	chi-squared test, Student t test, generalized estimating equations with a binomial distribution and a logit link, multinomial regression model	PDC, CCW depression algorithm (ICD-9-CM codes)
Qian et al, 2014^Citation52	USA	Retrospective cross-sectional study	74,863	F = 63.2% Mean age = 72.2(±12.0); range from under 65 to 85.	COPD maintenance medications use and adherence	No	No	Univariable and bivariable analyses, Chi-square tests, t-tests, modified Poisson regression, generalized estimating equations (GEE)	CCW depression algorithm (ICD-9-CM codes), PDC
Chen et al, 2017^Citation41	USA	Longitudinal cohort study	282	M = 80% F = 20% Mean age = 67.7±8.6 at baseline, 68.6 ± 8.6 at t1, 69.6 ± 8.6 at t2.	Structural and functional social support, self-care behaviors, adherence to inhaler or nebulizer medications	After 12 and 24 months	77 patients	Mixed-effects longitudinal unadjusted and adjusted models	BODE index, CCI, HADS, MOSSS, SAM, self-report questionnaire
Pierobon et al, 2017^Citation46	Italy	Multicenter observational cross-sectional study	84	M = 63 (75%) F = 21 (25%) Mean age = 70.2±7.0	pharmacological and non pharmacological adherence	No	No	Descriptive analysis, t-test, Mann–Whitney test, chi-square test, Fisher’s exact test, logistic regression model	rehabilitation program with educational sessions, exercise training respiration against resistance, calisthenics, MMSE, HADS, GDS, BDI-II, MMAS, ASiCOLD-R, MoCA
Busch et al, 2014^Citation38	USA	Retrospective cohort study	111	M = 56 (50.4%) F = 55 (49.6%) Mean age = 70(±10) for male completers, 70 (±14) for male non completers, 70 (±9) for female completers, 67 (±13) for female non completers	Predictors of completation of PR program	No	No	Descriptive analysis; chi-square, Fisher’s exact test, one-way analysis of variance, Logistic regression models	CRQ;6MWT; CES-D
Jarab & Mukattash, 2019^Citation47	Jordan	Cross-sectional observational study	133	M = 40.6% F = 59.4% Mean age = 63(±15)	Medication non-adherence	No	No	Stepwise logistic regression analysis	COPD knowledge questionnaire, 4-itemMMAS, SGRQ, HADS
Doyle et al, 2013^Citation53	Australia	Cross-sectional, multicenter study	105	M = 43% F = 57% Mean age = 70.9(±8.3), range from 52 to 90.	Compliance with program	No	No	Descriptive analysis, Pearson correlation	HADS, DSSI
Choi et al, 2014^Citation48	South Corea	Cross-sectional descriptive study	126	M = 116 (92.1%) F = 10 (7.9%) Mean age = 68.65 (± 8.62)	COPD action plan adherence	No	No	One-way analysis of variance, independent t-test, Pearson’s correlation	Short COPD AP developed by Family Physician Airway Group of Canadian Thoracic Society, Renaissance II portable spirometer (MedTek), BCKQ, HADS, SGRQ.
Alexopoulos et al, 2013^Citation32	USA	Clinical Trial	138	MISSING	Remission of depression and dyspnoea-related disability	At 52 weeks	82 patients	Intent-to-treat analyses, Cox’s proportional hazards survival analysis	PFSDQ-Modified, 17-item HRSD
Khdour et al, 2012^Citation25	UK	Cross sectional observational study	173	M = 75 (43.3%) F = 98 (56.7%) Mean age = 66.6(±9.7)	Medication non-adherence	No	No	Chi-squared test or the Fisher exact test, Student’s t-tests, Mann–Whitney U-tests; binary stepwise conditional logistic regression	MMAS, HADS, COPD knowledge questionnaire, HBM questionnaire, CSES
Bosley et al, 1996^Citation42	UK	Longitudinal Cohort study	82	M = 44 (53.7%) F = 38 (46.3%) Mean age = 65, range from 45 to 77.	St George’s respiratory questionnaire (SGRQ) score	After 4 weeks	11 patients	Pearson’s correlation; Chi-squared test and independent t-tests; multiple regression analysis (forward stepwise method)	Number of doses taken/number of doses prescribed x 100, HADS, SGRQ
