Improving the wellbeing of caregivers of patients with COPD using a home-based pulmonary rehabilitation programme

Jean-Marie Grosbois, Sarah Gephine, Maeva Kyheng, Olivier Le Rouzic, Cécile Chenivesse, Jean-Marie Grosbois, Sarah Gephine, Maeva Kyheng, Olivier Le Rouzic, Cécile Chenivesse

Abstract

Objectives: The aim of this study was to evaluate the effects of a home-based pulmonary rehabilitation (PR) programme on anxiety and depressive symptoms, general fatigue and burden in informal caregivers of patients with COPD. We also evaluated the baseline characteristics of both patients and caregivers that contributed to the change in caregiver's outcomes after PR.

Methods: In this retrospective study, patients with COPD were referred to an 8-week home-based PR programme consisting of a weekly supervised 90-min session. Informal caregivers were invited to participate in PR according to the patient's preference and its availability. Caregivers received educational support, behavioural therapies and self-management strategies using the same methods as for patients. Burden, anxiety and depressive symptoms, and general fatigue of caregivers were assessed at baseline and at the end of PR.

Results: 241 patients with COPD and 138 (57.3%) caregivers were included. The majority of the caregivers were women (70.5%) and spouses (90.3%) and had at least three comorbidities (57.3%). A large proportion of caregivers showed baseline high burden, anxiety symptoms and abnormal fatigue (40%, 40% and 45%, respectively). Burden, anxiety and depressive symptoms, and general fatigue of informal caregivers were all improved after PR (p<0.05). Long-term oxygen therapy and/or noninvasive ventilation, coronaropathy and/or peripheral arterial disease and a higher baseline modified Medical Research Council Dyspnoea scale score in patients with COPD were associated with a decrease in caregiver's burden after PR.

Conclusion: A large proportion of caregivers of patients with COPD showed anxiety symptoms, fatigue and a high burden. These outcomes were improved by integrating the caregiver into a home-based PR programme.

Conflict of interest statement

Conflict of interest: S. Gephine and M. Kyheng have nothing to disclose. J-M. Grosbois reports personal fees and nonfinancial support unrelated to the submitted work from AstraZeneca, Boehringer Ingelheim, Chiesi, CSL Behring, GlaxoSmithKline and Novartis. C. Chenivesse reports personal fees and nonfinancial support unrelated to the submitted work from ALK-Abello, AstraZeneca, Boehringer Ingelheim, Chiesi, GlaxoSmithKline, MEDA Pharma, Medexact, Novartis, Pierre Fabre, Pfizer, Roche, Sanofi, Santélys and TEVA. O. Le Rouzic reports personal fees and/or nonfinancial support unrelated to the submitted work from AstraZeneca, Boehringer Ingelheim, Chiesi, Lilly, Novartis, GlaxoSmithKline, MundiPharma, Pfizer, Teva, Santelys, Vertex and Vitalaire. Conflict of interest: J-M. Grosbois reports the following relationships outside the submitted work: payment or honoraria for lectures, presentations, speakers’ bureaus, manuscript writing or educational events received from AstraZeneca, Boehringer Ingelheim, Chiesi, CSL Behring, GlaxoSmithKline, Novartis and Roche; and payments to declarant for attending meetings and/or travel received from AstraZeneca, Boehringer Ingelheim, Chiesi, CSL Behring, GlaxoSmithKline, Novartis and Roche. Other financial or nonfinancial interests details available at https://www.transparence.sante.gouv.fr/. Conflict of interest: S. Gephine has nothing to disclose. Conflict of interest: M. Kyheng has nothing to disclose. Conflict of interest: O. Le Rouzic reports the following relationships outside the submitted work: payment or honoraria for lectures, presentations, speakers’ bureaus, manuscript writing or educational events received from AstraZeneca, Boehringer Ingelheim, Chiesi, GlaxoSmithKline and Novartis; support for attending meetings and/or travel received from Boehringer Ingelheim, Chiesi, GlaxoSmithKline and Vitalaire; and participation on a data safety monitoring board or advisory board for JGM Health Conseils, payments to declarant. Other financial or nonfinancial interests details available at https://www.transparence.sante.gouv.fr/. Conflict of interest: C. Chenivesse reports the following relationships outside the submitted work: grants or contracts received from AstraZeneca and Santelys; payment or honoraria for lectures, presentations, speakers’ bureaus, manuscript writing or educational events received from ALK-Abello, AstraZeneca, Boehringer Ingelheim, Chiesi, GlaxoSmithKline, Novartis, Sanofi-Regeneron and TEVA; support for attending meetings and/or travel received from ALK-Abello, AstraZeneca, Boehringer, Ingelheim, GlaxoSmithKline, Novartis, Pierre Fabre, Pfizer, Roche and TEVA.

Copyright ©The authors 2022.

Figures

FIGURE 1
FIGURE 1
Flow chart of patients with COPD and their informal caregivers. PR: pulmonary rehabilitation.

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