Dowson et al, 2004^Citation49	New Zealand	Observationalcross-sectional study	39	F = 23 (59%) Mean age = 71.3 (±7.2)	COPD Self-Management Interview (COPD-SMI) scores	No	No	Student’s t-test, Pearson coefficient, Mann–Whitney U and Spearman correlation	COPD-SMI, AIP, DSM-IV
Wei et al, 2018^Citation44	USA	Retrospective longitudinal cohort study	25,458	F = 72.3% Mean age = MISSING; range from under 65 to over 85	COPD maintenance use and adherence	Continuous follow-ups until death or 12/31/2012	MISSING	Marginal structural models (MSMs), multivariate unweighted regression models	PDC, ICD-9-CM, CCI
Turan et al, 2014^Citation50	Turkey	Cross-sectional study	78	M = 53 (85.5%) F = 9 (14.5%) Mean age = 64.9(±9.9) (data avaible at follow-up)	Medication use and adherence	6 months	16 patients	Chi-square test, independent sample t-tests	HADS, ASI, Short- Form 36-Item Questionnaire, National Guide of Turkish Thoracic Society for Asthma
Alexopoulos et al, 2016^Citation34	USA	RCT	101	Female = 43 (68.3%) for the favorable course and 15 (62.5%) for unfavorable course Mean age = 75 for favorable course and 67.5 for unfavorable course	Depressive symptoms, pulmonary funcionalt status, global disability, medical burden, anxiety	10 weeks, 14 weeks, 26 weeks	44 patients	Mixed-effects models, latent class growth modeling (LCGM), Bayesian Information Criterion (BIC)	24-item HAM-D, SCID-R interview, PFSDQ-M, interviewer-administered scale assessing dyspnea during performance of ten activities,12-item WHODAS-II, CCI, 7-item GAD Scale. NEO-PI, Liverpool Self-Efficacy Scale, PID-C and PSAscale
Alexopoulos et al, 2018^Citation35	USA	RCT	101	F = 35 (70%) in the stable trajectory, 22 (68.75%) in the improving trajectory Mean age = 72.06(±9.74) in the stable group, 71.56(±8.39) in the improving group	Dyspnea-related disability, Global disability, Depressive symptoms, medical burden, anxiety, neuroticism, social support and self-efficacy	10 weeks, 14 weeks, 26 weeks	14% of PID-C group and 13.7% of PSA group died. 15.6% with improving trajectory and 12% with stable trajectory died	Mixed-effects models, latent class growth modeling (LCGM)	PFSDQ-M, WHODAS-II-12, HAM-D, CCI, GAD-7, NEO-PI, DSSI, Liverpool Self-Efficacy Scale, PID-C and PSAscale
Jackson et al, 2019^Citation36	USA	RCT	101	F = 11(64.7%) in improving QoL trajectory and 47 (67.1%) in the stable Qol trajectory Mean age = 73.1(±8.7) in improving Qol trajectory and 71.8(±9.4) in the stable QoL trajectory	depressive symptoms, pulmonary funcionalt status, global disability, medical burden, anxiety	10 weeks, 14 weeks, 26 weeks	44 patients	Mixed-effects models, latent class growth modeling (LCGM), Bayesian Information Criterion (BIC)	WHOQOL-BREF, CCI, HAM-D, NEO-PI, PFSDQ-M, WHODAS-II-12, MMSE, Stroop Color and Word Test, Liverpool Self-Efficacy Scale, PID-C and PSAscale
Alexopoulos et al, 2014^Citation33	USA	RCT	138	F = 49 (69.0%) in Usual Care and 42 (62.7%) in Intervention Mean age = 71.0(±7.7) in UC and 70.9(±8.5) in Intervention	Depressive symptoms, dyspnea-related disability	9 sessions over 28 weeks	18% of PID-C partecipants and 17% of UC partecipants died. Other attrition was 25% in PID-C arm and 17% in the UC arm.	Intent-to-treat analyses, Cox’s proportional hazards survival analysis, mixed-effects models, exploratory moderation analysis,	17-item HAM-D, Pulmonary Functional Status and Dyspnea Questionnaire–Modified,CRAFT, CCI, Stroop Color-Word Test, Dementia Rating Scale, NEO-PI, DSSI

Abbreviations: COPD, Chronic Obstructive Pulmonary Disease; PR, Pulmonary Rehabilitation; USA, United States of America; UK, United Kingdom; UAE, United Arab Emirates; RCT, Randomized Control Trial; PDC, Proportion of Days Covered; ICD, International Classification of Diseases; ISWT, Incremental Shuttle Walk Test; HADS, Hospital Anxiety and Depression Scale; CAT, COPD Assessment Test; MCR, Medical Research Council; EQ-5D-3L, EuroQol Five-Dimension questionnaire; MMAS, Morisky Medication Adherence Scale; CCI, Charlson Comorbidity Index; CCW, CMS Chronic Condition Warehouse), BODE, Body-mass index, airflow Obstruction, Dyspnea and Exercise; MOSSS, Medical Outcomes Social Support Scale; SAM, Stepwatch 3 Activity Monitor; GDS, Geriatric Depression Scale; BDI, Beck Depression Inventory; ASiCOLD-R, Adherence Schedule in Chronic Obstructive Lung Disease – Revised; MoCA, Montreal Cognitive Assessment; CRQ, Chronic Respiratory Questionnaire; 6MWT, six-minute walk test; CES-D, Center for Epidemiologic Studies Depression Scale; SGRQ, St George respiratory questionnaire; DSSI, Duke Social Support Index; BCKQ, Bristol COPD Knowledge Questionnaire; PFSDQ, Pulmonary Functional Status and Dyspnea Questionnaire; HRSD, Hamilton Rating Scale for Depression; HBM, Health Belief Model; CSES, COPD Self-Efficacy Scale; COPD-SMI, COPD Self-Management Interview; AIP, Assessment of Illness perception; ASI, Anxiety Sensitivity Index; HAM-D, Hamilton Depression Rating Scale; SCID, Structured Clinical Interview for DSM disorders; WHODAS-II, World Health Organization Disability Assessment Schedule II; GAD, Generalized Anxiety Disorder; NEO-PI, NEO Personality Inventory; PID-C, Personalized Intervention for Depression and COPD; PSA, Problem Solving Adherence; WHOQOL-BREF, World Health Organization Quality Of Life – Abbreviated; CRAFT, COPD Rehabilitation and Activity Follow-up Talley.

Table 2 Characteristics of the Qualitative Studies Included

References	Country	Kind of Study	Sample Size	Gender/Mean Age	Primary Outcomes	Follow Up	Drop Out	Analysis	Intruments and Measurements
Sirey et al, 2007^Citation30	USA	Description of intervention + case example	112	MISSING (Case example is Female and 73)	Barriers to treatment adherence	Up to 6 months	No	Content analysis	Bungay personal communication, Link Stigma Coping Scale.
Torheim & Gjengedal, 2010^Citation31	Norway	Observational study with Phenomenological approach	5 patients (+ 8 nurses)	(patients) M = 2 (40%) F = 3 (60%) Mean Age = MISSING, range from 45 to 78.	How do the patients feel when using the mask, and what do the nurses experience in caring for these patients? What could contribute to making the treatment less traumatic?	No	No	Thematic analysis	Interviews, focus group

Abbreviation: USA, United States of America.

Table 3 Characteristics of the Reviews Included

References	Country	Kind of Review	Time Framework	Database	Search Strategies	Nr. Studies Included	Instruments of Included Studies	Treatments of Included Studies	Study Designs of Included Studies
Yohannes et al, 2018^Citation23	USA	Literature Review	Not specified	Not specified	Not specified	Not specified	AIR Disease scale, CAF, PRIME-MD, PHQ, PHQ-2 and PHQ-9, GAD-7, HADS, GHQ-20, BAI, BDI	CBT, Pulmonary rehabilitation, antidepressant treatment, antipsychotics, stress reduction therapy, self-management techniques	Not specified
Norwood & Balkissoon, 2005^Citation74	USA	Review	Not specified	Not specified	Not specified	6	Not specified	Antidepressant treatment	Not specified
Alexopoulos & Latoussakis, 2004^Citation57	USA	Literature Review	Not specified	Not specified	Not specified	Not specified	CES-D, Zung Depression Scale, HADS, BDI, GDS	Antidepressant treatment, Oxygen, cognitive therapy, aerobic exercise, progressive muscle relaxation, biofeedback, meditation, stress management, psychoeducation	Not specified
Alexopoulos et al, 2008^Citation72	USA	Literature Review	Not specified	Not specified	Not specified	Not specified	Not specified	Cognitive-behavioral therapy, cognitive therapy, behavioral therapy, reminiscence therapy, brief psychodinamic therapy, Problem solving therapy, multi-level intervention to increase treatment adherence, pharmacological treatment	Not specified
Yohannes & Alexopoulos, 2014^Citation18	UK	Review	Not spcified	Not specified	Not specified	10 (only studies on pharmacological treatments are listed)	HRSD, ELDRS, GDS, GMS, MADRS, MRADL, BPQ, Short- Form 36-Item Questionnaire, CRQ, HADS, BDI, SGRQ, 6MWD, ZSDS, 12MWD, SSAI, CGI, PRAS, PFSI, SIP, MACL	SSRIs, TCA, CBT, PID-C	Descriptive study, case report, RCT, Randomized, double-blind, placebo-controlled trial, Single-blind, open study, Randomized, double-blind, crossover trial
Hogea et al, 2020^Citation55	Romania	Literature Review	Not specified	Not specified	Not specified	Not specified	Not specified	LABA treatment, ICS treatment, PPI therapy, inhalers.	Not specified
Ranzini et al, 2020^Citation56	Italy	Short review	Not specified	PubMed, Medline, Scopus, PsycINFO	COPD, Chronic Obstructive Pulmonary Disease, chronic diseases, MCI, Mild Cognitive Impairment, cognitive impairment, dementia, adherence, compliance, self-care, self-management, daily activities, psychological, psychosocial.	9	MMSE, Babcock story recall alternate form, MoCA, SMAS-30, pulmonary function testing, 4-meter gait speed test, PHQ2, CRQ, mMRC dyspnea scale, ADO index, MMAS-4, SGRQ, Behavioral risk factor Surveillance System, HADS-A, BDI-II, ASiCOLD-R, BMI, MARS, validated standardize checklist about inhaler technique, S-TOFHLA	Not specified	longitudinal descriptive study, prospective study, reviews, cross-sectional studies, state-based telephone survey, multicentre observational cross-sectional study, observational cohort study
Zareifopoulos et al, 2019^Citation54	Greece	Narrative reviews	2014–2019	PubMed	the string (COPD OR COPD) AND (Depression OR Major Depressive Disorder OR Dysthymia OR MDD) to identify studies examining the association between COPD and depression. The string (COPD OR COPD) AND (Anxiety OR Generalized Anxiety Disorder OR Generalized Anxiety Disorder OR GAD) to identify studies examining the association between COPD and Anxiety.	16	clinical interview, PSS-14, EQ-5D-3L, HAM-D, STAI, BDI, BAI, DSM-IV criteria, telephone interview, HADS, PHQ	Antidepressant, standard COPD treatment VS active treatment, COPD maintenance treament, Psychological treatments, psychoteraphy, psychiatric treatment	cross-sectional studies, case-control studies, cohort studies
Bhattarai et al, 2020^Citation73	India	Systematic review	2003–2019	MEDLINE, CINAHL, EMBASE	(medicat* OR drug*) N3 (“chronic obstructive pulmonary disease” OR “chronic obstructive airway disease” OR “emphysema” OR “chronic bronchitis” OR “COPD”) AND (adhere* OR compliance OR persist* OR nonadhere* OR noncompli* OR nonpersist* OR nonadhere* OR noncompli* OR nonpersist*)	38	Self report scales (MARS, MMAS-4/MMAS-8, MTA, TAI, Morisky Scale and other non-specified self report instruments)	LABA, LAMA, ICS and combinations	Cross-sectional studies and Cohort studies

Abbreviations: COPD, Chronic Obstructive Pulmonary Disease; MCI, Mild Cognitive Impairment; MDD, Major Depressive Disorder; GAD, Generalized Anxiety Disorder; USA, United States of America; UK, United Kingdom; CBT, Cognitive Behavioral Therapy; RCT, Randomized Control Trial; AIR, Anxiety Inventory for Respiratory … ; PRIME-MD, PRImary Care Evaluation of Mental Disorders; CAF, COPD Anxiety questionnaire; PHQ, Patient Health Questionnaire; GHQ, General Health Questionnaire; HADS, Hospital Anxiety and Depression Scale; BDI, Beck Depression Inventory; BAI, Beck Anxiety Inventory; CES-D, Center for Epidemiologic Studies Depression Scale; GDS, Geriatric Depression Scale; HRSD, Hamilton Rating Scale for Depression; ELDRS, Evans Liverpool Depression Rating Scale; GMS, Geriatric Mental State; MADRS, Montgomery–Åsberg Depression Rating Scale; MRADL Manchester Respiratory Activities of Daily Living Questionnaire; BPQ, Breathing Problems Questionnaire; CRQ Chronic Respiratory Questionnaire; SGRQ, St George respiratory questionnaire; 6MWD, Six-Minute Walking Distance; 12MWD, Twelve-Minute Walking Distance; ZSDS, Zung Self-Rating Depression Scale; SSAI, Spielberger’s State–Trait Anxiety Inventory; CGI, Clinical Global Impression; PRAS, Patient Rated Anxiety Scale; PFSI, Pulmonary Function Status Instrument; SIP, Sickness Impact Profile; MACL, Mood Adjective Checklist; SSRI, Selective Serotonin Reuptake Inhibitor; TCA, Tricyclic Antidepressant; PID-C, Personalized Intervention for Depression and COPD; LABA, Long-acting β adrenoceptor agonists; ICS, Inhaled Corticosteroids; PPI, Proton Pump Inhibitors; MMSE, Mini-Mental State Examination; MoCA, Montreal Cognitive Assessment; SMAS, Self-Management Ability Scale; mMCR, modified Medical Research Council; ADO, Age Dyspnea Obstruction; MMAS, Morisky Medication Adherence Scale; ASiCOLD-R, Adherence Schedule in Chronic Obstructive Lung Disease – Revised; BMI, Body Mass Index; MARS, Medication Adherence Reporting Scale; S-TOHFLA, Short Test of Functional Health Literacy in Adults; PSS, Perceived Stress Scale; EQ-5D-3L, EuroQol Five-Dimension questionnaire; HAM-D, Hamilton Depression Rating Scale; STAI, State-Trait Anxiety Inventory; DSM, Diagnostic and Statistical Manual of Mental Disorder; MTA, Measure of Treatment Adherence; TAI, Test of Adherence to Inhale; LAMA, Long-Acting Muscarinic Antagonist.

Table 4 List of Included Studies That Discussed Different Kinds of Adherence

Article	Adherence to
Albrecht et al, 2017^Citation37	Antidepressants, COPD maintenance medications (corticosteroids, long-acting β-agonists, long-acting anticholinergics), healthcare utilization
Heerema-Poelman et al, 2013^Citation39	Maintenance exercise program after pulmonary rehabilitation
Zucchelli et al, 2020^Citation40	Triple inhaled therapy (with different devices)
Kokturk et al, 2018^Citation45	Oxygen, pharmacological treatment, inhalators
Gauthier et al, 2018^Citation51	LTOT
Albrecht et al, 2016^Citation43	COPD maintenance medication (inhaled corticosteroids, long-acting β-agonists, long-acting anticholinergics)
Sirey et al, 2007^Citation30	Generic psychiatric, medical and rehabilitation recommendations
Qian et al, 2014^Citation52	COPD maintenance medication (inhaled corticosteroids, long-acting β-agonists, ICS/LABA combinations, long-acting anticholinergics, methylxanthines)
Chen et al, 2017^Citation41	“self care behaviour” (pulmonary rehabilitation attendance, medication adherence, smoking cessation)
Pierobon et al, 2017^Citation46	Pharmacological adherence, nonpharmacological prescriptions (eating, smoking, exercise, LTOT)
Jarab & Mukattash, 2019^Citation47	COPD maintenance medication (short-acting β2-agonist, long-acting β-agonists, long-acting anticholinergics, oral steroids, antibiotics)
Torheim & Gjengedal, 2009^Citation31	BPAP mask treatment
Doyle et al, 2013^Citation53	Pulmonary rehabilitation
Choi et al, 2014^Citation48	Generic COPD Action Plan (including usage of meds or oxygen, avoiding triggers, contacting healthcare providers)
Alexopoulos et al, 2013^Citation32	Generic adherence to COPD meds and recommendations (enhanced by the PID-C intervention)
Kdhour et al, 2012^Citation25	Medications
Bosley et al, 1996^Citation42	Domiciliar nebulized therapy
Dowson et al, 2004^Citation49	Generic actions to self-management and maintenance
Wei et al, 2018^Citation44	Maintenance medications (oxygen, rescue/acute meds), antidepressants
Turan et al, 2014^Citation50	Bronchodilator therapy
Alexopoulos et al, 2016^Citation34	Generic adherence to physicians’ recommendations (enhanced by the PID-C and the PSA interventions)
Alexopoulos et al, 2018^Citation35	Generic adherence to physicians’ recommendations (enhanced by the PID-C and the PSA interventions)
Jackson et al, 2019^Citation36	Generic adherence to physicians’ recommendations (enhanced by the PID-C and the PSA interventions)
Alexopoulos et al, 2014^Citation33	Generic adherence to COPD meds and recommendations (enhanced by the PID-C intervention)
Busch et al, 2014^Citation38	Pulmonary Rehabilitation

Abbreviations: COPD, Chronic Obstructive Pulmonary Disease; LTOT, long-Term Oxygen Therapy; ICS, Inhaled corticosteroids; LABA, Long-acting beta-agonists; PID-C, Personalized Intervention for Depression and COPD; PSA, Problem Solving Adherence.

Moher D, Liberati A, Tetzlaff J, Altman DG, PRISMA group. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med. 2009;6(7):e1000097. doi:10.1371/journal.pmed.1000097

 PubMed Web of Science ®Google Scholar

Albrecht JS, Khokhar B, Huang TY, et al. Adherence and healthcare utilization among older adults with COPD and depression. Respir Med. 2017;129:53–58. doi:10.1016/j.rmed.2017.06.002

 PubMed Web of Science ®Google Scholar

Heerema-Poelman A, Stuive I, Wempe JB. Adherence to a maintenance exercise program 1 year after pulmonary rehabilitation: what are the predictors of dropout? J Cardiopulm Rehabil Prev. 2013;33(6):419–426. doi:10.1097/HCR.0b013e3182a5274a

 PubMed Web of Science ®Google Scholar

Zucchelli A, Vetrano DL, Bianchini E, et al. Adherence to COPD free triple inhaled therapy in the real world: a primary care based study. Clin Respir J. 2020;14(8):732–739. doi:10.1111/crj.13190

 PubMed Web of Science ®Google Scholar

Kokturk N, Polatli M, Oguzulgen IK, et al. Adherence to COPD treatment in turkey and Saudi Arabia: results of the ADCARE study. Int J COPD. 2018;13:1377–1388. doi:10.2147/COPD.S150411

 Google Scholar

Gauthier A, Bernard S, Bernard E, Simard S, Maltais F, Lacasse Y. Adherence to long-term oxygen therapy in patients with chronic obstructive pulmonary disease. Chron Respir Dis. 2018;16:1479972318767724. doi:10.1177/1479972318767724

 Web of Science ®Google Scholar

Albrecht JS, Park Y, Hur P, et al. Adherence to maintenance medications among older adults with chronic obstructive pulmonary disease the role of depression. Ann Am Thorac Soc. 2016;13(9):1497–1504. doi:10.1513/AnnalsATS.201602-136OC

 PubMed Web of Science ®Google Scholar

Qian J, Simoni-Wastila L, Rattinger GB, et al. Association between depression and maintenance medication adherence among Medicare beneficiaries with chronic obstructive pulmonary disease. Int J Geriatr Psychiatry. 2014;29(1):49–57. doi:10.1002/gps.3968

 PubMed Web of Science ®Google Scholar

Chen Z, Fan VS, Belza B, Pike K, Nguyen HQ. Association between social support and self-care behaviors in adults with chronic obstructive pulmonary disease. Ann Am Thorac Soc. 2017;14(9):1419–1427. doi:10.1513/AnnalsATS.201701-026OC

 PubMed Web of Science ®Google Scholar

Pierobon A, Bottelli ES, Ranzini L, et al. COPD patients’ self-reported adherence, psychosocial factors and mild cognitive impairment in pulmonary rehabilitation. Int J COPD. 2017;12:2059–2067. doi:10.2147/COPD.S133586

 Google Scholar

Busch AM, Scott-Sheldon LAJ, Pierce J, et al. Depressed mood predicts pulmonary rehabilitation completion among women, but not men. Respir Med. 2014;108(7):1007–1013. doi:10.1016/j.rmed.2014.04.010

 PubMed Web of Science ®Google Scholar

Jarab AS, Mukattash TL. Exploring variables associated with medication non-adherence in patients with COPD. Int J Clin Pharm. 2019;41(5):1202–1209. doi:10.1007/s11096-019-00895-3

 PubMed Web of Science ®Google Scholar

Doyle C, Dunt D, Ames D, Selvarajah S. Managing mood disorders in patients attending pulmonary rehabilitation clinics. Int J COPD. 2013;8:15–20. doi:10.2147/COPD.S36378

 Google Scholar

Choi JY, Chung HIC, Han G. Patient outcomes according to COPD action plan adherence. J Clin Nurs. 2014;23(5–6):883–891. doi:10.1111/jocn.12293

 PubMed Web of Science ®Google Scholar

Alexopoulos GS, Kiosses DN, Sirey JA, et al. Personalised intervention for people with depression and severe COPD. Br J Psychiatry. 2013;202(3):235–236. doi:10.1192/bjp.bp.112.120139

 PubMed Web of Science ®Google Scholar

Khdour MR, Hawwa AF, Kidney JC, Smyth BM, McElnay JC. Potential risk factors for medication non-adherence in patients with chronic obstructive pulmonary disease (COPD). Eur J Clin Pharmacol. 2012;68(10):1365–1373. doi:10.1007/s00228-012-1279-5

 PubMed Web of Science ®Google Scholar

Bosley CM, Corden ZM, Rees PJ, Cochrane GM. Psychological factors associated with use of home nebulized therapy for COPD. Eur Respir J. 1996;9(11):2346–2350. doi:10.1183/09031936.96.09112346

 PubMed Web of Science ®Google Scholar

Dowson CA, Town GI, Frampton C, Mulder RT. Psychopathology and illness beliefs influence COPD self-management. J Psychosom Res. 2004;56(3):333–340. doi:10.1016/S0022-3999(03)00040-0

 PubMed Web of Science ®Google Scholar

Wei YJ, Simoni-Wastila L, Albrecht JS, et al. The association of antidepressant treatment with COPD maintenance medication use and adherence in a comorbid Medicare population: a longitudinal cohort study. Int J Geriatr Psychiatry. 2018;33(2):e212–e220. doi:10.1002/gps.4772

 PubMed Web of Science ®Google Scholar

Turan O, Yemez B, Itil O. The effects of anxiety and depression symptoms on treatment adherence in COPD patients. Prim Health Care Res Dev. 2014;15(3):244–251. doi:10.1017/S1463423613000169

 PubMed Web of Science ®Google Scholar

Alexopoulos GS, Sirey JA, Banerjee S, et al. Two behavioral interventions for patients with major depression and severe COPD. Am J Geriatr Psychiatry. 2016;24(11):964–974. doi:10.1016/j.jagp.2016.07.014

 PubMed Web of Science ®Google Scholar

Alexopoulos GS, Sirey JA, Banerjee S, et al. Two interventions for patients with major depression and severe chronic obstructive pulmonary disease: impact on dyspnea-related disability. Am J Geriatr Psychiatry. 2018;26(2):162–171. doi:10.1016/j.jagp.2017.10.002

 PubMed Web of Science ®Google Scholar

Jackson DS, Banerjee S, Sirey JA, et al. Two interventions for patients with major depression and severe chronic obstructive pulmonary disease: impact on quality of life. Am J Geriatr Psychiatry. 2019;27(5):502–511. doi:10.1016/j.jagp.2018.12.004

 PubMed Web of Science ®Google Scholar

Alexopoulos GS, Kiosses DN, Sirey JA, et al. Untangling therapeutic ingredients of a personalized intervention for patients with depression and severe COPD. Am J Geriatr Psychiatry. 2014;22(11):1316–1324. doi:10.1016/j.jagp.2013.05.006

 PubMed Web of Science ®Google Scholar

Sirey JA, Raue PJ, Alexopoulos GS. An intervention to improve depression care in older adults with COPD. Int J Geriatr Psychiatry. 2007;22(2):154–159. doi:10.1002/gps.1705

 PubMed Web of Science ®Google Scholar

Torheim H, Gjengedal E. How to cope with the mask? Experiences of mask treatment in patients with acute chronic obstructive pulmonary disease-exacerbations. Scand J Caring Sci. 2010;24(3):499–506. doi:10.1111/j.1471-6712.2009.00740.x

 PubMed Web of Science ®Google Scholar

Yohannes AM, Kaplan A, Hanania NA. Anxiety and depression in chronic obstructive pulmonary disease: recognition and management. Cleveland Clin J Med. 2018;85(2 Suppl 1):S11–S18.

 PubMed Web of Science ®Google Scholar

Norwood R, Balkissoon R. Current perspectives on management of co-morbid depression in COPD. COPD J Chronic Obstr Pulm Dis. 2005;2(1):185–193. doi:10.1081/COPD-200050740

 Google Scholar

Alexopoulos GS, Latoussakis V. Depression comorbidity with COPD. Psychiatr Ann. 2004;34(4):289–296. doi:10.3928/0048-5713-20040401-09

 Web of Science ®Google Scholar

Alexopoulos GS, Raue PJ, Sirey JA, Arean PA. Developing an intervention for depressed, chronically medically ill elders: a model from COPD. Int J Geriatr Psychiatry. 2008;23(5):447–453. doi:10.1002/gps.1925

 PubMed Web of Science ®Google Scholar

Yohannes AM, Alexopoulos GS. Depression and anxiety in patients with COPD. Eur Respir Rev. 2014;23(133):345–349. doi:10.1183/09059180.00007813

 PubMedGoogle Scholar

Hogea SP, Tudorache E, Fildan AP, Fira-Mladinescu O, Marc M, Oancea C. Risk factors of chronic obstructive pulmonary disease exacerbations. Clin Respir J. 2020;14(3):183–197. doi:10.1111/crj.13129

 PubMed Web of Science ®Google Scholar

Ranzini L, Schiavi M, Pierobon A, Granata N, Giardini A. From Mild Cognitive Impairment (MCI) to Dementia in Chronic Obstructive Pulmonary Disease. Implications for clinical practice and disease management: a mini-review. Front Psychol. 2020;11(February):1–6. doi:10.3389/fpsyg.2020.00337

 PubMedGoogle Scholar

Zareifopoulos N, Bellou A, Spiropoulou A, Spiropoulos K. Prevalence, contribution to disease burden and management of comorbid depression and anxiety in chronic obstructive pulmonary disease: a narrative review. COPD J Chronic Obstr Pulm Dis. 2019;16(5–6):406–417. doi:10.1080/15412555.2019.1679102

 PubMed Web of Science ®Google Scholar

Bhattarai B, Walpola R, Mey A, Anoopkumar-Dukie S, Khan S. Barriers and strategies for improving medication adherence among people living with COPD: a systematic review. Respir Care. 2020;65(11):1738–1750. doi:10.4187/respcare.07355

 PubMed Web of Science ®Google Scholar